Special articleExecutive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout
Section snippets
The Challenge Facing Health Care Executives
This is a challenging time for health care executives. Increasing price competition, narrowing of insurance networks, and a greater proportion of patients with noncommercial insurance (eg, Medicare, Medicaid) due to the Affordable Care Act have all resulted in declining reimbursements. In parallel, requirements for “meaningful use” of electronic health records have resulted in large capital expenditures and dramatically increased clerical burden for staff.1, 2 These financial challenges have,
Implications of Physician Burnout
There is a moral and ethical imperative to address burnout in physicians. Physician burnout contributes to broken relationships, alcoholism, and physician suicide.10, 11, 12, 13, 14, 15, 16 In addition to the moral-ethical argument, there is a strong professional and business case to reduce physician burnout and promote physician engagement. Studies indicate that physician burnout influences quality of care, patient safety, and patient satisfaction.17, 18, 19, 20, 21, 22, 23, 24 Physician
A Shared Responsibility
Given the professional repercussions of physician satisfaction and burnout, health care organizations have a vested interest in cultivating physician engagement. Engagement is the positive antithesis of burnout and is characterized by vigor, dedication, and absorption in work.40, 41 Any health care organization that recognized it had a system issue that threatened quality of care, eroded patient satisfaction, and limited access to care would rapidly mobilize organizational resources to address
Nine Organizational Strategies to Promote Physician Well-being
Although the framework of shared responsibility and the need for system-level solutions have begun to be recognized, 2 pervasive myths have been barriers to organizations taking effective action. The first is the belief that the steps necessary to cultivate physician well-being will conflict with other organizational objectives. The second is the assumption that all effective interventions to reduce burnout will be cost prohibitive. The reality is that an engaged physician workforce is
The Mayo Clinic Experience
Our experience at Mayo Clinic demonstrates that deliberate, sustained, and comprehensive efforts by the organization to reduce burnout and promote engagement can make a difference. Between 2011 and 2013, the rates of burnout among our physicians went from lower than average to similar to that of physicians nationally.7 In response to this increase, a host of changes were pursued, including several of the strategies articulated herein (Figure 5). In the following 2 years, the absolute burnout
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Grant Support: This work was supported by the Mayo Clinic Program on Physician Well-being.
Potential Competing Interests: Dr Shanafelt is co-inventor of the Physician Well-being Index, Medical Student Well-being Index, and Well-being Index. Mayo Clinic holds the copyright for this instrument and has licensed it for use outside of Mayo Clinic. Dr Shanafelt receives a portion of any royalties paid to Mayo Clinic.