Re: “Resident Burnout a Key Concern for AMA” by Marty Stempniak in H&HN Daily, June 8


There are three major tasks with regard to burnout education for residents.


1. Teach the signs and symptoms of burnout (vs. normal stress) in yourself and others.


2. Teach the five causes of burnout. Here are the ones I've found in my work with hundreds of burned-out physicians:

a. The stress of the practice of medicine. Our patients are sick, hurting, scared, dying, and we carry a crushing load of complexity and responsibility. The simple practice of seeing patients is stressful.

b. Your job. Your specific job adds multiple layers of stress in the form of your electronic health records, call rotation, compensation formula, work team, etc.

c. Having a life ... or not. All the stresses outside work, one of which is maintaining some sort of life balance, a skill no one learns in residency.

d. The conditioning of our medical education. Workaholic, Lone Ranger, Superhero, Emotion-Free, Perfectionist tendencies get hardwired over time. Plus the two prime directives: "The patient comes first" and "Never show weakness" set us up to ignore our own needs, fail to recognize burnout and to reach out and support each other.

e. Your relationship with your boss/immediate supervisor. Bad bosses burn out good doctors.

3. Teach the healing and protective power of a supportive culture. You can establish a culture of support, where the providers have each other's backs, in residency. This is what all health care organizations are trying to do to combat the burnout epidemic. We can make this culture-building, bonding, supportive, team-based skill set part of the residency experience.

— Dike Drummond, M.D.

Challenges for LGBT Boomers

Re: “Is Health Care Ready for the Aging of America” by Bill Santamour in H&HN Daily, Sept. 15

As the general public ages, we will also find more than 4 million LGBT boomers by 2030. Their special needs include the fact that they are four times more likely to be childless, twice as likely not to have partners and living alone, and 89 percent predict care provider discrimination. Their most needed services are senior housing, transportation and social events.

— Jerrold Maki

President and Board Chair

Rainbow Healthcare Leaders Association

Creating Real Value for Patients

Re: “Thinking Like Michael Porter” by Dan Beckham in H&HN Daily, June 16

Dan, creation of value for patients has much more to do with physician-patient interaction than to corporate strategy. The Michael Porters of the world can best create value by enhancing and preserving this sacred relationship, something that is slipping away on the slope of economic misdirection.

— Suman Sinha, M.D.

Helping Docs Learn to Lead

Re: “Developing Physician Leaders” by Lee Ann Jarousse in H&HN Daily, April 14

In my work with physician leaders, we found coaching and process consultation, in some instances informed by 360 evaluations and feedback from peers, nurses, and nursing and administrative leadership, to be helpful. Might these methods complement formal programs of didactic and social learning, whether all classroom or blended classroom and online?

— William "Bill" Van Lente, MBA, PsyD

Dual Coding is Crucial

Re: “Dual Coding: Is It Worth the Price?” by Matthew Weinstock in H&HN Daily, June 9

Dual coding is the single most important readiness activity you can perform as part of any ICD-10 project. It is a catalyst and provides practical intelligence for every other workstream activity: reimbursement impact, coding and documentation improvement, production interface performance, claim testing, outpatient medical necessity impact, and even assessment of the impact on quality measures. If you can't get to 100 percent, code a subset that reflects production volumes and acuity, so the results allow you to take meaningful action.

— Jason