Novant Health, a North Carolina-based health system with more than 1,500 physicians in three states, seeks to prevent or mitigate burnout through a physician-resiliency program designed to help participants find fulfillment in their work and personal lives.
The challenge
Discussing physician burnout as an abstract concept is one thing; acknowledging the possibility that one is experiencing burnout is entirely different.
“Even though the topic is so widely talked about, physicians don't typically like to admit to the fact that they're struggling,” says Tom Jenike, M.D., senior vice president and chief human experience officer, Novant Health. “They might not even call it that — they might just say they are frustrated or ‘I wish it was like it was back in the good old days.’”
In Jenike’s own situation, dissatisfaction with his practice and his professional life prompted him to seek out a life coach to help him think through what was bothering him. That experience helped him to remember why he became a physician and to see what he needed to do to find meaning and joy in his work. Jenike wanted his colleagues to have the same kind of experience.
“Once I connected some dots and had some ‘aha!’ moments, I really got committed to trying to create a systemwide, proactive solution for our physicians,” he says.
Related: Solving Physician Burnout
Getting started
Jenike got support from Novant Health’s CEO to create and implement an intensive training program that would mimic the experience he had with his life coach. He worked with that same coach to develop a three-day program and recruited 32 senior physician leaders to participate.
The goal of the program is not to prepare participants for promotions or to embrace Novant Health’s mission and vision. Rather, the first objective is to give physicians an opportunity to think deeply about what they want to do and why.
“By allowing them to hit the pause button and take a good look at their lives and remember what's most important to them, we want them to have a significant enhancement in the experience of their lives,” he says.
The second objective: better interpersonal relationships, professionally and personally. “By virtue of this program, you're going to show up differently to others, with more compassion, less bias, better communication skills and more ability to influence what happens next,” Jenike says.
The response from those first participants in 2013 was so positive that the leadership development program has become embedded in the organization. More than 700 physicians, nurse practitioners and physician assistants have completed the three-day course, and nearly 800 nurses, respiratory therapists and other bedside caregivers have completed a one-day version.
Related: Case Study: Stanford Medicine Seeks to Understand Burnout Through Measurement
How it works
Physicians take three days of their own time and receive 32 hours of continuing medical education credit. Participation is not mandatory, but previous participants provide word-of-mouth promotion, encouraging their friends and colleagues to enroll.
The program is offered about once each month; each cohort includes 15 to 20 participants. Jenike and the coach facilitate each session.
“We go to a really nice, almost resortlike setting, and the participants stay on-site so we can have three full days of conversation there,” he says. “Then we have a follow-up day a month later. In some situations, we have an extra couple of follow-up days.”
The conversation includes a discussion about the external forces that burden physicians — electronic health records, changing payment models, new government policies, the pressure to increase efficiency — and the reality that none of those are going away. Participants learn to examine their reactions to those pressures and decide how to put them in context.
“Understanding my own patterns of thinking, patterns of behaving and patterns of feeling is, we think, foundational to helping to build resilience and wellness, and decreasing burnout,” Jenike says. “And this program focuses as much, if not more, on the participant's entire life rather than just the professional life.”
Outcomes
Novant physicians who have completed the program scored much higher on Press-Ganey engagement and alignment measures — in the 89th and 92nd percentiles, respectively, in 2015 — than those who had not participated.
While that is a gratifying side effect, that is not the best way to measure the program’s success, Jenike says. Indeed, participants are prompted to thoughtfully consider whether they want to work as physicians and want to work at Novant.
“The whole conversation is about them and their lives, and we make it very clear that we care more about them, as human beings, as people, than we care about the work they do with the company,” he says. “This is absolutely the opposite of ‘drink the company Kool-Aid’ conversation.”
Jenike prefers to focus on outcomes that demonstrate that physicians are more satisfied with their lives. Several participants have sought leadership positions at Novant or launched initiatives that reflect their own interests.
For example, a group of previous participants — all practicing physicians — formed an EHR optimization team. They proactively meet with Novant Health physicians to show them how to save time or perform tasks more easily.
“This team is in place because they went to this program,” Jenike says. — Lola Butcher
