Let's abandon the struggle for physician wellness and just let doctors do what they do best.
In response to the chronic epidemic of physician burnout -- 1 in 3 doctors is suffering from burnout on any given office day -- there is a lot of talk about physician wellness these days. Hospitals and groups are being encouraged to establish a physician wellness committee and do something, anything, for the doctors. These efforts almost always fail because of a blind spot buried in the fabric of our medical education system.In this blog post, let me show you
- Why these committees often sputter and die a quick, silent death
- Why the concept of physician wellness is always such a frustrating struggle
- Where to focus our energy instead to create the most good for the most doctors
Here is a true story of what often happens: A large academic medical center suffered two physician suicides in quick succession. The CEO "volun-told" a member of the medical school faculty to establish a physician wellness committee to address this issue. No funding was provided.
The board managed to scrounge six months of a 0.2 FTE in funds from other departments. All the time and all the money was spent researching what other organizations were doing about physician wellness. The project died researching "best practices" without producing a single visible action or effect.
This was one year ago. Nothing more has been done since. This tragic missed opportunity is just waiting for another suicide to drive people into another six month flurry of activity at some point in the near future.
Even though you can see how futile this effort was and how it was doomed from the start, this token attempt to address physician wellness is more than most health care organizations do for their doctors. In the average organization, the physicians and staff do not appear in the mission statement and there is no attempt to measure or address stress and burnout in the front-line care providers. In this setting, physician burnout remains the elephant in the room that everyone does their best to ignore.
Why is Physician Wellness Such a Frustrating Struggle?
"Wellness" is a totally foreign concept for doctors -- it is a non-starter
Think about it. We don't learn about health and wellness in our training. We never even used the word "wellness" in medical school and residency -- not once. We were too busy learning a physician's basic trade -- diagnosing and treating disease. Our "health care" system is a disease management system. Doctor's bandwidth is occupied 110 percent by rooting out disease and helping our patients prevent and treat it as best we can.
Wellness is a concept that is off the radar for physicians.
If you say "wellness" to a group of doctors, these three things will happen.
1) Confused stares and silence
It often looks like the face a dog makes when it does not know what it is looking at -- the head tilt and furrowed brow of complete confusion.
2) A 45-minute debate about the meaning of the word
- Is wellness more than just the absence of disease?
- Can you have an adequately treated disease and be well?
- If everyone's definition of wellness is different, how can we create physician wellness in a group of 120 doctors?
3) A small number of the old guard muttering "physician wellness... bah... that's just for pansies and women who never learned how to work like we had to when I was a resident" (this is a direct quote, not my words).
If you have ever tried to establish a physician wellness committee, you have seen all three of these reactions -- sometimes simultaneously. Each of them destroy enthusiasm and buy in. Physician wellness is possibly the worst possible term to use for what we are trying to create.
Let's focus our energy here instead. Keep the physicians in the comfort zone of disease paradigm and let them do what they do best -- prevent, diagnose and treat.
- The disease is physician burnout
- The risk factor is physician stress
- The task is to minimize the risk
- And prevent, detect and treat the disease
The Committee Is the "Physician Burnout Prevention Committee"
Immediately you can begin to have a productive conversation and plan your action steps, no matter how many physicians are in the meeting. You don't have to research what other people are doing about an exotic concept like "physician wellness." The research on prevention and treatment of physician burnout is deep and wide -- and remember this important point: Anything you do to prevent or treat physician burnout automatically increases physician wellness/health/happiness/fulfillment/engagement and productivity
So let's stop talking about physician wellness and instead, start our Physician Burnout Prevention Committee. When you frame this avoidable epidemic in this way, you will find at least 117 different ways to get started.
Any reduction in physician burnout will also reduce its pervasive negative effects. Here is what physician burnout is invisibly causing in your organization right now. Let's get started on turning these around.
- Lower patient satisfaction and care quality
- Higher medical error rates and malpractice risk
- Higher levels of physician and staff turnover
- Conflict between administration and physicians and consistent physician resistance to change and innovation
When physicians see your organization surveying them for stress and burnout and actively working to lower their job stress levels, it builds trust and engagement -- where a wellness committee would still be debating the meaning of the term or falling into the trap of researching best practices.
So here is my highest recommendation. Let's stop trying to get a physician wellness committee off the ground and focus on active physician burnout detection, prevention and treatment instead. Let the physicians do what they do best -- and wellness is absolutely not it.
PLEASE LEAVE A COMMENT:
Does your group have a Physician Wellness Committee and how is that going?
Dike Drummond, M.D., is a family physician, executive coach and creator of the Burnout Prevention Matrix report with over 117 ways doctors and healthcare organizations can work together to prevent physician burnout. He provides stress management, burnout prevention and leadership development services to physicians through his website, The Happy MD.
For more by Dike Drummond, M.D., click here.
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