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What is a leadership program? Why is leadership training important for physicians? Why are leadership skills important in health care?
Our guest is Nigel Girgrah, MD, PhD, chief wellness officer at Ochsner Health, discusses the critical connection between physician burnout and feeling valued at work, as well as the importance of career development and leadership programs in enhancing job satisfaction for doctors. AMA Chief Experience Officer Todd Unger hosts.
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Speaker
- Nigel Girgrah, MD, PhD, chief wellness officer, Ochsner Health
Transcript
Dr. Girgrah: I think our physicians feel valued because we've really worked hard to create an organization or promote a culture of well-being and support the mental health needs of our physicians.
Unger: Hello and welcome to the AMA Update video and podcast. Today we're talking about how feeling valued can have an impact on physician burnout. Our guest today is Dr. Nigel Girgrah, chief wellness officer at Oschner Health in New Orleans. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Girgrah, it's always a pleasure to have you with us.
Dr. Girgrah: Todd, it's always great to be with you. Yeah, thanks for the opportunity to have a discussion today.
Unger: Well, I'm really interested in finding out more about this topic because we know from AMA research that feeling valued is a strong mitigator of burnout in physicians. And this might seem like a natural connection, but tell us more. Give us some insight as to why it's more important than people might even realize.
Dr. Girgrah: Sure, I'll give you my perspective. It's certainly a key performance indicator we track closely at our organization. You alluded to the natural connection. It certainly seems to pass the sniff test as a key performance indicator. You referenced evidence that's come out of the AMA that feeling valued by the organization is associated with increased job satisfaction, decreased burnout. Certainly, our own internal data suggests that.
And I think it's a key performance indicator that an organization or an office of professional well-being can wrap their arms around in the short to intermediate term. There are many drivers of burnout that seem to be outside the organization's immediate sphere of influence, whether that's the local economy, CMS regulations. But I think this is a KPI that an organization can really commit to and see changes over a reasonably short period of time.
Unger: So I guess one of the key issues or questions is, of course, how do you drive that, that sense of feeling valued. And one of the key ways is by supporting career development. Your leadership program at Oschner is a great example of this. Will you tell us a little bit more about the program and how it works?
Dr. Girgrah: Yeah, I'd be happy to. I'll get to that in one second. But, I mean, as you mentioned, I think professional development, career development drives engagement and well-being, not just in the participants, but also in their direct reports or, if they're in the clinical setting, the clinical teams they lead. And I think whether you're a physician executive, leading physician leaders, or a department chair leading patient-facing physicians or a patient-facing physician leading your care delivery team, every physician is considered a leader. And to that end, we've developed a number of leadership curricula tailored to meet the needs of our advanced physician leaders, our progressing physician leaders, our emerging physician leaders and our patient-facing leaders.
I think the program you're referring to, Todd, is our personal leadership program. This one's a little unique and different. It's different in that our participants are pulled off-site for four days. And really, the idea, the rationale behind it is you can't lead others unless you're managing yourself, whether that's managing yourself with your home team, in your personal lives, or managing yourself at work and managing the different components of your energy tank, whether that's the mental component, the physical component, emotional, spiritual.
And over the course of the four days, the participants really take a deep look at their own life experiences, how that may have shaped the belief system that, in turn, has created biases. Some of these biases are good and have good outcomes for an individual, some maybe not so good. They may have served you well when you were 12 years old, but not anymore. And I think at the end of the retreat, the participants try and commit to creating a plan towards more positive, healthy behaviors in the future.
Unger: It's a really interesting observation that you've you have expounded on there about really working on yourself as that foundation level. And I'm curious for the folks that have gone through this particular program, do they see a reduction in their burnout?
Dr. Girgrah: Well, yeah, I think a couple of things. We've had qualitative feedback, so outstanding testimonials, life-changing. Certainly, emails of gratitude that have gone out to me, our chief physician executive, our CEO—I've even had comments from spouses of physicians about how this has made a meaningful change in their lives. But we also have some qualitative data.
