Photo Credit: Pondsaksit
Everything should be made as simple as possible, but not simpler. — Albert Einstein
Praying for a one-step solution for physician burnout is human nature but also a trap. One of the critical features of physician burnout is a desire to run away, escape, and make the pain stop. When you are deep in the downward spiral, your mind drops to its knees and prays for a quick fix, a potion, a simple one-step solution to this struggle. How can I fix this, make it go away, and get on with my career and life?
Because our questions are simple, we assume a simple answer—a solution—will come to our rescue. But this is magical thinking doomed to fail. Let me show you the simplest way to prevent physician burnout in any healthcare organization. I promise to make it as simple as possible for you, but no simpler.
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There are three key distinctions:
Distinction #1: Problem Versus Dilemma
First, you must understand that physician burnout is not a problem. The word “problem” comes from mathematics. By definition, problems have solutions. When I apply a solution to a problem, what happens to the problem? It goes away, right? Problem + solution = no problem.
So, we ask ourselves, “What is the solution to burnout?” We pray for a fix, but there is none. Do you think there is a solution to burnout that we have not discovered yet? That is because burnout is not a problem. Burnout is a classic dilemma—a never-ending balancing act.
Distinction #2: Strategy Versus Solution
Now that we are calling burnout by its proper name—dilemma—you will quickly realize there is no one-step solution. You can’t solve a dilemma simply because it is not a problem. You address a dilemma with strategy. Rather than a single step, a strategy contains 3 to 5 steps combined to maintain the energy balance you seek.
If you believe there is a one-step solution that makes burnout all go away, please let that go now. It is a fantasy everyone in healthcare must release once and for all.
Distinction #3: Canary in the Coal Mine
Physicians working in a healthcare delivery organization are a classic example of the canary in the coal mine. The canary’s health is an indicator of the conditions in the mine. Our current physician burnout epidemic (63% prevalence in the last major US study) reflects the stresses of the modern healthcare workplace. Once again, we find that healthcare workplace stresses are not a problem that can be solved. This is another example of a dilemma requiring a strategy to strike the right balance point.
Now, we are set to answer our original inquiry: what is the simplest and most effective approach to preventing physician burnout? The best answer is a pair of strategies operating simultaneously and in parallel—one for each canary and one for the coal mine.
In the canary strategy, each physician—the canaries—must have their individual and personal burnout prevention strategy. This strategy is the essence of physician resilience. Resilience is always necessary and never sufficient for protection from burnout. It is simple and common for a toxic workplace (the mine) to overwhelm personal defenses.
A system-wide burnout prevention strategy for the organization/group—the coal mine—is the essence of the quadruple aim. However, the organization cannot be supportive and efficient enough to eliminate burnout completely. We are programmed to burn out from the start.
