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What GIM Leaders Can Do to Address Physician Burnout?

 , September 6 , 2017

Colin P. West, MD, PhD, and Lotte N. Dyrbye, MD, MHPE

Dr. West is a professor of medicine, medical education, and biostatistics at Mayo Clinic. He practices general internal medicine and co-directs the Program on Physician Well-Being at Mayo Clinic in Rochester, MN. Dr. Dyrbye is a professor of medicine and medical education at Mayo Clinic. She practices primary care and co-directs the Program on Physician Well-Being at Mayo Clinic in Rochester, MN.

The physician burnout epidemic is increasingly recognized as a threat to modern medicine. Approaches to address burnout often focus on the individual physician despite the main roots of burnout lying within our institutions, health care system, and culture of medicine. Given these roots, there are important guiding roles for organizations and their leaders to embrace if they wish to successfully reduce burnout and promote physician well-being.

Broad strategies have been described by Shanafelt and Noseworthy1, and include willingness to acknowledge the problem, measure it, and develop interventions based on local input and engagement with physicians within individual practices. In addition, meaning in work is crucial and can be promoted by community-building efforts and a commitment to shared values between leaders and their constituents. Attention to key drivers of burnout such as work-home interference and lack of efficiency and support in work activities is also important.

Each of these strategies is relevant to GIM leaders, as outlined by Linzer and colleagues.2 Specific recommendations for GIM leaders include the following:

  1. Make physician well-being a metric of institutional success.
  2. Support work efficiency and meaning by addressing clerical burdens such as those often imposed by electronic health records and computerized physician order entry.
  3. Ensure that physical work environments for GIM physicians allow positive work experiences.
  4. Provide work control to physicians to the greatest possible extent, balancing the benefits of standard-ization against the risks of dimin-ished autonomy in work roles.
  5. Consider career fit and allow physicians to pursue the aspects of their career they find most personally meaningful. Even 20%FTE in these roles can mitigate against burnout.
  6. Model professional values that recognize physician well-being as a key requirement for professionalism, as we cannot optimally care for our patients if we are not ourselves well.

With attention to these recommendations, GIM leaders can work with the physicians they lead to mini-mize burnout and promote meaningful medical practices and sustaining careers. Leaders must have the courage to openly confront the problems their physicians face, but this courage will be rewarded many times over if leaders can implement these strategies to improve their physicians™ work lives and promote joy in medicine.

References
  1. Shanafelt TD, Noseworthy JH. Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. Mayo Clin Proc. 2017;92:129-146.
  2. Linzer M, Levine R, Meltzer D, et al. 10 bold steps to prevent burnout in general internal medicine. J Gen Intern Med. 2014;29:18-20.

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