I’m not an organizational leader, a member of the C-suite, a department chair, or a VP of anything. I’m a coach who guides physicians as they try to provide exceptional care and actually have a life. But I know a lot about setting goals, executing on priorities, and inspiring through vision statements.
Here’s the thing. THIS IS NOT a successful long-term strategy:
- Tell exhausted clinicians and staff to “do more with less” after the sacrifices and emotional losses of the past 15+ months
- Make direct patient care time a scarcity (more visits expected per day) when it’s where they find meaning and purpose
- Hold back on investing in the resources that would make a clinician’s job easier (or at least humanly possible)
- Provide inadequate protected time for required charting, committee work, and leadership activities
- Treat them (even if inadvertently) like a replaceable commodity instead of your most valuable resource
Physicians, nurses, advanced practice providers, medical assistants, and other health care workers are a finite resource. They don’t grow on trees. And, though we all seem to deny it, they are human.
The physicians I coach often wonder what they are doing wrong that their lives feel impossible. They are baffled by their inability to finish work on time, get the number of open charts down, clear their in-basket. They worry about the effects on their families and on their health and about whether they will later regret the long hours at work or charting at home when their children are hoping to engage with them. Poor work-life integration, when the needs of work and personal life collide, is a contributor to clinician burnout.1
Take Rachel, a 55-year-old primary care physician who’s adored by her patients yet is leaving at the peak of her career. She’s burned out and done with years of an unacceptable quality of life. Covid was the last straw.
Her choice is not only hard on her, given her love of medicine and her long-term relationships with her patients, it also creates access issues for her patients because there are no available PCPs to step into the gap. And it creates issues for her organization because it clamps down on the stream of revenue she provided from referrals for specialist visits, procedures, and testing—a stream that may well be picked up by another health system.
Rachel is the funnel, and she’s gone. Good luck replacing her quickly or with someone as dedicated and experienced.
From my perspective—watching a seascape of clinicians bobbing and struggling and too often going under—focusing so much on the financials and the short-term ROI isn’t serving patients, clinicians, or your organization’s long-term survival.
This is your wake-up call. A recent study recommended five strategies organizations can take to improve clinician work life integration:2
- Increased control in scheduling, both in the volume of patient care hours and timing
- Improved practice efficiency, such as expanded team-based care
- Addressing gender disparities in compensation, retention, and promotion
- Providing gender-specific mentoring, coaching, and networking opportunities
- Providing access to readily accessible backup childcare
I know that most health care organizations work with narrower profit margins than other industries, but if you want your organization to last and want to leave a positive legacy in your wake, get creative and find other places to squeeze (like delays and waste). The survival of your clinicians—and your organization—is at stake.
1. Shanafelt TD, Noseworthy JH. Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout. Mayo Clin Proc. 2017;92(1):129-146.
2. Tawfik DS, Shanafelt TD, Dyrbye LN, Sinsky CA, West CP, Davis AS, Su F, Adair KC, Trockel MT, Profit J, Sexton JB. Personal and Professional Factors Associated With Work-Life Integration Among US Physicians. JAMA Netw Open. 2021;4(5):e2111575.
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