Health care organizations are moving to address clinician burnout with a real sense of urgency. It is now commonly accepted that burnout is widespread among health care professionals and has serious repercussions for patient safety and the quality of care. A report released by several major Massachusetts health care organizations labeled the situation “a public health crisis” and warned about the adverse impact “on the health and well-being of ...

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I love the idea of turning a negative approach to improvement in health care -- looking for problems -- on its head. Appreciative inquiry, a process of focusing on a group’s inherent strengths and fostering positive interactions among group members, is one way of fostering change with a positive approach. Positive deviance (PD) is another. Basically, PD involves identifying what’s working and usual local solutions owned by the people ...

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When I left clinical practice, I thought I was prepared for the change in my identity. Wrong. I was shocked by the degree to which my sense of myself and my value in the world were rocked by leaving the profession. After all, I left practice less than seven years after I could legally write MD after my name. In residency and when practicing (and even to some extent as a medical ...

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In March 2018, The Collaborative for Healing and Renewal in Medicine (CHARM) published an article titled "Charter on Physician Well-being" in JAMA. The piece describes guiding principles and lists recommendations for promoting well-being among physicians. The charter successfully pulls together, in a 2-page document, a comprehensive approach to preventing burnout and fostering well-being among physicians. One recommendation especially caught my attention. “Anticipate and Respond to Inherent Emotional Challenges of ...

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In 2017, the flagship multispecialty practice of Oregon Medical Group, moved into its new digs -- a 46,000 square foot redesigned medical office building. Practice leaders and the 30-odd clinicians in six different specialties were committed to a coordinated patient experience. They wanted to ensure that patients could move smoothly between sequential visits with different care providers -- on the same day. To this end, the group invested in a ...

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I realize today that shame, and the stigma about needing help if you’re a care provider, profoundly affected my career path and even my sense of identity. When I was overwhelmed, exhausted, stressed, and scared, did I reach out for help? No, I kept going until I hit a wall, burned out, and left clinical practice. After leaving, did I talk publicly about the chaotic conditions and broken system that ...

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I am very resistant to burnout solutions that focus solely on the individual, as these seem to imply that the problem originates in the affected person. This approach pokes at a sore spot, because of the years I spent secretly worried that the reason I left practice was personal weakness or inadequacy, something I lacked or failed to do. When in 2013, I ran across the research on burnout, I learned ...

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The prevalence of burnout among physicians is estimated to be more than 50 percent and has grown in recent years. This alarming trend is largely due to changing patient demographics, increasing cost constraints, new federal and state regulations, and other external factors that have reshaped the daily work experience of physicians. Too often today, physicians spend more time on data entry than in direct patient care. Professional burnout, ...

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Recently, I was asked an intriguing question by an interviewer: “If you had a magic wand and could have one wish for improving the well-being of clinicians and addressing burnout, what would it be?” My response? Respect. Respect for the humanity of everyone who touches the health care system -- patients, family members, administrative staff, organizational leaders, clinical staff, clinicians, cleaning staff, parking valets, pharmacists, lab technicians, front desk staff, and ...

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Is the practice of medicine a different experience for male and female physicians? Two recent studies from athenahealth suggest that it is -- in ways that should make us rethink what we value in health care. The first study found that male physicians are more productive than their female counterparts. In an analysis of 47 million visits on the athenahealth network in 2016, male physicians generated 30 to 40 percent more ...

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Recently, I had an opportunity to drop in on two of the foremost researchers in physician burnout, Sara Poplau and Mark Linzer of Hennepin County Medical Center in Minneapolis. We chatted about various aspects of the current burnout crisis and exciting new initiatives on the horizon. Then we spent some time contemplating a frustrating truth: leaders in health care often fail to acknowledge a reality that leaders in other industries ...

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As a physician who left clinical medicine because of burnout and as a writer, I’m drawn to stories of physicians whose professional and personal lives have improved after reasoned interventions. So my ears jumped to attention earlier this month when a colleague at a summit on physician burnout described the positive results his practice had achieved in reducing burnout. Read Pierce, MD, is interim director of the Hospital Medicine Group ...

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A few weeks ago, I had the opportunity to interview a faculty physician at a large academic medical center. We spoke about burnout in students and faculty in general terms. He was aware of the problem yet did not seem affected himself. I asked him how he managed to avoid burnout. He talked about remembering his purpose in entering medicine -- that the profession is a calling, not just the daily ...

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Why would a well-respected, venerable health care organization adopt a soft and squishy approach -- tracking disrespect and other forms of emotional harm -- to monitor its performance? In 2007, Beth Israel Deaconess Medical Center (BIDMC), a 672-bed health system affiliated with Harvard Medical School, adopted the audacious aim of eliminating all preventable harm by January 1, 2012. According to Kenneth Sands, MD, chief quality officer of BIDMC, the organization has ...

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I want to share a cool idea used at Mission Health in North Carolina. I recently interviewed Dr. Ron Paulus, CEO of the health system. Three years ago the organization launched “Immersion Day,” when board members leave their corporate meeting rooms to shadow the doctors and nurses in their hospitals. Journalists and legislators are also invited to join. They don scrubs, go through an orientation, sign privacy forms, and spend 9 ...

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Physicians have long been seen as superhuman -- able to jump the academic hurdles required to gain entrance to medical school, willingly delaying many of the gratifications associated with young adulthood, surviving long hours during training and later when in practice, keeping a cool head amidst crisis. In many ways, we physicians thrive on this image. Personally, I was unaware of how much I enjoyed the mantle of hero until I ...

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During the Q&A period after a presentation I gave recently on understanding and preventing physician burnout, a physician in the audience voiced her vehement objections to the current electronic health record (EHR) with a simple statement: “We need a revolution.” In a few words, she described her frustrations with the EHR. “It is meaningless -- full of fields that we cut and paste from other fields. There are an ever-growing number ...

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When I hung up my white coat for the last time and left the practice of medicine, the term, “physician burnout” was unfamiliar. It wasn’t until I stumbled across research studies many years later, in my work as a freelance writer, that I finally understood the underlying reasons that I needed to walk away. Today, you can’t read about health care without seeing the term. Does the widespread use of ...

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I chose to leave clinical medicine in 1996 after just three years as a general internist. At the time, I was certain that it was the right decision and necessary for my overall health, but could not have articulated all the reasons why I needed to leave. I loved both the intellectual challenge and the art of medicine. I thoroughly enjoyed my connections with patients. I regarded my professional life ...

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When I introduce myself as a physician who left clinical practice, non-physicians ask me why I left. They’re generally intrigued that someone who sacrificed many years and many dollars for medical training would then change her mind. But physicians, almost universally, never ask me why I left. Instead, they ask me how. They call and email me with logistical questions, wanting to learn the secret of how I managed the ...

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