Clinician Burnout and the Meaningful Connection of the ACU Community

Much has been said recently regarding clinician burnout in health care. Whether it be the disengagement of front-line care givers, mental health status of care teams, or potentially the worst—suicide, which is higher among health care professions that most all others—burnout is a serious part of health care delivery today.

While the topic of burnout is a nuanced and complex one, there are three key tenets that require all those caring for the underserved to focus on at present. The Association of Clinicians for the Underserved continues to address all of these!

1. 1. The concept of the triple aim in health care has shifted to the quadruple aim, which continues to encompass high quality care, low cost care and increased patient satisfaction, but now also the fourth element—increased care team satisfaction.¹

2. 2. The ECRI Institute, which works closely with the United States Health Research and Services Administration (HRSA), through which almost all community health centers receive malpractice insurance (Federal Tort Claims Act, or FTCA) has noted that burnout is one of 10 top patient safety concerns for 2019.²

3. 3. While burnout can affect anyone, at any age, in any industry, it is important to note that there are certain sectors and roles that are at increased risk, and purpose-driven work—that is work (such as health care) which people love and about which they feel passionately—is one of them.³

Working in systems that support high-quality, patient-centered work—surrounded by a network of colleagues with shared ideals and goals—has defined the Association of Clinicians for the Underserved since its inception. From the many years of advocacy for the National Health Service Corps (NHSC), by many NHSC members and alumni, ACU has continued to be a leader in workforce retention and recruitment (most notably, through its recent work on the HRSA-funded STAR2 Center for Workforce). Burnout is not a new idea to ACU, nor is the concept of shared community, nor the data showing that being surrounded by a true community of peers helps to decrease (or, "treat") burnout.

Now a bona fide syndrome with ICD-11 classification, the World Health Organization noted that the syndrome of burnout is characterized by three dimensions: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from one's job, or feelings of negativity or cynicism related to one's job; and 3) reduced professional efficacy.³

According to Dike Drummond, MD—known to some as The HappyMD—"[R]esearchers are beginning to notice differences in the way physician burnout presents in men and women." For women it often begins with exhaustion and a feeling of not being able to recharge your batteries, followed by early signs of blaming your patients or clients. For men, it often begins with cynicism and blaming your patients or clients, followed by exhaustion and falling energy and engagement.⁴

Whether the sufferer is male or female, though, burnout has an impact on patient care: it not only produces less engaged employees, but also leads to reduced patient engagement, reduced patient satisfaction, reduced quality and value of care that is delivered, and increased risk for a health care error or mistake. Whether these impacts are recognized by a chief executive, medical or compliance officer, the chief financial officer will also be keen to note that burnout leads to increased staff turnover—costing organizations thousands or millions of dollars, well beyond the loss of organizational knowledge that results from employee change.

Organizational risk management plans for 2020 are something ECRI strongly endorses, including efforts to measure (and perhaps mitigate) burnout. Patients are beginning to demand the same, and with good reason: they simply want more engaged care, delivered by more empathetic care teams, that is safer.

Paul Huschilt, CSP (Canadian Speaker Hall of Fame) spoke with the ACU community at this year's 2019 annual ACU meeting in Washington D.C. As health care professionals, we face urgent demands, responsibilities and pressures. His talk, replete with laughter and concluded with...