Right as COVID-19 hit, AMA member Shawn C. Jones, MD, started his role as medical director of provider wellness for Baptist Health Medical Group. This resulted in spending much of his first year looking into already available resources across Kentucky’s largest system, while juggling the immediate well-being needs of physicians and other medical group health professionals in the system’s nine hospitals.
But now that the federal government is declaring an end to the COVID-19 public health emergency, Dr. Jones has been finding ways to not only attend to daily and local needs turning his attention to infrastructure and resources needed for long-term impact across the system.
In June 2020, Baptist Health completed a COVID well-being assessment, which revealed a burnout rate of 52%. Then, in June 2022, they completed an AMA Organizational Biopsy™ where their burnout rate rose to 58%. While burnout increased, it was lower than the national rate of 63% in 2021, according to the latest research co-written by experts at the AMA. More recently, based on data from AMA assessment of health systems across the country, overall burnout rates dropped to 53% in 2022.
“I took that as good news/bad news. And the way we framed it was optimistic offense. It was obviously not optimal that our burnout increased, but it was predictable based on the pandemic,” said Dr. Jones, an otolaryngologist at Baptist Health—a member of the AMA Health System Program—and an alternate delegate in the AMA House of Delegates for the Kentucky Medical Association. “I wasn’t surprised that our prevalence of burnout went up, but we were still a little bit below the national average, which was good, but it’s still too high.”
With burnout rates in hand, Dr. Jones took a new approach to addressing burnout and improving well-being at Baptist Health. Here is how.
Invaluable help from the AMA
The AMA STEPS Forward® program, work that Christine Sinsky, MD, and others have done, and the help of the AMA team—in terms of building the surveys and completing the analysis—have “been invaluable in figuring out where we are as an organization to get some steps that are applicable to use as opposed to just picking things off a laundry list,” Dr. Jones said. “I can’t imagine doing it without the AMA, so it’s been invaluable in that regard.”
In fact, during a meeting with Isaac J. Myers II, MD, Baptist Health Medical Group president, Dr. Jones noted they should look toward applying for the AMA Joy in Medicine™ Health System Recognition Program next year and gathering the data needed.
This would help to “make the case that we are an organization that deserves some recognition for the work we’ve done in burnout,” he said, noting that Dr. Myers agreed.
Reducing physician burnout is a critical component of the AMA Recovery Plan for America’s Physicians.
Far too many American physicians experience burnout. That's why the AMA develops resources that prioritize well-being and highlight workflow changes so physicians can focus on what matters—patient care.
Offer physician coaching
Based on the increase in burnout at Baptist Health, Dr. Jones made some recommendations to deepen personal coaching for physicians in leadership positions.
“As part of my administrative package, physician leaders are able to meet with a coach once a month to talk about how to do some of the things they need to do,” he said. “It is as much—in my experience—a therapy session as it is anything else, but it’s always much more well received if it’s a coaching session than a therapy session.”
“I’ve made a recommendation to broaden that program and deepen it so that it’s more widely available to physician leaders throughout the organization,” Dr. Jones said. “If our leaders are healthier and making better decisions and treating people better, that goes into that culture of wellness that is important.”
“If I treat you poorly and I’m not good to you as a leader, we know that my leadership score affects how you view me and it also affects your risk of burnout,” he said. Also, “your chance of leaving the organization is higher and it costs a lot of money to replace you.”
“It’s hard to see the return on investment, but we need to keep making the case” to the C-suite, Dr. Jones said. Burnout is “a real cost for organizations.”
Make people feel appreciated
Even though burnout at Baptist Health had increased, 62.2% of respondents indicated they felt satisfied with their current job, compared with 75.9% at the national benchmark. Yet 58.8% felt a great deal of stress because of their job and 42.2% reported a likelihood of leaving their current practice within two years. Meanwhile, feeling valued by the organization dropped from 44.3% in 2020 to 36.5% in 2022.
“What specialty you are in, where you practiced and what capacity in which you practiced reflected your experience of the pandemic and how you felt about the organization,” Dr. Jones explained. “If, for example, I was in the emergency room or the ICU or was a critical specialty, then all that meaning and purpose was there.”
“If you were in an urgent care setting that shut down and didn’t work for a few months, then your experience of the pandemic was different—you probably lost some wages, you didn’t feel as important,” he said. “And also, the length of the pandemic. I don’t think anyone anticipated that it would be two or three years before we got back to normalization.”
Additionally, “some physicians experienced really horrible, traumatic things and it doesn’t matter how much we meditated or how much we slept, we’re going to have some issues and some feelings about that. So, a combination of those things led to those numbers,” Dr. Jones said. “Now it’s about recognizing the importance of physicians and making them feel appreciated. And that isn’t always—or even most of the time—related to financial renumeration.
“It has to do with making people feel appreciated and doing the things to help them facilitate their day and getting them the help they need when they need it,” he added.
Address EHR issues
“We’ve established a wellness committee with physicians from different locations than I am to help champion locally the ideas that we have about how to proceed,” Dr. Jones said. “And some of the things the organization is doing and was doing when I came on board.”
For example, Brett Oliver, MD, chief medical information officer for Baptist Health, worked to improve applicability of the EHR, “which for a lot of physicians is a point of stress, and he had some programs going,” Dr. Jones said, noting one just getting off the ground was called “Epic Mastery, which allows an Epic trainer to come and watch you work in the office for an afternoon and then sits down with you the next day or a couple days later and shares some things that could make you more efficient.”
“In my naivete or my egotism, I thought I don’t need any help with that, but because I was a wellness officer and I knew this was something a lot of people probably needed, I wanted to experience it before I recommended it,” he said. “They were really phenomenal. I had templates that I knew I needed to make that I just hadn’t taken the time to make, and they sat down with me and helped me do that in a more efficient fashion than I would have.”
Make well-being part of all decisions
“We’re going to keep monitoring physician wellness and doing the burnout surveys. Some of the things that are probably most important are very difficult to measure, but are critical,” Dr. Jones said. “And one of those is making physician wellness a consideration in every administrative decision.
“It doesn’t mean that it drives the boat or that it necessarily completely changes the direction of what the decision will be, but at least it needs to be discussed,” he added. “Making physician wellness a consideration at every level and at every decision is really critical and my main focus moving forward is doing that.”