Physician Wellness Services and Cejka Search Physician Stress

Physician Wellness Services and Cejka Search Physician Stress and Burnout: Cause, Effect and What Can Be Done About It Alan Rosenstein, MD, MBA, Medical Director, Physician Wellness Services www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Physician Wellness Services About Us Physician Wellness Services provides a coordinated, comprehensive and confidential suite of services designed specifically for physicians and the organizations that employ them. National in scope, with wideranging expertise in every aspect of behavioral health. § The Physician EAP § Physician Intervention Services § Training and consulting services www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Physician Stress and Burnout: Causes, Effects and What Can Be Done About It Learning Objectives § Develop a better understanding of physician stress and burnout § Identify and address organizational factors that may be contributing toward physician stress and burnout § Demonstrate increased understanding of and commitment to physician wellbeing in the existing physician population and to potential candidates § Design wellness programs for physicians to help them cope with the stressors in their lives § Formulate retention and recruitment strategies and initiatives to reduce turnover www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Physician Stress and Burnout Survey Methodology § Web-based survey deployed in September, 2011 to nationwide, multi-specialty panel of 115 k § 2069 completed surveys representing 99% confidence level, +/- 3% margin of error against 750 k active physician population in the US • Slight skew to non-primary care physicians • Skew more female, somewhat younger than active physician population; average 45. 3 years • Average years in practice: 13. 1 • Employed by hospitals (41. 3%), single or multi-specialty practice (41. 0%) www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Physician Stress and Burnout Survey Prevalence of Stress and Burnout § Almost 87% of physicians identified themselves as moderately or severely stressed and/or burned out § 37. 7% identified themselves as severely stressed and/or burned out § 70. 4% scored themselves in the upper 50 th percentile www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Not at all 1 2 Stress Level 1. 8% 3 7. 5% 4 7. 4% 9. 0% 5 12. 3% 6 7 20. 4% 8 22. 4% 9 Extremely 10 0. 0% 11. 2% 4. 2% 5. 0% 10. 0% 15. 0% 20. 0% 25. 0% www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Physician Stress and Burnout Survey Change vs. 3 Years Ago § 62. 3% of physicians identified themselves as more stressed and/or burned out compared to 3 years ago § The largest number of respondents (34. 3%) identified themselves as “much more stressed” than they were 3 years ago www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Much more stressed than I was 3 years ago Stress Compared to Three Years Ago 34. 3% Somewhat more stressed than I was 3 years ago 28. 6% About the same level of stress as 3 years ago Somewhat less stressed than I was 3 years ago Much less stressed than I was 3 years ago 18. 5% 11. 2% 7. 5% 0. 0%5. 0%10. 0% 15. 0% 20. 0% 25. 0% 30. 0% 35. 0% 40. 0% www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

§ Stress and burnout had multiple causes, measured across 3 sectors: Physician Stress and Burnout Survey Results: Cause and Effect • External factors • Work-related factors • Personal life-related factors § Effects were measured across work life and personal life § Difficult to control or address for external factors directly, but there are more options regarding the work and personal life www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

§ Top 3 external factors were: • The state of the US economy, in general (51. 6% of all respondents) • Healthcare reform (46. 4%) • CMS policies (41. 2%) Physician Stress and Burnout Survey Top 3 Factors Causing Stress and/or Burnout— External, Work. Related and Personal-Life Related Sectors § Top 3 work-related factors were: • Paperwork and administrative demands (39. 8% of all respondents) • Too many hours of work (33. 3%) • On-call schedules and expectations (26. 2%) § Top 3 personal life-related factors were: • Not enough time to relax or for leisure/recreational activities (52. 6% of all respondents) • Not enough time for exercise or wellness activities (50. 6%) • Concerns about work/life balance, in general (45. 0%) www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

§ The top 2 work-related impacts of stress and/or burnout were: Physician Stress and Burnout Survey Work-Related Impacts of Stress and/or Burnout • Lower job satisfaction (51. 2% of respondents) • Desire to work fewer hours (41. 2%) § The next cluster indicated an overwhelming desire by respondents to do something different than what they are currently doing, job- and careerwise: • Desire to retire early (29. 9%), desire to leave the practice of medicine entirely for another career (27. 6%), desire to switch jobs (21. 8%) and desire to switch to a new practice (15. 9%) www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

§ The top 3 personal life-related impacts of stress and/or burnout were: Physician Stress and Burnout Survey Personal Life. Related Impacts of Stress and/or Burnout • General feelings of tiredness (41. 4% of respondents) • Less sleep or problems sleeping (36. 7%) • General feelings of irritability and moodiness (33. 9%) § The next cluster involved impacts on their personal health (24. 7%) followed closely by more conflict with a spouse or partner (22. 6%) www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Physician Stress and Burnout Survey § § § § Physicians Are Suffering From a Number of Effects of Stress and § Burnout Decreasing job satisfaction Decreasing productivity Insufficient work/life balance Conflict at work and at home Feelings of irritability, moodiness, anger and hostility General tiredness, lack of sleep and difficulty sleeping Negative impacts on physical health Negative impacts on mental health such as depression and anxiety, or symptoms such as apathy and cynicism, less interest in engaging with others, or in normal activities Patient safety-related concerns such as difficulty making decisions, communicating effectively with others, and increased risk of medical errors www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

