Clinician burnout, in many ways, is a costly problem for CEOs.
It takes a mental toll on your physicians, nurses and other practitioners. It is undoubtedly the reason some of the most talented people in your organization will leave the job. It is a culture killer. Studies have shown that burnout among clinicians has led to decreased productivity, lower quality of care, as well as reduced patient satisfaction and, perhaps most important, safety.
For all these reasons and more there is an actual business cost to burnout. Yes, a cost that can be calculated.
A survey in the Annals of Internal Medicine last June, in fact, estimated that burnout costs the U.S. health care industry $4.6 billion every year — a conservative estimate, according to authors Christine Sinsky, MD, Vice President of Professional Satisfaction for the American Medical Association, Stanford University’s Tait Shanafelt, MD and Harvard Business School’s Joel Goh.
While not every physician leaves a job because of burnout, research suggests that burned out physicians are twice as likely to turn over. Researchers have found there is significant cost savings for installing an intervention that helps reduce burnout.
“As a CEO, you’re already investing considerable financial resources every year on physician burnout … you just may not recognize it. If your organization has 1000 physicians, experiencing average rates of turnover and factoring in very conservative rates of the cost to replace one physician, you’re already investing $10 million per year on burnout. You’re just investing it at the sharp end of the stick, on replacing physicians who leave because of burnout rather than on prevention,” says Sinsky.
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While there are obvious moral and ethical reasons to address burnout, it has also become a legitimate business imperative.
Dan Shapiro, Vice Dean for Faculty and Administrative Affairs at the Penn State College of Medicine, who has written books on physician burnout, says there is an immediate ROI in trying to solve this problem. He and colleagues developed a five-tier hierarchy to help CEOs and other administrators prioritize burnout interventions.
Interventions and other solutions not named yoga
The five-tier intervention, Shapiro says, is comparative to how pilots use a systematic approach when responding to a warning light in their cockpit. The intervention starts with
- Physiological wellness. Are your employees hungry? Are they sleep deprived? The first tier also touches upon behavioral health and their mental wellbeing. Up from there, it goes to…
- Safety and security. Shapiro says one institution found that 58 percent of nurses had been struck, bitten, spit upon or kicked in the last year. “That makes it a more dangerous profession, in some ways, than law enforcement,” Shapiro says. This can also come in other forms (Is my job secure? Am I being threatened?)
- Respect. Am I respected by the people and things I interact with every day? This could mean the obvious examples of respect (a culture of accountability and communication) and the less obvious (is the EHR optimized? Are their dead spots where pagers don’t work?).
- Connected and appreciated by colleagues. Shapiro says that isolated health professionals burn out in higher numbers and leave in higher numbers.
- Making an impact. The highest level of this five-tiered intervention is whether or not the clinician feels they are making an impact. “If you clear up a lot of details lower on the hierarchy, you get to a place where physicians and nurses feel they are making an impact,” Shapiro says.
Other advice to CEOs: Yoga isn’t going to fix burnout
Both Sinsky and Danielle Ofri, MD, say that just offering yoga or Pilates to cure burnout won’t solve anything. The most successful approach, Sinsky adds, is by identifying and understanding the drivers of burnout within your organization and tackling them head on.
“We’re not just sitting here recommending goat yoga,” Shapiro says. “The problem with not having a prioritized list and organized approach is you’re just throwing darts.”
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Ofri, a Clinical Professor of Medicine at New York University School of Medicine, has written essays and books about physician burnout, including an op-ed in The New York Times. She says health care CEOs often miss the mark on clinician burnout because they don’t understand what their day-to-day is like.
“Everyone in the hospital, and I mean everyone, should have to do patient care for a day. They should have to spend regular time with patients. If you have an MD or RN degree, then do patient care. If you don’t have one of those degrees, work at the front desk. See what it’s like. See how the system impedes your ability to do a good job,” Ofri suggests.
