Burnout is the enemy of the Triple Aim. Some deny that it exists. Most press on with their work ignoring its symptoms in themselves and others. At times the impact can be disastrous for individuals and for practices. Burnout in clinicians often has an impact on patients and the care they receive.
Dr. Paul DeChant recently “tweeted”:
@Dr_CommonSense: @HealthcareWen Providers are responsible 4 coming 2 work with a full #compassion fuel tank; Employers responsible 4 ensuring refills at work
I plan to ask Paul for clarification of his message, but I read his “tweet” as an admonition to healthcare leadership to recognize that when physicians and other providers show up to work ready to give their all to patients, their employers (this probably includes administrators, medical leadership, boards, and owners) have a moral responsibility, as well as a practical advisability, to be careful not to waste their efforts and capacity to care by having them work in systems that are inefficient. Empoyers have some responsibility to be sure that the work is meaningful, renewing and professionally satisfying.
A review of online industry newsletters shows that burnout in healthcare is not limited to physicians. Every professional in healthcare seems to be at some level of risk. The synonyms for burnout that you can find in a thesaurus read more like symptoms: exhaustion, stress, tension, weariness, poor health, fatigue and breakdown. Wikipedia’s discussion of burnout has a succinct description that fits the typical workplace in healthcare:
Burnout is becoming a more common result as the modern workplace changes. Being both economically and psychologically exhausting, the increasingly hostile and demanding environments employees work in is being studied as a cause. More frequently are economic values being placed ahead of human values. The phenomenon is more likely when a mismatch is present between the nature of the job and the person doing the job. A common indication of this mismatch is work overload. It involves doing too much with too little resources, going beyond human limits. This may occur in a situation of downsizing, which often does not reduce a company’s mandate, but allocates it to present employees.
As I have thought about Paul’s enthusiasm for returning joy to practice and the issue of burnout, there seems to be a real connection. They are diametrical opposites. Where there is joy, there is unlikely to be burnout. There is likely to be enthusiasm for continuous improvement. Without deriving joy from practice we are sitting ducks for an escalation into full-fledged burnout and for many of us burnout is an initial step in the progression to cynicism and depression. In my next blog post, I will address the role that Lean can play in curbing burnout in healthcare.