We use the AMA Mini-Z survey to look at a number of key performance indicators. And we're able to look at these key performance indicators in the 250 participants that have gone through the leadership program versus those that haven't. Now, I'll admit that early on there's a bit of a selection bias. But we've been at this for three years and we have more frontline patient-facing physicians that have completed the program. And I'll just read some of these.
So this is leadership participants versus nonparticipants. Job satisfaction, 92% versus 75%. Stress—job stress, 40% versus 44%. Burnout, 26% versus 44%. And yes, feeling valued by the organization, 84% versus 55%.
Unger: Wow
Dr. Girgrah: So, I think this has some legs to it.
Unger: That is really impressive. Those results are pretty incredible. I have two questions for you. Just listening to the details of the program itself, I mean, do people expect this coming from work? I mean, it's digging in.
Dr. Girgrah: It surprises folks when they get the invitation. And I think that's part of the feeling valued by the organization, that the organization is willing to invest in our physicians, pull them out of Louisiana, and over four days—not talk about health care, not talk about Oschner, but really talk about creating more fulfilling personal lives. And I think that really makes an impact with physicians.
The individuals who've completed the program talk about how they're leading more fulfilling lives, not just at work, but more importantly, at home and with their families. And then I think, Todd, there's the social connection part of this. These are sort of cohorts of 20 that go through at a time, but many of the cohorts have stayed connected over three years, get together regularly for dinners. So, there is this kind of this commensality, social connected piece to this, I think.
Unger: So if I hear you right, I think one of the reasons that you're having such a big impact is this is not a surface level program here. This is really getting to the root of a system of things that interact in that physicians' lives that have such an impact on them feeling valued. Is that reasonably accurate?
Dr. Girgrah: So—and certainly that's the feedback that I've received. I've gone through—I went through the program in 2019. And I think certainly the happiest person with the outcome of the program was my wife, Shelly. So, I think this is meaningful.
Unger: That's terrific. Beyond this leadership program, what else is on the in the queue here for helping physicians grow in their careers and getting to that idea of feeling valued?
Dr. Girgrah: Yeah, I mean, professional development or leadership development is just one strategic area of focus in terms of workforce well-being at Oschner. I think our physicians feel valued because we're invested in their ease of practice, are invested in high tech solutions, whether that's ambient listening, AI-assisted message return, low tech solutions that I've talked about before, pharmacy refill clinics, enhancing certain workflows to promote top of license work. And I think our physicians feel valued because we're really—we've really worked hard to create an organization or promote a culture of well-being and support the mental health needs of our physicians. In the past year, Todd, we've removed stigmatizing mental health questions from our credentialing forms and our peer reference forms. We've certainly tried to expand our support services that support mental health outside of traditional EAP program. And I think over the last five years, there's really been much more of a general normalization about the importance of promoting healthy mental health, for sure.
Unger: There just seem to be a lot of proof points here that Oschner really invests and cares about physician well-being. And I'm just curious, do you find that physicians are more likely to stay at Oschner because of programs like this?
Dr. Girgrah: That's a great question. So with the Mini-Z survey, turnover intent is a ... is a KPI that we track. We've seen some reasonably recently changes year over year. This is going to be even more important, Todd, I think, in the future because, in Louisiana, this noncompete atmosphere is changing. So there will be more freedom for physicians to make choices.
But we talked about the personal leadership program. When we asked about turnover intent in those participants versus nonparticipants, we've seen a 50% reduction. So, 17% versus 34%, so I think it is an incredibly important key performance indicator that not one thing is going to solve for you have to have a multi-pronged approach to this.
Unger: And I just love your use of KPIs. I feel like I'm talking to people on my team, but what you're really saying is this is a quantitative aspect to this of really measuring progress. And when you hear about a reduction like that. That's incredible.
So congratulations to you and the team at Oschner for all of this work that's going on right now. And Dr. Girgrah thanks for joining us. Your work in well-being is always so inspiring, and we look forward to talking with you again soon.
For more strategies to help physicians feel valued, check out the episode’s description for a link to the AMA's new playbook, The Value of Feeling Valued. And to support the AMA's work to reduce physician burnout, please consider becoming an AMA member at ama-assn.org/join.
That wraps up today's episode. We'll be back soon with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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