Today I attended a very entertaining and inspiring seminar, and yet I left it with a sick feeling in the pit of my stomach.
Bryan Sexton, a national authority on health worker burnout and patient safety, made a convincing case for the importance of addressing burnout. Staff burnout causes surgical complications, medication errors and even hospital deaths. And burnout affects roughly half of all healthcare employees.
But his solution, which I was invited to substantiate by participating in Duke University’s latest NIH sponsored study, was a series of educational videos and daily SMS reminders prompting followup activities to reinforce six lessons. These lessons had titles like “Gratitude” and “3 Good things”; smartphone Buddhism, I told my wife over dinner. I qualified my statement by admitting that the six lessons from Duke could make us all better providers and better human beings. In fact, my own writing sometimes serves the purpose of focusing my attention away from the frustrations and distractions in medicine and toward those aspects of my patient interactions that enrich, humble or awe me.
The irony in this study, financed by our Government, is that instead of spending money to fix the system, they are spending money on making health workers more “resilient”, which is touted as the opposite of burnout. The same Government that gave us Meaningful Use, ACOs and MACRA now wants to help us be more resilient as they load even more clerical tasks on our shoulders, and continue to penalize us if we can’t make it work on rudimentary software with interfaces that would shock computer users in other industries.
I do believe that in these times, all healthcare workers can benefit from discovering and cultivating the joy that actually can be found right under our noses in clinic and hospital work. But, just like Viktor Frankl’s “Man’s search for meaning” wouldn’t have had any credibility if it had been published by his captors in Auschwitz or Dachau, the coping mechanisms to combat burnout don’t sound too credible coming from those who are the cause of health worker burnout.
This analogy is an exaggeration just to get a point across: Those in charge have a moral obligation towards those without power. If health care organizations and even our own Government realize that our current healthcare system is hurting those who work there, can’t they do more than help us cope?
Duke’s program would be more credible if the AMA or some nurse’s union would sponsor it than coming from Uncle Sam. I expected more from him.
This ties nicely into Mr. Purcell’s posting.
I get it ..
Unfortunately, apparently a lot of people don’t.
On the other hand, as the economist said .. This is one of the “Damned if you do. Damned if you don’t things.” This is medicine and burnout is a symptom. What do we do if we get a symptom? We treat it. And that’s what they’re trying to do.
If you have a chance listen to the linked talk Bryan gives. I found myself doing on a lot of nodding and amen’ing. On the other hand, there was one line that caught my attention.
Note, I’m paraphrasing. And this may be an example of psychiatrist humor not translating. Describing his program, Bryan said something along the lines of:
“And gosh. It’s as if, its as if you found away to “aerosolize” prozac and give it to your staff, your colleagues and everybody suddenly feels better!”
Wow. What a great analogy!
On the other hand, what does it say when we say that we need to set a system of ducts and and pump air-borne Prozac into our work environment?
It means that something is very wrong.