Fighting the silent crisis of physician burnout

I’m a physician and the son of a physician. I went into medicine because I wanted to help people get better and stay well. Somehow along the way, I got worse. Five years ago, I hit a wall, and admitted to myself that I was burned out.

My joy of practicing medicine had faded. I was overloaded with countless hospital initiatives and committees. I felt like I was letting down my patients, my colleagues, and my family. My most important relationships and my own sense of health and well-being were eroding. In my mind, I had become a victim of the machine of medicine, putting myself and the people in my personal life at the end of the line.

Despite this, I never entertained the idea of quitting. That is part of the dilemma of physician burnout. By and large, you don’t make it through the gauntlet that is medical training by adopting a mindset of quitting. Unfortunately, many physicians check out without leaving the profession, which jeopardizes quality, safety, and the patient experience.

Determined to remain engaged as a doctor, I began working with an executive coach. This helped me gain more clarity about what was important to me as a physician, as a father, as a friend. It also made me recommit to my life’s work.

I knew I wasn’t alone in feeling burned out. Doctors all over the country are expected to deliver world-class clinical care while trying to keep up with the economic, technological, regulatory, payer, and organizational shifts that make being a doctor harder and harder. The ever-increasing demand for our time and availability, the way we are currently paid, the changing technology, and the advent of patients acting more like true consumers all contribute to this phenomenon. Physician burnout is a silent epidemic that poses serious challenges to patient health and our health care system.

At Novant Health, where I work, it became clear that burnout threatened the organization’s ability to consistently deliver quality care to the patients we serve in North and South Carolina, Virginia, and Georgia. But we didn’t talk about it, especially the physicians. Based on my personal experience and newfound clarity, I suggested to our executive team that we address burnout head-on, with efforts to reverse it and to prevent it.

In partnership with my executive coach, we created a comprehensive program to help other physicians achieve better work-life balance; develop their leadership skills; boost their engagement, resiliency, and wellness; and find more fulfillment in their professional and personal lives.

The Novant Health Leadership Development Program focuses on self-awareness to help doctors better understand their own patterns of thoughts, feelings, and behaviors. It guides them to see more clearly what they value most and reclaim why they initially chose the profession — both of which can help them better cope with the mounting pressures on today’s physicians. The program is completely focused on the individual, not the system.

While the program is voluntary, we encourage our health care providers to take advantage of it and see it as an investment in themselves.

Since we launched the leadership development program in 2013, more than 500 physicians have taken part. It has had more of an impact than any of us thought possible. In a survey of our clinic and acute care physicians last year, those who participated in the program scored 50 percent higher than nonparticipants on measures such as personal fulfillment, alignment with Novant Health’s mission and vision, and engagement and positive attitudes towards the organization.

Just as important, participants — and sometimes their family members — have told us that the program has saved their careers and, in some cases, their marriages. Here is what two of the participants have to say about the program:

“My life changed significantly since participating in the physician wellness program. Like many, I was frustrated and overwhelmed both personally and professionally. By sharing experiences in a nonjudgmental and supportive atmosphere, I was able to gain insight, rejuvenate, and begin to improve my future. Because of this program’s tools and guidance, I have learned how to take control of my happiness and have a much brighter outlook overall.” — Dr. Barbara Meyer

“This program gives physicians a space to let their guard down, look inside themselves, and allow us to realize the importance of personal wellness. As a result, I can say that I am a better physician, friend, father, husband, and son.” — Dr. Ehab Sharawy

The program’s success has prompted us to start earlier. We now match physicians new to Novant Health with an experienced provider to offer connection and support, both personally and professionally. We also incorporate aspects of the program into on-boarding sessions for new clinicians.

Other efforts to improve physician engagement and prevent burnout include investing in the leadership capabilities of physicians in each of our practice sites; providing tools to promote authentic and empathetic communication; and openly discussing the changing roles of nurse practitioners and physician assistants in health care today.

As health care organizations across the country redesign their operations to meet the demands of a new landscape, they should not ignore physician burnout. If burnout is effectively and respectfully addressed, health care organizations can create environments that help physicians and other providers achieve a healthy work-life balance while providing the highest quality care to their patients.

Tom Jenike, MD, is chief human experience officer and senior vice president at Novant Health.