I work in healthcare recruiting and often hear from physicians and administrators alike about the extreme burnout that is pervasive across our sector. New research that my company and our partners at the Medical Group Management Association conducted this summer confirms that both physician burnout and turnover rates are still dangerously high. This is in part due to the rising toll of pandemic-induced stress and the consequent staffing shortages. We wanted to better understand these impacts, and better understand how medical groups — and the people who run them — can improve how physicians experience their work.
If you work in healthcare or have been treated in a doctor’s office or hospital recently, the results may not surprise you. The extreme nature of the data may give you pause, however, as you think about the critical role of healthcare in society. I know it does for me. We learned that:
Nearly two-thirds of physicians (65%) said they are experiencing burnout this year, up four percentage points from the 2021 research. More than one in three physicians (35%) who are experiencing burnout report their levels of burnout increased significantly in 2022. Physicians don’t think enough is being done to mitigate burnout, to better include them in finding solutions, while administrators believe they are acknowledging burnout. Fifty-one percent of physicians report they have considered leaving their current employer, up from 46% last year.
It’s especially disheartening to hear that one in three physicians is experiencing a significant increase in their level of burnout this year. After all, the intensity of the pandemic has waned, and in theory, a “new normal” is emerging thanks to vaccines and other COVID mitigation efforts. What this survey tells us is that not much has changed for physicians, and in fact, many of them are struggling harder than they did at the worst moments of the pandemic.
In fact, we know the number of physicians leaving the workforce has grown; a recent article in Fierce Healthcare cites a 2021 study from Definitive Healthcare that found that “nearly 334,000 physicians, nurse practitioners, physician assistants and other clinicians left the workforce in 2021 due to retirement, burnout and pandemic-related stressors.”
So what is the solution? When I talk to administrators and physicians, both recognize that solving the burnout crisis is super complicated, because many of the drivers of stress have their roots in the way the business of healthcare operates. Simply increasing pay for physicians, or adding staff (if you can find and recruit and retain them) likely isn’t enough to transform the persistent problems we’re facing.
One thing physicians are pretty clear about is that the source of their burnout is less about the nature of the work they do as doctors, and more about how the administration handles the organization. They simply don’t trust administrators to solve the problem.
With one in two physicians seriously considering leaving their current employer for a new one and 36% considering early retirement, we need to rethink how we solve burnout. Physicians have ideas: they range from streamlining clinical workflows, managing workload equity amid ongoing staffing shortages, improving two-way communication between physicians and administrators, and increasing psychological safety in the workplace to encourage quality, honest feedback.
It’s that last one — the concept of psychological safety — that may have the most potential to lead to solutions.
The IKEA Effect on Medicine
What does the IKEA effect have to do with creating a psychologically safe space for physicians to come to the table?
Our partner in research, Halee Fischer-Wright, MD, MMM, FAAP, FACMPE, president and CEO at MGMA, says it best, “Instead of just talking about burnout, we need to focus on empathy and organizational efforts to revive these professional relationships that make high-quality care delivery a sustainable reality for everyone involved.” In other words, we need to bring everyone to the table and empower physicians to co-create in the solution. And then we need to follow through with their input, so that participation is met with action.
Jessica Dudley, MD, chief clinical officer at Press Ganey, was responsible for teaching oversight for physician-led efforts to better the quality and efficiency of healthcare during her tenure as chief medical officer at Brigham and Women’s Hospital in Boston. She believes in the concept of psychological safety, and creating a culture where everybody on the team feels comfortable sharing their thoughts. “We need people to be honest and transparent about where the challenges are if we’re ever going to be able to fix them,” Dr. Dudley states in the white paper of our research mentioned above.
Dr. Dudley’s recommended approach to physician engagement includes cultural transformation, easing the administrative burden on physicians and focusing on their mental well-being — all ideas she has gathered by consulting physicians to co-create the solution. Physicians rank their need for transparency in the organization high. Co-creating solutions can go a long way toward physicians feeling invested and trusting leadership. Long-term, the transformation into a culture that supports and nurtures physicians and provides for their mental well-being, as well as their need for moments of light-heartedness and joy, is the goal. In other words, when physicians can participate in building something new — even if it is a complicated and frustrating experience — they will come to put a high value on what has been created.
Are there lessons beyond healthcare?
Perhaps this optimistic model for transforming the business of healthcare has implications for business more broadly: Bring employees to the table, invite them to co-create the solutions, and shift organizational priorities away from hierarchy, outdated staffing models and a failing system that demands more from people than they are able to give. Invite participation, and together, we can celebrate what we have built.
