4 keys to kickstart organizational work to cut physician burnout

Transforming a physician practice or health care organization may sound like a grand goal, but all progress—no matter how significant or minor—begins with action. And with an alarming number of physicians experiencing symptoms of burnout, leaving their jobs or cutting back hours, the rewards of improving well-being are worth the undertaking. 

With that in mind, the AMA offers steps that health care leaders and organizations can take to begin the process of transformation, with extra emphasis placed on how, exactly, those lofty goals may be achieved.

“When leading health care transformation, implementation and sustainment of new systems and workflows is the greatest challenge,” Jane F. Fogg, MD, MPH, physician director of organizational transformation for the AMA, said in an interview. “We have a wealth of great ideas on how we can change the delivery model to support patient outcomes, high quality care, and care team and professional wellness. The hard part is executing.”

With physician burnout a continued epidemic in the U.S., that execution is more important than ever. 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™.

Jane F. Fogg, MD, MPH

Dr. Fogg presented several practice-transformation ideas during a two-day AMA training event to help physicians eliminate unnecessary work and free up more time to focus on what matters most—patient care. 

For additional ideas and tools for practice innovation, check out the AMA’s “Saving Time: Practice Innovation Boot Camp,” March 31–April 1 at the Association’s Chicago headquarters. The conference will cover topics including debunking regulatory myths, de-implementing unnecessary work, implementing practice fundamentals for team care, optimizing the EHR for practice and more. Learn more and register now.

Here are just some of the strategies available for leaders and organizations looking to improve the lives of physicians—benefitting patients, health systems and even the bottom line along the way.

1. Create leaders that foster well-being

   1. Creating a culture that supports physician well-being at work—crucial for any organization that wants to reduce physician burnout, lower costs and improve patient care—starts at the top, with leaders. There are several key behaviors that translate to positive leadership: Good leaders are inclusive, share information, solicit input from those they lead, engage in professional development and authentically express gratitude. 
   2. “It is not just how to you design your governance,” Dr. Fogg said, “it is how leaders perform that has a strong impact on wellness and on successful transformation.”
   3. This “Wellness-Centered Leadership Playbook” offers four strategies that leaders can use to create the kinds of workplaces that benefit physicians, care teams, health systems and patients alike. Leaders need to build trust, give and receive feedback, prioritize well-being and make unit-level changes effectively. The playbook also delves into two special focus areas: crisis care and recovery, and health equity.

2. Take time to listen to physicians

   1. It’s not hard to learn what’s stressing and frustrating physicians about their jobs. All you need to do is ask them. But there are specific ways to go about asking that will lead to more productive conversations, ones that can bolster physician leaders and executives in developing improvements and well-being programs that will address burnout. 
   2. Dr. Fogg recommends undertaking a “listening campaign”—a series of meetings between physician leaders or facilitators and a group of practicing physicians—to see what is working well and what isn’t in their department and what’s negatively impacting their day-to-day experiences at work.
   3. Surveys are helpful, but they don’t provide the kind of personal stories that result in a commitment to real and lasting change. Health care organizations should supplement survey data with listening campaigns, and the AMA STEPS Forward^® toolkit provides seven steps for undertaking one in your health system or practice.
   4. “Engaging physicians in uncovering and addressing sources of burnout is critical to success,” she said. “The ability to positively impact your work environment and the quality of care you deliver is a powerful reward.”

3. Ensure “real PTO” for physicians

   1. Taking three weeks or more of vacation per year and having full EHR inbox coverage is associated with a lower risk of burnout, but most physicians don’t take all (or in some cases, any) of their allowed paid time off (PTO). There are a variety of reasons for the phenomenon—including pressure to generate revenue, a culture of self-sacrifice in the field of medicine and a reluctance to burden fellow physicians with their clinical work while they’re gone.
   2. But there is a lot that leaders and health systems can do to encourage physicians to take time off. They should also ensure the vacation is “real” time off, when responsibilities are removed from their plates and physicians can unplug in a way that is truly restorative. 
   3. There are seven steps to achieving this “real PTO” for physicians in the AMA toolkit, which includes advice on how to create a culture that celebrates time off, how to provide full coverage for physicians on PTO and how to create a productivity expectations that include taking vacation, among other topics. 

4. Show physicians they’re valued

   1. Physicians want to feel they matter at work. But for physicians to believe that they’re valued in a health care organization, they need more than just to be told that. This toolkit lays out five specific strategies for health systems and organizations that want to show physicians the crucial role they play.
   2. Key to physicians’ job satisfaction is giving them some autonomy and control over their work pace and conditions. Schedule and panel size optimization are challenges, but ones that can be met with planning and an awareness of what are reasonable and effective workloads for physicians. Other strategies for helping physicians feel valued include encouraging their professional interests and development, helping them overcome trauma and supporting them in developing resilience and in caring for themselves.

AMA STEPS Forward open-access toolkits and playbooks 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.