By JOSHUA WASHINGTON
"I was finally able to complete a full run. I haven't been able to do that in quite some time due to the noise (in my mind). Previously I would just stop running, now I can finally finish again."
These were the words from one of my physician clients. As an organizational psychologist my world is communication coaching, however, due to the nature of the beast known as burnout, physician communication coaching sessions easily evolve into a focus on the stress and challenges at the personal and practical level, venturing beyond needs such as assistance with enhancing communication skills. Sessions like these reveal the importance of providing support for caregivers individually with a tailored approach.
A tailored approach to wellness takes into account the mental, systematic, and interpersonal factors of physician wellbeing, rather than just the symptoms. Physicians must be resourced with tools, skills, techniques, and individualized support that helps navigate the challenging factors faced daily, while also helping to lower stress, re-energize their work, and ultimately make the most out of a broken system.
This emphasis is key to overcoming the growing epidemic of burnout among caregivers but should not replace efforts that are already in place.
Nothing beats the local level
Our efforts are most impactful at the individual (local) level with strategic and diligent focus on identifying what wellbeing looks like for each physician. While many physicians may demonstrate the same symptoms, the cause of their challenges often differ. Frequently, I’ve witnessed businesses approach human challenges with a broad-brush strategy. Why would many organizations do this you ask? The answer is that humans are complex, which makes providing care tailored to the individual physician challenging. Consider the topic of communication for instance. I’ve been asked to help doctors enhance their communication in the exam room – a positive request. However, after meeting with the doctor and listening to their personal and practical needs, I quickly realize that while the challenge is indeed communication, for the physician, the communication challenge wasn’t with the patient but rather communicating better with their team. I would have targeted the wrong source. Scenarios such as this present some of the drawbacks by well-intended initiatives meant to help doctors, instead these initiatives cause more frustration or worse, waste of valuable resources. Nothing promotes healing and wellbeing, provides greater clarity, or accelerates performance improvement like connecting with and understanding the needs of the individual.
Focus on physician centered care
Increasing physician wellness requires a physician centered focus. For example, there are usually three important sources of communication that serve as the nucleus for a great work environment. These three areas are skills, systems, and staff. Skills represent the individual ability, systems represent the technical support, process, and operational functions that drive efficiency, and staff represents care team coordination and inter-departmental collaboration. Much of the focus around these three elements though usually concentrate on the patient in healthcare. Do we possess a high level of skilled individuals to care for the patient, are the systems functioning at peak levels creating a seamless experience for the patient, and does our team work well together in coordinating care for the patient? None of these focal points are wrong, however, when it comes to physician wellness, the focus must be on the physician. We must ask questions such as:
- How does the physician’s current skill level promote wellbeing (as a leader, communicator, and competent clinician)?
- How do the systems around the physician promote wellness or lack thereof (scheduling, operational demands, constraints, and responsiveness)?
- Finally, how does the team’s coordination and collaboration promote overall wellness for the physician (think staff training, job competency, team communication, conflict resolution, talent management, etc.)?
We should concentrate our focus on the balance of patient and physician care.
Identify the source, then target the source
Identifying the source allows for a more targeted conversation with the physician and will help uncover leading causes of burnout and poor performance.
The administrator that requested I meet with this physician wasn’t aware that there are seven potential sources of communication that can cause poor performance and/or burnout. See list below for a primer on potential sources.
Administrative <> Physician Communication
Scheduling <> Access communication
Physician <> Clinical Team Communication
Physician <> Manager Communication
Manager <> Team Communication
Team <> Interdepartmental Communication
Team <> Patient Communication
It’s vital that we listen to the physician’s individual pain-points, then act on those points by developing resources and solutions.
Remember, physicians are in the business of relationships
Picture this. You are tasked with floating from one small room to the next every 15 minutes where you are expected to connect with each person at the relational level (personal), while also caring for their medical needs (practical). If that doesn't seem daunting enough, throw in RVU’s that measure how many of these relationships you can manage to serve per day, while Value Based Care judges the quality of each interaction. This is a difficult task for an expert communicator, much less professionals who sparingly trained on highly effective communication techniques. These are the battles many of our doctor’s face daily.
Doctors are not only in the business of medicine, but more importantly, in the business of relationships. A physician's ability to manage relationships has always been an important indicator of success and wellness.
Earlier I mentioned how many organizations struggle to focus on providing care tailored to the personal and practical needs of the physician but when you think about it, that’s exactly what physicians are expected to provide every single day for their patients and team?
For this reason, I believe it is essential that physicians have access to the same individualized care they are expected to provide both personally and practically. We must ensure that doctors are developed and equipped properly by focusing on the needs of each individual physician, providing a tailored approach to wellness.
Joshua Washington is an organizational psychologist and expert communicator who specializes in personalized coaching and training. Physician well-being, communication within healthcare teams, and talent management are a few of his most common focus areas. Joshua’s goal is to help reduce workplace stress and burnout for caregivers and teams by applying scientific principles of human behavior. Visit www.LeeMalveaux.com to learn more, or contact joshua@leemalveaux.com
