Addressing Physician Burnout
The third-annual Great Lakes Health Combined Medical and Dental Staff Meeting was the largest yet with some 325 participants. I had the honor of serving as emcee and presented on the topic of Provider Professionalism and Wellness.
For those of you unable to attend or who would care for a refresher, what follows is an overview of the night's program. You can view a video of the entire program (one hour and 45 minutes) here.
Kaleida Health CEO Jody Lomeo began by emphasizing that Great Lakes Health is an “us organization” that includes a solid partnership between Kaleida Health, the University of Buffalo and ECMC. He thanked the members of the medical staff for their leadership, stressing that “this is all about culture,” adding that culture needs to be a joint effort including boards and administration from each facility.
In reviewing progress of the past five years, Lomeo stated that in 2014 it was determined that all major decisions would be physician led, and that a commitment was made to create centers of excellence with an initial focus on new construction.
He described the gap that then existed between the excellence of caring staff in Buffalo and quality outcomes that were not up to expectations. Since then, significant enhancements have been achieved in quality outcomes, financial performance and growth of the organization. As one example, he reported that the Oishei Children’s Hospital was one of only 13 children’s hospitals in the nation to achieve Leapfrog A designation last year.
Looking ahead, Lomeo emphasized that "Job #1" will always be providing the highest possible quality care. Having a common IT platform will facilitate that goal. Other essential goals include having best-in-class educational and research programs. Finally, he emphasized that we “simply can’t get big enough” in today’s world and must continue to grow. There should be no reason, he said, for anyone to leave Buffalo for medical care elsewhere – rather, Great Lakes Health should be known for such excellence that it will attract others to come to Buffalo. He closed with an overview of the CARE values.
I began my remarks on physician burnout by conducting a live polling exercise which showed that four out of 10 providers in attendance had at least some symptoms. Those results are consistent with national trends. Physician burnout is a serious problem that must be taken seriously by the organization, but it is not because people are inadequately tough to deal with the challenges. Three key factors in burnout are individual, collegial and environmental. The latter, including learning and using new electronic health records, is the largest contributor to the problem, and was addressed in David Hughes's presentation (outlined below).
Turning to the subject of professionalism, I shared results of fourth-year medical student exit interviews on how they perceive the way Great Lakes Health providers treat patients, students and each other. Great Lakes Health results were significantly below the national average in every category, and they got worse between 2016 and 2017. Correcting that problem will be critical to achieving the Great Lakes Health goal of being nationally recognized for clinical and educational excellence.
Kaleida Health Chief Medical Officer David Hughes, MD, then explained why having an integrated medical record that includes Kaleida Health, ECMC and the University of Buffalo is essential to helping Great Lakes Health move “from reactive care to proactive health,” and to achieving better quality outcomes. He described steps being taken to assist physicians and others with “at-the-elbow” coaching support from Cerner. Such support, he said, can reduce screen time by up to 20 percent, freeing up time to be with patients. He concluded with a timeline through the second quarter of 2020 showing progress toward a community-based medical records system.
Values Coach founder Joe Tye provided the closing keynote by discussing the importance of moving toward a culture of ownership where people take initiative and responsibility for their actions and their outcomes. He stated that physicians and advanced practice professionals have a disproportionate impact upon the culture of healthcare organizations and encouraged Great Lakes Health providers to make sure that theirs was a positive impact.
Referring to the CARE values presented by Jody Lomeo, he said that if some people are excused from holding to those values then Great Lakes Health would have a culture of optionality and not a culture of ownership.
During the subsequent Q&A period, George Matthews, MD, asked Tye what immediate steps he would recommend. As a follow-up to his off-the-cuff remarks at the podium, he recorded a four-minute video that can be viewed at this link.
Peter Winkelstein, MD, MS, MBA, FAAP
Medical/Dental Staff President
Kaleida Health