Work Closely With Administration
Employed physicians in large organizations have an additional hurdle—getting the administration to sign off on their proposed changes, which can be particularly challenging if proposed improvements require funding.
"In a large organization, the administration has to be persuaded that these changes will work," Dr Linzer says. This is where data gathered by the mini Z on burnout come in, because they can graphically show the extent of the problem, he says.
"Telling them that a majority of their doctors are burnt out and many of them are getting ready to leave has a powerful impact," he says. You then present your improvement plan as a way to avoid this. "You can explain that just a few small steps need to be taken to improve morale," he says.
You may even be able to convince the administration to take more ambitious steps, such as lowering productivity thresholds so that physicians can better treat their patients. When an organization wants a 15- to 20-minute visit, "it's often not possible to squeeze these patients into that short a time frame," Dr Linzer says.
His own medical center, for example, is undertaking a pilot program introducing longer primary care visits for patients with more complex health issues. The medical center plans to make up the cost of longer appointments by making sure that all of its appointment slots are filled. This involves staff contacting patients before their appointments to make sure they're planning to show up.
As with any new initiative in a large medical group, working with the administration to develop creative re-engineering solutions involves making contacts throughout the organization. Allies in diverse departments will see the problem from a different perspective and provide different suggestions as to how they'd fix it.
"When we provide the administration with the data on burnout, it changes the conversation," Poplau says.
Keep Up the Momentum
In just about any practice, there are opportunities to re-engineer workflow and reduce burnout, Poplau says. Her office contracts to help physicians in other organizations or in independent practices, in addition to working with clinical staff within her own medical center. "We've always had success in reducing burnout," she says.
"Sometimes it takes a while," she concedes, "but as long as we see a decrease year after year, we're satisfied that they're on the right path."
Progress can be delayed due to logistical issues, such as getting permission in large organizations, she says. Even in a small practice, where permission can be easier to get, you have to deal with "small bandwidth"—that is, the person you need to make the change has many other duties and can't get to the work right away, she says.
During these delays, you'll need to boost morale by keeping the momentum of your projects going. This involves celebrating each step of progress toward your goal. "Maybe the first step is just identifying the person who can help you, and then the next step is just meeting with that person," Poplau says.
"Don't get discouraged," she insists. "Learn to celebrate the small successes."
Medscape Business of Medicine © 2016 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Leigh Page. Beating Burnout: How Doctors Can Regain Control - Medscape - Oct 12, 2016.
Comments