Good health care leaders realize that physicians need more than free food and thank yous to thrive. Well-meaning expressions of appreciation that do not address the root cause of burnout or stress cannot alleviate physicians’ stress or stave off burnout the way that truly feeling valued can.
But it takes more than knowledge to change a work environment—it takes concrete action.
“Many leaders know the importance of teamwork and communication,” said Jill Jin, MD, MPH, an internist and senior physician adviser for professional satisfaction and practice sustainability at the AMA. “But where they kind of struggle is, how do you actually support the individual at a level that is meaningful for them?”
Dr. Jin discussed “muffin rage,” a phrase that came about as a result of a 2021 Los Angeles Times op-ed by Jillian Horton, MD, when she—deep in the throes of work-related burnout and distress—happened upon a “resident appreciation” event handing out muffins.
“Muffin rage is what we feel when there is a vast chasm between our actual needs and what another person or an institution thinks we need,” Dr. Horton wrote.
Dr. Jin spoke alongside Jane Fogg, MD, MPH, physician director of organizational transformation for the AMA, in a recent webinar on how health care organizations can make doctors feel valued, which highlighted an AMA STEPS Forward® playbook on the topic.
During the event, Drs. Jin and Fogg touched on some of the ways that health systems, organizations and leaders can take actions that will make physicians feel valued in a way that avoids muffin rage, a crucial effort with implications for physician well-being, burnout and even the quality of patient care.
Understand feeling valued, burnout link
Physician burnout rates have fallen somewhat from their historic highs during the COVID-19 public health emergency, but too many physicians continue to suffer its damaging effects. And when physicians quit or cut back their hours due to overwork and overstress, the impact is felt by patients and colleagues.
In fact, physician turnover can cost organizations anywhere from $500,000 to $1 million or more for every physician who leaves.
“Aside from it being the humane thing to do, there is also a financial benefit—a business case—for investing in your people,” Dr. Jin said.
For those looking to lessen the load on physicians, a key avenue to pursue is helping them understand the crucial role they play in their organization. Dr. Jin pointed out that research shows feeling valued correlates strongly with lower burnout rates, mentioning a 2022 study published in JAMA Health Forum that found physicians who felt valued had a 37% burnout rate, compared with 69% for those who did not.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine™.
Help physicians know their worth
Once the importance of feeling valued as a key mitigator for physician burnout has been understood, Drs. Jin and Fogg said, the next step is determining what, exactly, helps physicians know and understand their worth in an organization.
Instead of superficial gestures like the one described in Dr. Horton’s piece, Dr. Jin said there are ways to effectively communicate gratitude to physicians. Those ways have much more to do with actions than with words.
Some key ways to show doctors they are valued, as described by Drs. Jin and Fogg, were to support:
- Schedule flexibility and autonomy.
- Paid time off (PTO).
- Professional development.
- Individual resilience and self-care.
- Care during and after trauma.
Make work-life balance a priority
Often it can be difficult to justify costly changes aimed at improving physicians’ work conditions, said Dr. Fogg, but overwork and lack of autonomy in matters such as scheduling result in burnout, which is even more expensive.
“Productivity is a pressure that we often feel because of falling revenues across the health care landscape,” she said. “With pressure to fill our schedules, we can lose valuable time for our continuity patients. This tension between being productive and being available to our own patients often lies in how we design and manage our schedules.”
The key, Dr. Fogg said, is giving doctors the ability to “co-design the scheduling processes with their operational team. Make sure you partner with operational leaders to have a physician voice in designing the optimal schedule system for patient access, continuity, and work life balance.”
PTO is another area of concern for organizations looking to create a culture of value, Dr. Jin said.
Health care leaders can be role models in taking time off themselves, and organizations can proactively block off vacations, celebrate time off and resist the impulse to praise working while out of the office. Physicians’ responsibilities should also be fully covered when they’re on vacation, and compensation models and appointment schedules should take PTO into account.
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Support the physician as a person
To show a physician that they are more than just a cog in the machine, their professional development must be supported, recognizing their individual aspirations and passions beyond the clinical practice of medicine.
“Feeling valued means the people around you—your supervisor in particular—know who you are, what excites you and what makes you passionate” outside the confines of the clinic or hospital corridor, Dr. Fogg said. “Asking physicians about their long-term goals and offering opportunities to get involved in a variety of activities outside of clinical practice can create a stronger sense of feeling valued. Some opportunities for growth include teaching, research, process improvement initiatives, leadership, community engagement and more.
And, said Dr. Jin, “self-care” is not a replacement for—and should not be the major focus of—systemic efforts to reduce burnout, organizations can support an individual’s resilience by helping physicians set boundaries, prioritize tasks and limit their distractions. Leadership also should provide resources for and support physicians in self-care, promote collegiality and create spaces for breaks.
Health care organizations should address both individual and collective trauma, Dr. Fogg said, by creating peer-support programs and providing confidential mental health services. They should consider developing develop suicide-prevention plans and response teams in some situations. Additionally, the credentialling process should remove questions about mental health care so they don’t discourage physicians from seeking care if needed.
“Burnout is not a sign of mental illness, but there is a lot of overlap that happens when we are severely distressed by the way in which we're practicing and what we're witnessing in our practices,” she said.
For more information on this and other topics, explore the AMA STEPS Forward open-access toolkits and playbooks, which offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. These resources can help you prevent burnout, create the organizational foundation for joy in medicine and improve practice efficiency.
