Geeta Nayyar, MD, chief medical officer of Tampa, Fla.-based Greenway Health, shared her insights on the key ways health systems and ASCs can reduce physician burnout.
Question: What are some actions health systems and physicians themselves can take to combat burnout?
Dr. Geeta Nayyar: Burnout comes in many forms, and there are several contributing factors — from managing requirements of insurers, regulators and administrators to feeling like physicians have a never-ending amount of work that requires them to be “always on.” Technology plays a major role in this.
For health systems, it’s crucial to ensure that physicians are involved in technology decisions and are properly trained on the technology they are required to use. EHRs can drive significant improvements in patient care, documentation and efficiencies, but they can also add to the burden on physicians and their teams, especially if they are not effectively trained after their initial go-live or during new hire on-boarding. As new processes or technology optimizations are developed, doctors also need to be involved so everyone is on the same page about how the technology should function.
When it comes to steps that physicians can take themselves, everyone is different. However, it’s important to focus on your own well-being. Find something that makes you happy and carve out time for it. It could be listening to music, running, yoga or another hobby. The important thing is that the time you set aside is consistent and focused.
Q: How do you see the burnout issue changing in the next five to 10 years — either improving, getting worse or something else? Why?
GN: Physicians have always been time-strained, which is why we love technology. We love our stethoscopes, heart monitors, MRI machines, etc, so long as these tools work and help us save time while also being more efficient. I truly believe that today’s technology can play an even larger role in combating physician burnout overall. Therefore, I do believe physician burnout will improve within the next five to 10 years.
To experience this, however, we need technology that’s designed to be compatible with the way physicians and their teams work, both now and into the future. I believe the first generation of EHR systems were rushed to achieve market advantage with improvements made over time, but the next generation needs to be focused on getting the technology right. To solve this challenge, the entire industry — technology vendors, government regulators, healthcare leaders, physicians — must come together. We cannot afford to let our doctors suffer any longer.
Q: If an organization doesn't have a lot of resources (like a smaller healthcare facility like an ASC) what can staff do to alleviate burnout?
GN: It’s easy to feel like there’s not enough time in the day to complete all of the work that needs to be done — especially in a smaller healthcare facility with fewer providers. Left unchecked, this pressure can contribute to feelings of burnout with the performance costs attached to it. However, compared to the costs of replacing a physician, organizational improvements that can reduce these stressors are much more effective. A few steps organizations might take include assigning fair productivity goals, optimizing electronic medical records, shifting clerical burdens to non-physician staff members and defining appropriate work schedules/level of connectivity for a true work-life balance.
In addition, in smaller organizations or those with even fewer resources to invest in personnel or technology solutions to support workloads, creating a culture that is supportive of physicians is key. The entire organization needs to recognize the burden on physicians and set up a system where staff can feel like they can disconnect — even if it’s only for a short time. Because when stress seeps into every part of physicians’ days, there’s a culture problem. And once someone is already burned out — or at the verge of quitting — it’s often too late to fix it.
Q: How does the physician shortage affect physician burnout?
GN: I think it’s also important to touch on the current physician shortage we are facing. Research shows that by the time many medical students and residents enter clinical practice full time, they are already burning out in high numbers. It’s a systemic problem, and it’s only going to get worse if we don’t take the time to recognize this. We’re at risk of not just having experienced physicians leave the profession, but also driving away potential doctors who are needed in so many places. With this in mind, medical schools and programs need to put greater emphasis on student wellness. Schools like Vanderbilt, for example, have taken steps to contract burnout by promoting their students’ physical, emotional/spiritual, interpersonal, academic/professional and environmental/community needs. I’d like to see even more universities implement these types of programs in order to help these aspiring individuals better manage the demands of working in healthcare and prevent feelings of burnout from the beginning.
