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Stress and burnout a growing concern for healthcare leaders

MGMA Stat - September 7, 2022

Performance Management

Practice Efficiency

Culture & Engagement

Christian Green MA
The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders, “Has your level of stress and/or burnout changed in 2022?” The majority (80%) said “increased,” while 14% responded “stayed the same.” And 6% noted that it “decreased.”

According to the latest MGMA Stat poll, eight in 10 medical group practice leaders said that their stress and burnout levels increased in 2022.
 
The poll was conducted Sept. 6, 2022, with 691 applicable responses. For those who responded that their stress and burnout has increased, the overwhelming majority said it was due to staffing issues, which often results in increased workload. Responses included:
  • “No real vacation since COVID started. Every day time demands increase and the number of hours in the day is finite.”
  • "Staffing issues forcing us to adopt automation and new technologies much faster than we are ready for has been a huge stressor.”
  • “Over focus of financial goals and provider recruitment over basic operational issues. The expectation to keep the doors open when there is a huge shortage of basic staff to handle day-to-day operations.”
 
In elaborating on how they’ve dealt with stress/burnout, some respondents said that the answer was leaving a job or starting a new one:
  • “I changed jobs; moved to a company that respects time away from the office, mental health.”
  • “I quit my job as medical group practice manager after 30 years of employment and started my own consulting business. I've never been happier. I am appreciated by my clients. I have a very flexible schedule. I can work remotely or in person.” 

More factors contributing to stress and burnout in 2022

More than four years ago, a June 26, 2018, MGMA Stat poll revealed that 45% of healthcare leaders reported feeling burnt out in their job, while another 28% said they were “somewhat” burnt out. During the past few years, healthcare has changed significantly. Two medical group practice leaders who did not feel burnt out at their job provided insight into how their level of stress and burnout has changed since that 2018 poll.  
 
A director of operations in New Jersey said a new supervisor added a “layer of confusion,” making an already stressful job even more taxing. “The healthcare landscape is shifting so rapidly that decisions made on data today are becoming unusable within a few months,” he noted, adding that retaining clinical workers has become increasingly difficult.
 
Recruitment and retention was also cited as the principal reason for burnout for an assistant vice president of operations in Kentucky. Although she noted that patient volumes have exceeded 2018 levels and that financial budgeting, strategic planning and workflow optimization are back to pre-COVID-19 pandemic norms, staffing shortages continue to negatively impact her practice.
 
“It has become increasingly challenging to recruit new support staff (clinical and administrative), which leaves our clinics short-handed and feeling overwhelmed,” she said. “Without being properly staffed, operations suffer. Routine tasks of scheduling appointments and returning calls, to the leadership tasks of optimization, are anything but routine.”
 
She added that these factors have contributed to staff feeling more tired and dispirited, often wondering if working conditions will ever get better. Compounding this issue is stiff competition from healthcare organizations near and far.
 
“We raise our salaries ... and they answer by raising their salaries and we lose a few staff,” she said. “Everyone is offering sign-on bonuses, which makes loyal staff question why they are not being offered a stay bonus.”
 
Ultimately, these added staffing expenses have a profound financial impact. “The expense contributed to these efforts to provide care for our patients has severely fractured a once-prosperous bottom line, which creates another problem to address and the cycle continues,” she stated. 
 
As reported in a Feb. 1, 2022, MGMA Stat poll, 59% of medical practice leaders said staffing was the top reason employees left for another job in 2021, while an April 12, 2022, MGMA Stat poll revealed that 56% of medical practice leaders said raising wages was the best tactic to address staffing, followed by 29% who stated flexible schedules were a key retention tactic.
 
However, if stress and burnout are the primary drivers for leaving one’s job, higher compensation and flexible schedules can only carry practices so far. They should also consider expanding employee benefits. To that end, a May 31, 2022, MGMA Stat poll reported that 45% of respondents added or expanded their practice’s employee benefits in the past year. The most common benefits included:
  • Additions and improvements to paid leave offerings
  • Wellness and employee assistance program (EAP) benefits
  • Increased employer contribution toward health insurance costs.

Addressing stress and burnout

In an Aug. 23 MGMA Stat poll, more than one in three (34%) respondents noted that they have a formal plan or program to address physician burnout. But how do practice managers address their own burnout and staff burnout?
 
A good first step is to check in with your staff and leaders to promote open communication. The director of operations in New Jersey said that it’s important for those in his organization to “share our stress and concerns among each other so we know it is not just one individual feeling the stress and we can support one another.” This is important because stress and burnout can create feelings of loneliness and isolation, which can have long-term consequences to one’s health. In fact, according to research by Sarah Pressman, of the University of California, Irvine, loneliness can reduce longevity by 70%.
 
Verbal communication is not the only way to ensure employees are valued. As the assistant vice president of operations in Kentucky noted, something as simple as a handwritten note or card can help them feel appreciated.
 
“I recognize staff who are working hard or who have been recognized by another staff member for doing something special by writing them a thank you card and mailing it to their home, and encouraging our leaders to do the same,” she said. “If the person has committed a lot of extra time to complete a project, I also write a thank you card to the family for supporting them and letting them know their family made a difference.”
 
Beyond open communication and recognition, practices can offer mental health resources, including free counseling services, wellness initiatives and app-based programs to help improve work-life balance. 
 
In addition, staff and providers should be continually reminded of the importance of recharging. “Some of the ways I try to address burnout for my leaders (and myself) is to encourage them to take time off,” said the assistant vice president of operations in Kentucky. “For leaders, the work never really stops, but it is impactful to walk out without a laptop and files to work on.” She added that this also includes leaving work early some days.
 
She also noted that spending time with friends and family helps her recharge. “There are days that I do not want to go to dinner or meet up with friends, but I force myself to go and end up having a great time and feeling reset,” she said. “When I have a day that is too overwhelming, I talk to someone or take a few minutes to sit quietly and reflect on my purpose and reconnect to my why.”

JOIN MGMA STAT 

Our ability at MGMA to provide great resources, education and advocacy depends on a strong feedback loop with healthcare leaders. To be part of this effort, sign up for MGMA Stat and make your voice heard in our weekly polls. Sign up by texting “STAT” to 33550 or visit mgma.com/stat. Polls will be sent to your phone via text message. 
 
Do you have any best practices or success stories to share on this topic? Please let us know by emailing us at connection@mgma.com.  
 
Additional resources 

About the Author

Christian Green
Christian Green MA
MGMA Writer/Editor MGMA

cgreen@mgma.com

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