Mayo Clinic Researchers: Physician Burnout Is an Institutional Challenge

The famed institute is working to change the culture of burnout by investing in ways to reduce it on an organizational level.

Burnout affects at least half of the physicians in the United States, but at many medical institutions, the responsibility to cultivate personal resiliency lies on the shoulders of individual clinicians.

“In a way, it is a culture of machismo,” says Colin West, MD, PhD, associate director of research programs at the Mayo Clinic’s Program on Physician Well-Being. “That has really shaped the historical narrative of how people think about stress, burnout and well-being as very much an individual responsibility.”

Leaders at Mayo Clinic are working to change the culture of burnout in their institutions by investing in ways to reduce it on an organizational level. They hope physicians around the world benefit from what they learn.

“There are many factors that are part of the environment within medicine that are unhealthy and have been major contributors to dissatisfaction and success,” West says. “The system is where the root of many of these problems are, but these people who are working in and suffering within the system are responsible for dealing with it better. [Medical institutions] are putting the set of solutions on the wrong shoulders.”

A paper published in 2016 by Tait Shanafelt, MD, the program’s director, and John Noseworthy, MD, the president and CEO of Mayo Clinic, outlines nine strategies for reducing physician burnout on an institutional level:

• Acknowledge and assess the problem of burnout.

• Harness the power of leadership.

• Develop and implement targeted interventions.

• Cultivate community at work.

• Use rewards and incentives wisely.

• Align values and strengthen culture to achieve the mission.

• Promote flexibility and work-life integration.

• Provide resources to promote resilience and self-care.

• Facilitate and fund organizational science.

Two years after implementing corresponding changes at Mayo Clinic to reduce physician burnout, the rate decreased 7 percent. At the same time, the national rate increased 11 percent.

West says Mayo has pursued a range of studies researching physician well-being, from national surveys to randomized trials of interventions. One of the most recent projects completed was an initiative to encourage physicians and research scientists to eat meals together and commit to discussing topics that are relevant to physicians for a short period at the beginning of their meeting.

West describes the initiative as a shared responsibility program. Mayo Clinic pays for the meals, and the physicians decide when and where to meet. Each group meets 12 times over six months, and they can re-enroll as soon as they finish with one group.

Mayo Clinic reports success with the program, with more than 1,400 people actively enrolled since it began in October 2015. Mayo plans to make it accessible to all 3,700 physicians and research scientists in the organization.

West says programs like this show that it does not always take a huge investment to work toward creating a more supportive workplace culture.

“We just simply haven’t been putting in the resources that were necessary to support our health care professionals,” he says. “If you start talking about fixing a system to get back to a normal standard in the first place, that is perceived as a new cost as opposed to how I think it should be correctly be viewed — as correcting an underfunded situation.”

The outcome of providing institutional support for physicians is positive for the health care institution as well, providing what West calls a “competitive advantage.” Mayo Clinic has collected data that suggest health care professionals who are less stressed are less likely to retire or reduce the number of hours they spend on the job.

“They are able to see more patients, they are able to have longer careers, they are able to deliver more care over more years,” West says. “And that’s what people want to do.”

A major part of the Mayo initiative is driven by leaders who have been trained to listen and help health care professionals feel included in the process of changing the institutional system to better support individual needs. This includes training new leaders and retraining leaders who never were taught the skills needed to engage health care employees.

“Being a leader in medicine is not just about delivering your financial metrics,” West says. “It’s not just about helping connect people with research productivity. It’s got to include leading people to flourishing within their medical careers.”

The goal of these initiatives is both immediate and long-term, with an aim to make life better for individual health care professionals while also making the field more desirable for future employees. West believes that by investing in their people, health care institutions have the potential to counteract the expected physician shortages in the coming years.

Hannah O. Brown is a freelance health care writer based in Florida.