Physician Burnout and High-functioning Teams

October 3, 2016

Addressing physician burnout in radiology.

Physician burnout is receiving a substantial amount of national attention currently. There are a number of organizations that have identified this entity as an epidemic – one that threatens health care in this country. Many professionals have begun to devote their academic careers to burnout and figure out how best to mitigate it. In fact, the emotions that this topic elicits are impressive. Simply reading the comment sections following various blogs/posts addressing burnout reveal an inner-fury that is insinuating throughout the fabric of physicians from all specialties. This is indeed a problem.

There are some very smart people implementing creative solutions to this crisis. And before I continue any further – I must acknowledge that I think physician burnout is real, it is important, and we need to deal with this swiftly and effectively.

But, while it is easy to jump on the burnout bandwagon, a few hard questions should be asked and answered – before we collectively reach (perhaps overreach) for solutions to a problem we are yet to fully understand.

1. In an era of work-hour restrictions and emphasis on work-life balance, why is burnout at an all-time high NOW?

2. What are physicians who are NOT burnt-out doing differently? (Maybe they’re just emotionally numb...?)

Oft cited reasons for burnout among radiologists and other physicians are plentiful. Pain points include EMR mandates, lack of tort reform/defensive medicine, quality reporting metrics, increased individual accountability, voice-recognition software, increasingly challenging patients, health care websites, student loans, declining reimbursement, non-physician administrators, insurance companies, pre-authorization, radiology benefit managers, peer-review discoverability, driving Hondas instead of Acuras, other policies, offices without windows, bad parking, and cessation of unlimited free scrubs.

We can’t fix all of these things in health care. And yet – again – there are physicians that aren’t burning out. Why?

Now – I don’t claim to be an expert in the burnout field. I am far from it. I am classified by many as a failing work-aholic that put life out to pasture while pursuing a fairy-tale treasure at the bottom of a career-abyss. But I think one singular question may begin to at least raise attention regarding a dominant reason many of us in health care are burning out.[[{"type":"media","view_mode":"media_crop","fid":"52453","attributes":{"alt":"Physician burnout","class":"media-image media-image-right","id":"media_crop_1868704444348","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"6514","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 205px; width: 200px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"©Lightspring/Shutterstock.com","typeof":"foaf:Image"}}]]

How many of us like the people we work with?

I don’t mean “like” as in, “He is so nice!” or, “She is great to hang out with.” I’m talking about a relationship of mutual understanding and common goals. Where team members respect the skill set that each brings to the table and where each is intrinsically motivated to do a little extra to reach the level of performance that is jointly expected by all members of the team. Where accountability is considered premium. Where everyone on the team is excited about the opportunity to excel beyond the conventional bounds of health care-workflow-limiting vices. How many people work with a team like that?

High-functioning teams have a few common characteristics:

Shared goals

Mutual trust and understanding

Ability to adapt to unforeseen circumstances quickly

Continuous learning and willingness to identify areas for improvement

We should all take a moment and reflect on these characteristics and ask ourselves whether or not our work-teams embody them. And I am not suggesting to only think about our physician teams – rather I am imploring us to reflect upon the actual teams we work with every day. Nurses, technologists, trainees, medical assistants, ancillary staff, etc.

Now again, let’s think about physicians that aren’t burning out. Are they more or less likely to be a part of high-functioning teams? Perhaps, nurturing and promoting the development of high functioning teams in health care would be a sound strategy for battling the health care burnout epidemic.

But, how much time to we actually devote in health care to building and studying high-functioning teams? I think we all agree that there are some high-functioning teams in health care. Why aren’t we studying them more? What is the highest functioning team in your department? What are they doing differently?

One of my favorite posts regarding high-functioning teams is by Liz Ryan. And to quote her directly, “Making your team’s focus the achievement of goals and milestones imposed on them by someone high up in the chain, someone who is not part of the team and has no mission-connection to them, is the best way to stop your team’s forward motion.”

I would offer that most of our teams in health care and in radiology are charged with doing exactly what is described in the quote above. Seems like a poor strategy…

I am not here to endorse or criticize existing efforts to fight physician burnout. But I would encourage that our profession – radiology – lead the charge in creating environments that promote the development of flourishing, high-functioning teams. To trust our leaders to function autonomously and intrinsically motivate their teams, rather than menially “manage” them and “monitor” performance.

If physicians work on teams with people they like -- putting effort into work that they believe in -- they won’t burn out.