024 - Burnout and Moral Injury: Products of a Business School Mindset

In this encore episode, I’m touching on some of the enormous quantity of research that has been directed at physician burnout. We have clear and convincing descriptions of the causes of physician burnout. What we don’t have, is a lot of action directly tackling those causes.
How is it that healthcare leadership has had a lackluster response to the crumbling careers of those whose credentials are required to open a hospital? Whether it’s the head honchos of healthcare systems, advocacy organizations, or hospitals -- the response to physician disaffection has been anemic. In many cases, disingenuous.


A case in point is captured in this week's encore excerpt. Ten prominent healthcare system CEOs and the CEO of the AMA put their heads together and published Physician Burnout is a Public Health Crisis: a Message to our Fellow Healthcare CEOs. They presented this call to action by saying: “Addressing the issue of burnout is a matter of absolute urgency.”


I walk through their “Call to Action” and raise the question: where’s the action? Where are the decisive moves and hard dollar commitments to knock down barriers and build up solid systems that work? It’s a cringe-worthy list of waffle words like monitoring, tracking, and trying. In this podcast I offer up a few of my own suggestions that are better suited to be on a list regarded as a “matter of absolute urgency.”  
What will it take to get physicians from being commoditized assembly line workers who pose a flight risk—to well-supported professionals with the autonomy required to serve patients (not profits)? 

Here’s what:
--Leadership courage to speak clearly about the issues, ditch the waffle words and B.S. — and to sponsor real bucks for real fixes.
--A professional leadership ideology that recognizes the following as critical foundational leader traits: superb technical expertise, profound respect among peers and staff, and deep tacit knowledge of the profession.
--New leaders — with MDs and DOs behind their names.
Resources:
Ending Physician Burnout Global Summit
Landon BE, Reschovsky J, Blumenthal D. Changes in Career Satisfaction Among Primary Care and Specialist Physicians, 1997-2001. JAMA. 2003;289(4):442–449. doi:10.1001/jama.289.4.442
Friedberg, Mark W., Peggy G. Chen, Kristin R. Van Busum, Frances Aunon, Chau Pham, John P. Caloyeras, Soeren Mattke, Emma Pitchforth, Denise D. Quigley, Robert H. Brook, F. Jay Crosson, and Michael Tutty, Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy. Santa Monica, CA: RAND Corporation, 2013
Dyrbye LN, Shanafelt TD, Gill PR, Satele DV, West CP. Effect of a Professional Coaching Intervention on the Well-being and Distress of Physicians: A Pilot Randomized Clinical Trial. JAMA Intern Med. 2019;179(10):1406–1414. doi:10.1001/jamainternmed.2019.2425
Schrijver, Iris, Brady, Keri J.S., Trockel, Mickey An Exploration of Key Issues and Potential Solutions that Impact Physician Wellbeing and Professional Fulfillment at an Academic Center. PeerJ. 2016; 4: e1783. Published online 2016 Mar 10. doi: 10.7717/peerj.1783
Frederick Herzberg HBR One More Time–How Do You Motivate Employees?
Agarwal SD, Pabo E, Rozenblum R, Sherritt KM. Professional Dissonance and Burnout in Primary Care: A Qualitative Study. JAMA Intern Med. 2020;180(3):395–401. doi:10.1001/jamainternmed.2019.6326
Health Affairs Blog March 2017 Physician Burnout Is A Public Health Crisis: A Message To Our Fellow Health Care CEOs
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