Academic journal article Journal of Healthcare Management

Physician-Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience/PRACTITIONER APPLICATION

Academic journal article Journal of Healthcare Management

Physician-Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience/PRACTITIONER APPLICATION

Article excerpt

INTRODUCTION

Physician Burnout: The Challenge

Burnout is a pervasive international problem affecting the healthcare workforce. It is a syndrome of depersonalization, emotional exhaustion, and a sense of low personal accomplishment leading to decreased effectiveness at work (Maslach, Jackson, & Leiter, 1996). In other words, a burned-out physician is cynical and exhausted and feels ineffective in his or her work (Leiter, Hakanen, Toppinen-Tanner, Koskinen, & Vaananen, 2013; Leiter, Laschinger, Day, & Oore, 2011; Maslach & Leiter, 2008). The syndrome primarily affects those in the "helping" professions, with recent studies suggesting that physicians are at particular risk (Shanafelt, Boone, et al., 2012).

The high prevalence of burnout among physicians results in loss of engagement and commitment (Dewa, Jacobs, Thanh, & Loong, 2014; Dewa, Loong, Bonato, Thanh, & Jacobs, 2014; Prins et al., 2010; Shanafelt, Balch, et al., 2009; Shanafelt, Boone, et al., 2012; Shanafelt, Raymond, et al., 2014; Shanafelt, Sloan, Satele, & Balch; Williams et al., 2001). The 5 out of every 10 physicians affected by burnout are unable to optimally care for their patients, much less engage in the development and sustenance of the systems in medical organizations that foster the best patient care (Dewa et al., 2014; Firth-Cozens & Greenhalgh, 1997; Prins et al., 2009; Shanafelt et al., 2010; Shanafelt, Hasan, et al., 2015; Wallace, Lemaire, & Ghali, 2009; Williams, Manwell, Konrad, & Linzer, 2007).

Addressing this threat to quality of care is a shared responsibility of physicians and their organizations. Accordingly, organizational efforts to deal with burnout are an essential step to enhance physician engagement and improve safety and teamwork (Dewa et al., 2014; Firth-Cozens & Greenhalgh, 1997; Prins et al., 2009; Profit et al., 2014; Shanafelt et al., 2010; Wallace et al., 2009; Williams et al., 2007). Many factors contribute to burnout, including high workloads; an inefficient environment; problems with work-life integration; lack of flexibility, autonomy, and control; and loss of meaning in work. Other factors, such as medical specialty, practice setting, and personality type, also play a role, as do sleep deprivation, exposure to patient suffering and death, experience with medical errors, and malpractice suits (Balch et al., 2011; Meier, Back, & Morrison, 2001; Shanafelt, Boone, et al., 2012; Shanafelt, Sloan, & Habermann, 2003). Physicians who suffer from burnout are impaired (Shanafelt et al., 2010), and they and their organizations are at risk of having higher rates of medical errors (Dyrbye et al., 2010; Shanafelt et al., 2010; West et al., 2006; West, Tan, Habermann, Sloan, & Shanafelt, 2009), less professionalism (Dyrbye et al., 2010; Shanafelt, Bradley, Wipf, & Back, 2002; Shanafelt et al., 2010; West, Shanafelt, & Kolars, 2011), lower patient satisfaction (DiMatteo et al., 1993), and lower productivity (Dewa et al., 2014), as well as more turnover (Shanafelt, Raymond, et al., 2014; Shanafelt, Sloan, et al., 2011) and suicidal ideation (Dyrbye et al., 2008; Shanafelt, Balch, et al., 2011).

Burnout also erodes pride, idealism, and dedication (Leiter et al., 2011; Leiter et al., 2013; Maslach & Leiter, 2008). A strong connection exists between higher rates of provider burnout and a poorer safety culture (Profit et al.; 2014). When physicians are burned out, healthcare systems' performance is suboptimal. Thus, stronger partnerships and wellness benefit the individual physician, as well as facilitate the organization's ability to deliver high-value care (Wallace et al., 2009).

Physician Burnout: The Opportunity

The effort to eliminate burnout is motivated by a genuine interest in the well-being of patients and providers. Reducing burnout results in improved quality, safety, and efficiency and lower turnover rates (Epstein & Krasner, 2013; Shanafelt, Kaups, et al. …

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