Healing moral injury: What should your strategy to reduce physician burnout look like?

Medical practice leaders face a tall task in working to turn the tide on an epidemic of physician burnout in the United States. At the core of healthcare leaders’ work is the need to balance financial expectations with the well-being of clinicians and staff.
 
According to a May 11 MGMA Stat poll, only 14% of healthcare leaders say they have a formal plan or strategy to reduce physician burnout, compared to 86% who do not. The poll had 770 applicable responses.

Responses varied whether it was about the causes of burnout or potential solutions:

• In many cases, respondents who said they had no formal strategy or plan pointed to lots of discussion and informal efforts to monitor burnout among physicians and staff.
• One practice leader pointed to pain points in the EHR for clinicians: “All the extra clicks suck the life out of everyone.”
• Other respondents noted they invested in specialty-specific EHRs that are more intuitive for clinicians to use, as well as more functionality to help the team follow up on oustanding labs and other items that can prove stressful if left unchecked.
• Many healthcare leaders say they have adopted formal physician wellness committees to inquire about key issues and provide guidance in efforts to address them.
• Developing a one-on-one coaching/mentoring system is another common strategy many healthcare leaders have adopted, sometimes as part of a provider leadership academy. A March 30, 2021 MGMA Stat poll found almost half of practice leaders say they provide leadership coaching or mentoring to clinicians.
• To assess physicians’ well-being, one respondent said the practice takes a weekly pulse survey to find out how to help providers to alleviate various types of stress they encounter, especially if it can be addressed via staff training or knowledge sharing.

Addressing the causes of burnout

In a recent article for Physicians Practice, MGMA’s Andy Swanson, MPA, CMPE, vice president, industry insights, pointed out that burnout levels were startling for healthcare workers prior to the pandemic, especially physician-owners — “the pressure to achieve ever-higher patient volumes, relentlessly long work hours, obstacles that prevent spending more time with each patient, daily battles with insurance companies, and Medicare, the downward pressure on small practices coming from competing healthcare providers, and … the stress of being a business owner on top of everything else.”

Other recent MGMA Stat polls point to the necessity to find burnout mitigation strategies to retain talented physicians: A March 2 poll found that 28% of healthcare leaders said a physician unexpectedly retired in the past year. 

Swanson recommends healthcare leaders shift away from treating symptoms and instead “address the underlying issue” that poses chronic frustration for healthcare providers and contributes to burnout, including:

• Technology: Swanson recommends forming a working group to achieve EHR customizations that can streamline processes and address issues in other areas related to the practice’s EHR, such as patient portals and scheduling software.
• Payment processing: Swanson recommends improvement in insurance verification, prior authorization, collections or timeliness of payment, which “may seem minor, but in total they will lessen the kind of chronic stress that wears down doctors.”
• Patient care access: Swanson recommends a five-step methodology, similar to how clinicians diagnose and care for patients, to make small gains in areas such as time spent with those patients or medication and treatment adherence.

Insights from #MPE21

The need to address burnout was a major topic throughout many of the sessions at the Medical Practice Excellence: Pathways Conference this week.

• Practice leaders need to find “incremental” ways to get more time and resources for addressing physician well-being, according to Laurie Baedke, MHA, FACHE, FACMPE, director of healthcare leadership programs, Creighton University, during her keynote presentation, “Resilient Leadership: The Role of Well-Being in Individual and Organizational Performance.” (Listen to Baedke’s recent appearance on the MGMA Insights podcast for more.)
• MGMA consultant Adrienne Lloyd, MHA, FACHE, chief executive officer and founder of Optimize Healthcare, said that healthcare leaders leading teams that have embraced remote work need to “draw boundaries to prevent burnout while maintaining communication and productivity,” by setting a clear vision for yourself and your team, with clear expectations and alignment between your team and the organization’s goals.
• In a discussion group focused on strategic leadership, many practice leaders noted that building psychological safety within the organization can address many of the elements needed in physician's work lives that mitigate burnout, such as trust and willingness to share feedback. (Read more about steps for cultivating psychological safety in healthcare settings.)

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.

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Other resources

• MGMA Stat: COVID-19 polls — Get a comprehensive look at MGMA Stat’s data since the beginning of the pandemic
• "How eliminating the ‘stupid stuff’ can reduce clinician stress and physician burnout" — In this episode of the MGMA Insights podcast, Jay Anders, MD, chief medical officer, Medicomp Systems, addresses EHR pain points such as usability and how eliminating the "stupid stuff" can help decrease clinician stress and physician burnout. 
• “Limit physician burnout risk by analyzing company culture, contract criteria” (Physicians Practice)
• “Guide to physician mental health and disability” (Physicians Practice)
• MGMA Consulting — With a collective 400+ years in healthcare experience, there isn't a challenge they haven't already thought of a solution for, and in a way that is tailored for your organization.