Articles of Interest for Healthcare Executives

 

December, 2016

WHAT HEALTHCARE ORGANIZATIONS CAN DO TO HELP REDUCE PHYSICIAN STRESS - Margaret Palmer, Ph.D. President, DocExecutive

No one, within medicine, disagrees that physician stress is presenting itself with increasing frequency and intensity. Greater work dissatisfaction, a gradual degradation of personal and professional relationships, depression, and, most alarmingly, the rapidly escalating incidences of physician suicide are being experienced from the smallest rural healthcare settings to the large, urban, trauma centers. Distressed physicians were the first iteration of those we singled out to receive special help. But, the phenomenon is growing rapidly with the need for more widespread support. Pamela Wible, M.D., reveals, in her shocking but realistic books, the true desperation that is being experienced in silence by those on whom Americans depend for our good health.

So many factors contribute to the rising and serious trend of severe physician stress, many of which are individual and personal and the responsibility of the physician to address. These are the same individuals, however, who we trained to put aside any sense of personal or professional vulnerability, and carry on, no matter what they might be experiencing inside of themselves. To say that physicians are masters of keeping their vulnerabilities secretly tucked away is quite an understatement. Most who do reveal their exhaustion and dissatisfaction with medicine are already in late stage levels of stress.

But, employing organizations can be more alert and ready to adjust some current practices that will produce immediate and long-term sustainable reductions in physician stress. According to a recent study in JAMA, (12/5/16), “Controlled Interventions to Reduce Burnout in Physicians”, organizational interventions can involve simple changes in scheduling and reductions in the intensity of workload, thereby creating institutional support for the fragile mental health of its providers. Additionally, the article points out that attending to improved team work within medical practices, changing the ways in which physicians are evaluated, and enhancing job control can contribute greatly to a sense of balance not currently felt. As physicians are invited into discussions that can alter their stressful work environments, there is a greater feeling of empowerment and control, somethings that physicians have lost, incrementally, since the advent of employment by healthcare organizations.

It is true that healthcare organizations must maintain a healthy enough bottom line to sustain the continued provision of contemporary and advanced healthcare, but acknowledging the increased expectations placed at the feet of the revenue producers is essential to providing support to an ailing population of physicians. Encouraging are the data that point to the efficacy of organizationally based interventions for reducing physician stress, and ultimately, burnout. “Organization-directed interventions were more likely to lead to reductions in burnout. Those that combined several elements such as structural changes, fostering communication between members of the health care team, and cultivating a sense of teamwork and job control tended to be the most effective in reducing burnout.” (Linzer, Grossman, et al., J Get Intern Med. 2015).

Healthy healthcare organizations are built around the longevity and commitment of their physicians to provide the high quality care that attracts patients to them. It makes perfect sense to tune into the simple organizational interventions that cost little to initiate but pay off hugely to all constituents involved in the delivery and receipt of quality medicine.