Local medical professionals met this week with representatives of the Colorado Hospital Association to identify common causes of individual and systemic physician burnout.
They used a case study, or a real-world example, involving physician burnout at a rural Montana hospital.
About 40 physicians, hospital board members and hospital CEOs participated in the discussion Wednesday at Fort Lewis College. Participating medical organizations included Centura’s Mercy Hospital, Animas Surgical Hospital, Axis Health System, La Plata Integrated Healthcare, Southwest Women’s Health, U.S. Anesthesia Partners, Western Healthcare Alliance and Whole Health Family Medicine.
Details about an overworked rural hospital in Montana were provided to attendees to spark discussion about burnout. Interestingly, the case study was designed to talk about physician burnout years before the pandemic, but has become more relevant as the COVID-19 pandemic enters its third year.
Case study authors Lauren Hughes and Benjamin Anderson led the discussion. Anderson is the vice president of rural health and hospitals for the Colorado Hospital Association, and Hughes is the state policy director at Farley Health Policy Center. The two opened by defining burnout as a syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment that can occur among individuals who do “people work” of some kind.
“We have an issue, and we’re coming together tonight not just to talk about how prevalent the issue is, but really work through the systemic and individual drivers of the issue,” Anderson said.
According to statistics given by Anderson, in 2013, around 45% of U.S. physicians were experiencing at least one symptom of burnout.
“Advance to 2021, nearly 80% of physicians said they feel burnt out prior to the pandemic, but one in five said that burnout only emerged in the last year,” Anderson said. “Forty-nine percent of physicians reported that they were happy in 2020, versus 69% pre-pandemic.”
Attendees were broken into several groups to talk about the individual and systemic causes of burnout in the case study.
Many pointed out that the individual causes of burnout include things such as workload, communication and failure to set boundaries, among others.
“Guilt, expectations and boundaries are three friends that can kind of travel together,” Hughes said.
Group discussions found that systemic causes for physician burnout have to do with a culture of overwork in medicine, understaffing and a lack of shared vision, among others.
The presentation ended by offering a framework for how to think about making changes locally to address the individual and systemic causes of burnout. Some of the questions brought up by the framework included what outcomes need improvement, who are the stakeholders and why aren’t changes already happening?
“What I picked up is that there’s an opportunity for us as a community to make a change in our current health care situation, but physicians, organizations and CEOs have to be willing to be aligned with making those decisions,” said Dr. Steve Lavengood, family physician at La Plata Integrated Healthcare.
The case study is a real scenario of rural burnout. Anderson revealed at the end how the hospital in the study solved its problems. He mentioned things such as making sure hospital board members, physicians and CEOs have an aligned strategy for success. He said the Montana hospital from the case study was able to turn its burnout issues around by implementing standardized roles for physicians, equitable on-call structure, fair compensation and a mission-driven culture.
One physician asked when another meeting might take place, to which Anderson said it depends on the people in the room representing each of their organizations. By that he meant the discussion was intended to help La Plata County medical professionals think about ways to address burnout in their community, not solve it for them.
“To the community leaders that are seeing despair among friends, neighbors and family members that have carried the community through a pandemic on your shoulders, we see you,” Anderson said. “We hope that through this case if you’re a physician in the room that you feel seen.”