Identifying the Root Cause of Physician Burnout and How to Change It

Healthcare and the way physicians and other clinicians work is changing. The pandemic magnified a problem that was already prevalent in medicine: burnout. The healthcare industry — even without the pressure of a pandemic — is inherently susceptible to burning out its clinicians. Becoming a physician isn’t easy; it takes years of study and long hours of work to become proficient in the art of saving and improving quality of life. It often requires working nights, weekends, and holidays, and its entire purpose is to directly help others.

Combine this with individuals who are willing to go through all the training for the privilege of caring for others, and you have people who want to put in the extra effort and hours, because they are directly impacting the lives of others.

However, more and more physicians are coming to realize that it’s possible to offer excellent patient care and still have a life for themselves. A recent survey my company performed found that nearly half of physicians (43%) changed jobs during the first two years of the pandemic, and most indicated it was because they were seeking better work/life balance. This is the same reason thousands of physicians give us when they start working locum tenens as independent contractors rather than pursuing traditional employment.

A better work/life balance is one way to fight burnout, but alone it isn’t enough to address to root cause of the problem. Health systems around the country have been trying different ways to combat burnout for years, but many are unable or unwilling to devote the resources necessary to effect lasting change.

I believe that the best way to solve burnout is by changing the factors that cause it in the first place. And this isn’t unique to physicians. I work in an industry that has traditionally had very high turnover; 20 years ago, we decided that if we really wanted to succeed, we needed to identify and address the reason so many people were leaving. In the subsequent years, we have learned a lot about what people are looking for in their jobs — and all of it is applicable to hospitals and physicians.

Step one: Listen to your people

The first step in addressing burnout and why people leave your organization is to find out what is really going on. I can tell you that your leadership team may think they know the answer, but they don’t. There are certain things you can only find out by asking questions. And it requires a certain degree of trust among your employees. If you don’t have a lot of trust, the best way to start building it is to listen to your employees and make changes based on what they tell you. So how do you do it?

Regular one-on-ones: Meeting regularly one on one with an employee — whether they are a physician or a parking attendant — is crucial to understanding what is going on in their lives. For physicians, this may seem out of reach because you want them treating patients. However, the time they spend with their leader is invaluable to learning what they like and don’t like about their jobs and how you can improve your processes and environment.

Stay interviews: Everyone has heard of exit interviews, and many organizations do them. But by then it’s too late, you’ve already lost the employee. Asking people those exit interview style questions while they are still working gives you a chance to address concerns before they drive people away. For physicians this could be part of a regular review process or even done over time as part of the regular one-on-ones discussed above.

Round table/feedback sessions: Giving opportunities for groups of physicians to come together and share their thoughts can be booth therapeutic and helpful in learning what is happening within your organization and identifying areas for improvement.

Surveys: This is a big one, it’s important to get both personal feedback — like you receive in one-on-ones and feedback sessions — and data. Annual employee surveys are a great way to see themes across your entire organization and allow you to break down issues affecting specific teams. Now, one of the most important things about surveys is this: don’t ask questions you don’t want the answer to. What I mean by this is if you’re not willing to make a change based on what you hear in the survey then don’t ask. For example, if you have no plans to switch to flexible schedules, then don’t ask about them. If you get to a point where they might be possible, then use questions that will help shape your decisions. It is also important to ensure that survey responses are anonymous. Whether you are new to employee surveys or you have been doing them for years, I have another recommendation: after compiling the data, post all of it somewhere your employees can see. I admit this can be tough. Every comment isn’t going to be positive, but if you have the courage to share the data with your people and then act on it, it becomes a great physical example of you taking action to address employee feedback.

Step two: Communicate with them

Nobody likes to be out of the loop. No matter who you are or what group you belong to, you want to know what is going on. This is especially true when it relates to your employment. Not being involved in decisions that impact you is tough, and not even knowing that they are happening is even worse. I’m not suggesting that every employee needs to be involved in every business decision. That’s unrealistic, and organizations hire leaders they trust to make those decisions. If you’ve been listening to your employees, hopefully those decisions will reflect their input. With that said, the other side of listening is communicating. Here are some methods for communicating information to your people.

Emails/newsletters: Email is often the quickest way to share information with a large audience at once, and it is still a good way to disseminate information. However, physicians may not always have easy access or time for email, so it’s important to not rely solely on this method of communication.

Company intranet: An intranet is a great way to share a lot of information. From benefits, to policies and procedures, as well as the latest company information. An intranet is also a great place to give people options for providing feedback. Unlike having to dig through hundreds of emails, a busy physician can go to a good intranet when it is convenient to find the latest news and happenings. The intranet is also where we post the full results of our annual employee surveys.

Video chats: This is something we started doing during the pandemic and found to be a very effective way to communicate business news, benefit improvements, and other timely information. I host a 15- to 30-minute live video once a month with any employees who are able to tune in. The video is then posted on the intranet along with links to resources or data that we discussed. Hospital systems often have many locations and can be spread over multiple states. It’s not realistic to have an in-person meeting with all of your employees but live video allows you communicate directly to a wide audience at the same time.

Leader cascade: Cascading information is a method of passing information that may be more sensitive, requires discussion, or needs to only go to certain groups. Leaders are given the information and tasked with passing it on to their direct reports. It is important to have a formal process for this to ensure that no one is left out and that the information is being shared in the way it was intended.

Step three: Address their concerns

Finally, listening and communicating should lead directly to making changes. This is where I want to bring it back to burnout. There are many causes of physician burnout: working too many hours, seeing too many patients, being frustrated with a manager or colleagues, or a host of other issues. How do you know what is affecting your physicians most? How do you address those concerns? You need to involve yourself in the lives of your physicians, you need to get to know them and what they really deal with. It also calls for empathy and compassion.

In conclusion, stopping physician burnout is not something that will happen overnight, but it is possible. It may be hard at first — and identifying ways to help them have a work/life balance is a good start. However, the best thing you can do to start fighting burnout is to build trust and open communication so you can truly understand the factors that are contributing to it.