Continuing the Journey to Wellness

By Matthew Reeves, DO, chief medical officer, Atrium Medical Center

I have served as the chief medical officer at Atrium Medical Center for nearly two years. My experience and research have convinced me that we should take a more focused look at physician burnout. This condition contributes to diminished collaboration, often a posture of defensiveness, and less physician-to-physician communication. With team work impaired, our quality, safety, service, and patient experience are at risk. In these pages last year, I proposed that physician satisfaction be the fourth aim of all health care systems, or what’s known as the quadruple aim. (In 2008, the Institute for Healthcare Improvement proposed the Triple Aim: Experience of care, health of populations, and cost.) Premier Health has invested in its physicians through liaisons, leadership development – both personal and professional – as well as advanced degrees. We are also rolling out many electronic medical record enhancements, as well as seeking your feedback in the current KLAS survey. 

I recently reviewed the annual Medscape Survey on Physician Burnout and Depression. My interest was also sparked by Dr. Belcastro’s writing in Premier Pulse last month. I hope you had an opportunity to read his very personal and touching article. 

Let’s first look at the Medscape survey results collected from 15,500 physicians over a four-month period from July to October of 2018. Sixty-one percent of the respondents were men and 39 percent were women. Fifty percent of the women reported being burned out, compared to 39 percent of men. Forty-four percent of all respondents reported being burned out regardless of employment. Self-employed physicians reported only slightly lower rates at 41 percent. Twenty-six specialties had burnout rates of 33 percent or higher – critical care came in at 44 percent; family medicine and medicine were at 48 percent and 49 percent, respectively; and urology topped the chart at 54 percent. Reasons for burnout were identified as too many bureaucratic tasks (paperwork, charting, etc.), spending too many hours at work, increasing use of EHRs, lack of respect (from peers, staff, patients, and/or administration), and financial compensation. The report also noted that burnout adversely affects physicians’ personal lives as well as professional lives. Surprisingly, 64 percent stated they have not and do not plan to seek help of any kind. Yet 49 percent of physicians who reported burnout rated their symptoms at a 4 or 5 on a 7-point scale, with 7 indicating intent to leave the profession, and an additional 22 percent rating their level of burnout a 6 or 7. While most physicians indicated that they choose positive coping skills to deal with their condition, some admitted to engaging in maladaptive behaviors such as isolating themselves by reducing work hours, changing work environments, or withdrawing from normally enjoyable social activities and hobbies outside of work. 

Dr. Belcastro is beginning a new journey and inviting any and all who want to join him to come along. His presentations, planned for MEC and other physician groups, introduce one antidote to this affliction of health care worker burnout. The message takes a new look at compassion – one of Premier Health’s core values along with respect, integrity, and excellence. While I don’t want to steal his thunder, we both believe that this message is too critical to not utilize every forum of communication. You may begin your journey by watching a 15-minute TED talk on YouTube titled “How 40 Seconds of Compassion Could Save a Life”. From there, feel free to reach out to any of the CMOs for feedback or ideas. 

Back to the February 2019 issue of Premier Pulse