Shedding Light on the Culture Behind Physician Burnout

Geeta Nayyar, M.D., MBA: Hello, and thank you for joining us for the first Peer Exchange from Inside Digital Health™, formerly known as Healthcare Analytics News™. Today, we’re bringing you a hard-hitting discussion on a grave threat to high-quality healthcare: physician burnout. This panel, titled “Leveraging High-Tech Tools in the Fight Against Physician Burnout,” is not your typical take on this ubiquitous topic. Of course, we know physician burnout is a problem. In a recent report from Geneia, 80 percent of physicians said they are at risk of burnout. Research suggests that the problem not only harms doctors, but it also negatively affects patient care and raises costs for hospitals, all while we’re losing doctors to suicide and dealing with a physician shortage.

So, what can we do? That’s the most important question at hand, and that’s the question we’re going to answer today. We know that EHRs [electronic health records] are linked to health IT [information technology]-related stress in physicians, but we also know that EHRs have a massive potential upside. While it’s easy to blame technology for physician burnout, today we’re taking on a more challenging, more important task: We’re exploring how healthcare leaders can actually use technology to combat physician burnout. Because we cannot afford to let our doctors suffer any longer.

I’m Geeta Nayyar, a health-technology executive who hosts the digital medical news channel “TopLine MD TV,” as well as “Dr. #YOLO,” a podcast series dedicated to helping you live your one and only best life. I’m recognized as one of the most powerful women in health IT, a top 100 health-tech influencer, and one of the top 26 smartest people in health IT, according to Becker’s Report.

Participating today on our distinguished panel is Heather Staples Lavoie, a 30-plus-year healthcare leader and current president of the health-tech company Geneia, which integrates EHR data as well as other sources such as wearables and social determinants and applies analytics to help hospitals, physicians, and health plans succeed in the digital transformation. Geneia also produced the Physician Misery Index, which measures this problem.

Janae Sharp is one of today’s most sought-after health-tech key opinion leaders, with experience in building EHRs, media, and more. She serves on the board of Utah HIMSS [Healthcare Information and Management Systems Society], several startups, and is also the founder of the Sharp Index, a nonprofit organization she created after her husband, a physician, died by suicide.

And finally, we have Rasu Shrestha. Rasu is a respected thought leader and health IT visionary who is known for driving enterprise change. He recently became chief strategy officer and executive vice president at Atrium Health, following 11 years at University of Pittsburgh Medical Center. He is also a HIMSS board member, and he chairs the HIMSS Innovation Committee.

Thank you so much for joining us. Let’s dive right in. After learning that a problem exists, the next step is to really measure its scope. What would you say is critical, aside from technology? Is it the culture? Is it attitudes? What is it, Rasu, that makes this such a difficult topic?

Rasu Shrestha, M.D., MBA: Geeta, it’s really important. This topic of burnout is so real and so prevalent really across the board. And I think the No. 1 thing that we need to get our arms around is the mindset. We’re not ready, in large part, to admit the fact that the very people who are healing our patients are actually hurting right now. And the mindset around how we might be able to address that notion, that reluctance to really admit to the fact that we have a major problem, is what we need to get our arms around.

Given the fact that there is a God complex that oftentimes exists with physicians — and it’s bidirectional, and I’m not saying this in a bad way — physicians are expected to heal. And physicians conversely expect their patients to obey and to understand what they’re saying and to listen to the protocols and the prescriptions that they put on the table. And that God complex, this notion that, “Oh my goodness, that physician, the healer, could actually be hurting,” we need to get around that.

Geeta Nayyar, M.D., MBA: Yes, those are some big words, Rasu. Would you agree with that, Heather? Do you think that the mindset is one of the biggest problems in the system today?

Heather Staples Lavoie: It is. I certainly think that physicians are viewed as invincible, and because they tend to be workhorses, they take on so much. Sometimes I think they have been a bit reluctant to admit that the burden they’ve been bearing is too great. Maybe it feels a little bit like admitting to failure to a certain extent.

And yet I think the burden that we’ve placed upon them is just unnecessary, and it really is too great. We’ve asked them to do so much more than is expected as part of clinical practice. We’ve relegated their role to be data entry clerks, which I think certainly dehumanizes them to a certain extent. It diminishes their importance in the organization, and so I think it’s not only extra burden on them, but also it really undermines all of the training that they have pursued in their entire career.

Geeta Nayyar, M.D., MBA: I totally agree with you. No one really feels bad for physicians, right? They’re held to this pedestal and are supposed to be perfect in many ways. Janae, I know you’ve done a lot of work on measuring burnout and metrics. Can you share with us your thoughts on some of these things?

Janae Sharp: Yes. I think it’s important to think about it, too, because we talk a lot about burnout, and some people also call this phenomenon of not really being able to meet your expectations the moral injury. Is this burnout? What exactly is going on? And we know when we’re talking about someone’s mental health, we ask, “How are we really measuring this?” And nobody wants to look at it and say, “Oh, on a scale of 1 to 10, I’m pretty burned out, which means I’m bad at my job.”

And quantifying that is difficult. We know that what gets measured matters in healthcare, and in some cases right now that’s a billing code. And the challenge for everyone is to say, “OK, we know something is wrong. How do we measure this appropriately? How do we look at it? What matters?” And that’s a lot more challenging. I know I’ve said challenge five times, but it is just a giant challenge to ask, “How much of a moral injury do you have?”

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