Physicians in the U.S. already know there’s a burnout crisis. Statistically, they’re even likely to be experiencing some symptoms of it themselves. But how can they make the business case to their health care organizations for meaningful and effective investments to combat the systemic drivers of burnout, translating philosophical agreement into solid financial support?
Burnout “is a huge burden to our national economy and certainly to our health care systems,” Kevin Hopkins, MD, a family doctor and senior physician adviser for practice transformation at the AMA, said during the AMA’s most recent “Saving Time: Practice Innovation Boot Camp.”
It’s estimated that burnout costs the U.S. health care system $4.6 billion a year, largely due to physician turnover and work-hour reductions. For every physician who leaves due to burnout, the related cost to the organization is $500,000 to $1 million or more depending on the specialty.
“It's a large but partially avoidable expense to health care systems,” said Dr. Hopkins. “When you start to put it in the language of health system leaders, it begins to make a lot of sense to invest in well-being.”
While those figures can be persuasive, Dr. Hopkins and Jane F. Fogg, MD, MPH, an internist and senior physician adviser at the AMA, said more can be done to show how burnout affects the bottom line.
Find common language, value system
One key to making the business case for well-being is tailoring your message to the audience, said Dr. Hopkins.
“It's important for us, when we're having these conversations, to speak the language,” Dr. Hopkins said. “If I'm talking to our chief quality and safety officer, I might focus on the increased risk of serious safety events and lower quality outcomes which accompany physician burnout. If I’m talking with our chief financial officer, I’ll pivot to how the investment in relieving system drivers of burnout will improve efficiency, allowing us to see more patients and increase revenue while decreasing costs associated with attrition.”
Dr. Fogg said it’s also helpful to determine your listener’s priorities.
“Most of us tend to focus on the priorities of our department or specialty. We work in complex health care systems and must be aware of the priorities and perspectives of all stakeholders,” she said. “If a department leader appeals to the C-Suite for new resources, and they don’t realize that their leadership just made a difficult decision to reduce expenses, this misalliance can lead to distrust on both sides.”
Having informal discussions in advance of any pitches can help find alignment and increase your chances for success, Dr. Fogg said, noting “you want to figure out how your needs can also support the larger success of the organization.”
“For example, if the organization needs to grow and increase access for patients, what investments will support both patient access and physician well-being?” she said. “Providing scribes, documentation support, in-basket support and enhancing team-based care, all of these investments can give time back to the physician so they can focus on seeing patients, improve access, and have less administrative burden.”
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™.
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Be prepared, not bogged down
Dr. Fogg said it is helpful to come into discussions ready to give a full picture of the issue. For example, AMA STEPS Forward® offers an interactive toolkit on joy in medicine that can help doctors and physician leaders determine how much burnout costs their organization, which can aid in requests for project support or funding.
“Be a comprehensive thinker. ... You have to think of clinical workflows and needs, operational feasibility, quality, safety and financial impact —get all those pieces in your head,” Dr. Fogg said. “Even if you don't know the operational impact of what you're asking for, go ask somebody who does.”
It’s also good to have “validating information other than what we've done ourselves” on how similar changes have produced measurable improvements elsewhere. Presentations should keep in mind the project’s scope and what is out of scope. The project’s impact should be measured, tracked, and results shared, she said.
But Dr. Fogg cautioned that pitches can get overloaded with detail. Using an appendix is a good way to offer additional information without weighing down the presentation. “Be clear about your proposal, what you are trying to solve, current state, resources, metrics, and your project plan.
Making the case for investment in well-being requires preparation, Drs. Fogg and Hopkins said, but boils down to understanding your audience.
“If you get curious about how your audience is making their decisions, and what is most important to them, you'll be more successful when you deliver your pitch,” Dr. Fogg said.
Being prepared also means measuring physician burnout. This can be accomplished through the AMA Organizational Biopsy®, which is an assessment tool and set of services that support health systems in holistically measuring and taking action to improve the health of their organization.
AMA STEPS Forward open-access toolkits 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.
The next “Saving Time” boot camp takes place Sept. 23–24 at the AMA’s Chicago headquarters. Learn more and register now.
