How the Mayo Clinic is battling physician burnout

Troy Parks
Staff Writer
AMA Wire
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With physician burnout at 54.4 percent nationwide, according to a study on burnout in specialties, the medical world needs solutions now—and the Mayo Clinic is pioneering a model designed to raise camaraderie and increase collaboration to reduce burnout among its physicians. Find out why this health system started treating physicians as architects in practice rather than construction workers.

A physician-led solution

Stephen Swenson, MD, medical director of the Office of Leadership and Organization Development at the Mayo Clinic and professor of radiology at the Mayo Medical School, worked with his colleagues to develop the Listen-Act-Develop model that focuses on physician engagement as a strategy to reduce burnout and involve physicians in the mission of their organization.

“If you have seen the causes of burnout in one unit, you have seen the causes of burnout in one unit,” Dr. Swenson said. “They are unique and variable.”

The first staple of the model is establishing a formal listening forum to hear from physicians. Dr. Swenson’s group made sure physicians were in a psychologically safe setting while they discussed top pain points physicians identified, such as clerical work, process inefficiencies, and ways for clinicians to have some control of their daily and weekly schedules.

What was “important was the simple act of caring and listening and then working together,” Dr. Swenson said. This is what he calls participative management. “Response [from physicians] was positive and hopeful,” he said. “It is critical, once expectations are raised with a survey or focus group, to really and authentically follow through. Otherwise,” he added, “[it] could actually make the situation worse.”

The Listen-Act-Develop model considers three factors that physicians need to flourish:

  • Choice: Physicians want to have some control over their lives. This comes with granting certain levels of flexibility and placing genuine value on physician input in the process. Organizations can increase flexibility and control for physicians by treating them as “architects” in the design of their care delivery model and not “construction workers” who follow someone else’s plans, Dr. Swenson said.
  • Camaraderie or social connectedness: Taking the time to socialize with team members and colleagues can lift spirits and improve collaboration. “We led two randomized controlled studies with docs,” Dr. Swenson said. “Both showed that simply getting together for a meeting or a meal raised camaraderie and lowered markers of burnout.” “The teamwork involved in addressing the local drivers of burnout is also a vehicle for growing camaraderie,” he added.
  • Excellence: Everyone wants to be a part of something meaningful. Organization leaders should establish constructive relationships with physicians and have a “genuine conversation [with physicians] to understand life in their moccasins,” Dr. Swenson said. “And then [create] a partnership to address the opportunities at the frontline and organizational levels.”

“If [physicians] are treated as employees or cost centers, that is how they will behave,” he said. “If they are treated as partners in delivering the needs of patients, [physicians] will ignore their job descriptions and skyrocket discretionary effort.”

More on physician burnout

Also, check out these modules from the AMA’s STEPS Forward™ collection:

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Tragically long over due<br/> Professional Collegiality vs Nonprofessional Mandates makes all the difference in patient management. In addition, as Warren Buffett says Price is what you pay, Value is what you receive.
In my man years of practice burnout occurred only by being overworked...too many cases and too many hours working. We had lots of camaradie and support...weekly luncheons, periodic social affairs, we were our own masters of the practice, we had self-respect. We were Physicians. You are all now Providers and patients are clients and the insurance companies and the government have provided forms you must fill out. How much timem do you spend on paper work and how much time actually with the patient. We don't talk about a young woman who is having a problem with an ovarian cyst. No...she is a case of an ovarian cyst in a young female. No wondeer there are problems. Go back tro the old ways of practice. What you are doing now is ot something new. Wwe did it way before you are doing it now.
Dis-engagement is a symptom of burnout. What this Listen-Act-Develop model does is lower stress and increase the physicians (percieved) ability to influence decision making inside the Mayo bureaucracy. Simple, makes sense and if you don't follow through this will make everything worse. Nothing worse for morale than fielding doctor's cries for help and then doing nothing.<br/> <br/> This is also a difficult model to take system wide since each front line leader would have to be skilled in these conversations and have the free time to meet with all of their direct reports.<br/> <br/> Last it is refreshing to see something other than burnout prevalence studies coming out of Mayo!<br/> <br/> D ike<br/> D ike Drummond MD<br/> <a href="http://www.TheHappyMD" rel='nofollow'>www.TheHappyMD</a> (dot) com
Tragically I think physician burnout is likely going to continue. Us physicians are now expendable. We are expected to perform clinical and administrative tasks perfectly and sadly the health care industry and government mandates are such that we will suffer penalties with respect to pay, reputation and even our own health since it is a societal expectation that we are supposed to "fix" the health of our patients without regards for the complexity of what is the human experience of medicine.
The transition of physician status from "professional" to skilled labor is at the core of this issue and most of the other dysfunctions that afflict healthcare in the USA.<br/> The professional managers that now control the practice of medicine will happily create the "illusion of partnership". After all, isn't that why they have a Human Resources department.? One of the most important organization goals of all "management" is to always and as much as possible separate responsibility from authority. There is near perfect achievement of this goal in US healthcare. The systemic issues that have enabled the current situation are entrenched. Good Luck!
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