§ Increased turnover and retention challenges § Patient safety and quality issues Consequences for Healthcare § Lower productivity Organizations § Disruptive behavior and lower morale Physician Stress and Burnout Survey www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Physician Stress and Burnout Survey Results: What is Being Done—and What is Needed? § What are organizations doing —and what should they be doing? § What are physicians doing— and what do they want and need? www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Physician Stress and Burnout Survey Top 3 Things to Help Reduce Stress and Burnout § When asked, open-ended, for the top 3 things that would reduce stress and burnout, physicians said: • Better work hours and/or less call (32. 5% of respondents) • More or better work/life balance (30. 7%) • Improved finances, compensation, reimbursement (29. 0%) § Generally, throughout the survey, financial-related factors were far down the list relative to other factors www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Physician Stress and Burnout Survey Current Organization. Sponsored Initiatives to Address Stress and Burnout § When asked if their organization currently provided support for stress and/or burnout, only 15. 7% said yes § The top initiatives cited were: • Wellness initiatives (30. 6%) • Workshops and education (29. 3%) • Onsite exercise facilities or classes (19. 1%) • EAP, counseling or other behavioral health services (15. 4%) § Several respondents noted that it was difficult to find time to utilize services, especially during normal clinical hours, and some were not available after hours www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

§ When asked what organizationsponsored initiatives they would like to help address their stress and burnout, physicians asked for: Physician Stress and Burnout Survey Desired Organization. Sponsored Initiatives to Address Stress and Burnout • More ancillary support, such as physician aides, to deal with things like paperwork and charting (63. 0%) • Onsite exercise facilities or classes (38. 9%) § The next cluster involved wellness initiatives (27. 8%), workshops and education on managing and coping with stress and burnout (23. 8%), conciergetype services (19. 8%) and coaching and mentoring resources (18. 5%) www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Physician Stress and Burnout Survey What Physicians Are Doing to Combat Stress and Burnout § When asked what they were doing, themselves, to combat stress and/or burnout, the top 2 choices were: • Exercise (62. 8%) • Spending time with family and friends (56. 9%) § The next clusters were taking vacation or time off (47. 8%), watching movies or listening to music (44. 3%), reading (38. 0%) and getting more sleep (35. 8%) § Several respondents noted that finding the time or money to do things to relieve stress was a challenge www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

§ There were 3 primary areas where physicians asked for help: Physician Stress and Burnout Survey Next Steps: What Do Physicians Need the Most? • More time, and more control over their time—for the things that are most important to them at work, and to carve out more time for their personal lives and interests • More opportunities for self-care, such as exercise and other wellness activities • More support in helping them more effectively deal with the stress and burnout in their lives www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

flexibility and control over their working hours to mitigate burnout and stress: Physician Stress and Burnout Survey What Can Organizations Do? • Provide more ancillary support to free up physician time for patients, achieve better work/life balance • Facilitate part-time and flexible work schedules • Look for creative ways to address call: o Make it more lucrative o Reduce regular hours surrounding call o Encourage each practice to brainstorm and develop its own plan o Allow for reduced call for those with children under the age of 3 and those over the age of 60 www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Physician Stress and Burnout Survey What Can Organizations Do? § Physicians need more opportunities for and assistance with taking better care of themselves, and to understand practice better self-care: • Onsite exercise facilities or classes • Workshops • Facilitated support groups • Physician wellness committees • Individual coaching • Time to take advantage of all resources • Easy accessibility—times, locations www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

§ Physicians need support on multiple levels in dealing with stress and burnout in their lives: Physician Stress and Burnout Survey What Can Organizations Do? • Physician-specific employee assistance program (EAP)— counseling resources, coaching and mentoring, concierge-type services • Strong Physician Wellness Committee • Education—grand rounds, workshops • Cultural change through training and facilitated discussions— communication skills, stress and anger management, dealing with workplace conflict, building resilience, etc. • Normalizing work/life balance www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Physician Stress and Burnout Survey Keeping Physicians: Retention and Recruitment Promoting a “culture of wellness” creates a sense of being valued and increases satisfaction • Address factors within your control: work environment, personal life impacts at work • Provide support services • Normalize seeking help when it’s needed—remove the stigma from doing so • Be sensitive to physician barriers and priorities www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

A robust Physician Wellness Committee can provide valuable support and outreach, promote a Physician “Culture of Wellness” Stress and § Clear mission and scope Burnout Survey § Committee expertise and Physician commitment Wellness Committees: Best § Administration support § Resources—administrative Practices support, budget § Benchmarking results vs. goals www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Physician Stress and Burnout Survey Physician Comments From the Survey § The data on the negative impact of sleep deprivation on patient safety and personal health have accelerated my burnout. I feel that in the near future working more than 12 -18 hours and having an adverse outcome will expose me to liability based on sleep deprivation alone. § Physicians’ burnout negatively affects patients in a myriad of ways. Many doctors feel trapped and feel they can't leave. Coaching helped me have the strength and courage to leave. I am a much better doctor since I left and came back because I take care of myself first. It took me a long time to learn how to do that. Self sacrifice is rewarded but causes so many problems. www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

Physician Stress and Burnout Survey Physician Comments From the Survey § It is a problem with so many contributing issues. Most docs I work with are unhappy. I, myself, am miserable, depressed, drinking too much and unable to formulate a plan to change—while all day I help others. § We have to find a way to help docs recognize burnout. We didn't get through medical training by thinking about how it affected us; we just put our heads down and muscled through. You can do anything for 8 years, but you can't live that way for 40 years. We need to encourage ourselves to develop an external barometer so someone can tell us we're burning out. § I think surgeons in my generation are squeezed between those who are getting ready to retire and those who are starting but already set limits on what they are willing to do (hours, time and salary). The difference is carried by those of us who aren’t at either end. No wonder we are burned out. www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©

§ For more information: Physician Stress and Burnout Survey Questions? • Physician Wellness Services 888. 892. 3861 www. physicianwellnessservices. com § For a copy of the survey results: survey@physicianwellnessservice s. com www. Physician. Wellness. Services. com A division of Workplace Behavioral Solutions, Inc ©