Rewriting the Script: A prescription for treating physicians with greater dignity and respect

Last week, I received a call out of the blue from an old friend. I immediately could hear in his voice that he was upset and shaken.

A long-standing physician leader with a history of excellence, he had been summarily relieved of his management duties in the wake of pending management reorganization. His dismissal came without any consideration of his years of service and dedication, his strong reputation in the community, his talent and passion as a physician, and his track record of providing exceptional care and delivering best-in-class results for the organization he had served for nearly a quarter-century. 

I certainly understand the need to make management and leadership changes. I recognize that it’s hard and unpleasant, but I also know from my own experience that there are ways to do it while honoring a team member’s service and demonstrating compassion and respect. I was sad and frustrated for my friend, but I was also frustrated by the industry in which I have dedicated my life’s work. I was left to wonder why there seems to be a mounting and continuous devaluing and disrespect of physicians, viewing them as easily replaceable cogs in a giant machine, as opposed to seeing them as the talented and, for the most part, compassionate and dedicated healers they are. 

In the complex web of healthcare, physicians have long been the linchpin holding it all together. They are the diagnosticians and the guardians of our well-being. Yet, in recent years, there's a growing concern that the very backbone of our healthcare system is being devalued by the industry itself. Not so coincidentally, physician burnout and depression are at an all-time high. 

In fact, in a 2023 Medscape survey, "'I Cry, but No One Cares': Physician Burnout & Depression Report 2023," over 50 percent of physicians reported experiencing burnout in the past year and nearly 25 percent of doctors expressed feeling depressed — the highest percentages in over five years. In this same report, nearly 40 percent of physicians attributed "lack of respect by co-workers" as the factor contributing most to their burnout — second only to "too many bureaucratic tasks."

Not only is this trend negatively impacting the doctors themselves, but it also has a rippling effect on patient care and health systems. For health systems to thrive, we must retain top talent instead of deterring folks from entering the profession. Additionally, the treatment of physicians, like that of my friend, can have a negative impact on the culture of the organization by fostering bad feelings and a decrease in team member engagement. More importantly, when doctors are respected, supported, and given the time and resources they need, they can deliver a higher level of care. (See Health Care Management Review, Williams, et al, 2007).

But beyond the impact on health systems and patients, there is a moral and ethical imperative to treat physicians with dignity, respect and reverence. They shoulder the weight of life-and-death decisions, work long hours and face an emotionally taxing profession. Recognizing their dedication and sacrifice is simply the right thing to do.

So, then what are we to do to turn the tide? 

  • First, we must acknowledge that burnout and mental health challenges are real and provide a safe space for folks to get help or take a respite without fear of repercussions. This, unfortunately, is all too common in our industry today. As Jesse M. Ehrenfeld, MD, president of the American Medical Association, wrote in an opinion piece about the need to address physician burnout that was published in The Boston Globe this past July, "Seeking care for burnout, mental illness, or a substance use disorder is a sign of strength — an act that takes courage and deserves our health system's unconditional support. As physicians, we need to be leaders to deliver and model that message and behavior in our practice every day."

At Florida Health Sciences Center/Tampa General Hospital, where I am president and CEO, we have embraced providing mental resources for everyone with whom we work in hopes of helping our colleagues as well as removing the stigma of mental health. In fact, we established It's Okay Not to Be Okay, a collection of emotional and mental health resources ranging from wellness and resilience-building activities to professional counseling and crisis support.

  • Second, we need to provide more professional/administrative support for physicians. At Tampa General, we have deployed a dyad model for clinical service line operations. This means we pair a physician clinical leader with a non-physician administrative leader to manage, lead and oversee each service line. This collaborative approach not only brings a host of benefits to the health system and the patients they care for, but also contributes significantly to the satisfaction, engagement and well-being of the physician leader. It promotes shared responsibility and shared decision-making, decreasing the burden on physicians and providing clinical leaders with the opportunity to develop leadership skills beyond their clinical expertise. It also promotes a more positive work environment driven by a spirit of collaboration and innovation — all of which likely contribute to a decrease in physician burnout and dissatisfaction.  
  • The third and equally important approach is to lead everyone across your organization with love, from those in patient transport to our physicians in the emergency department. I have written and deployed the concept of leading with love across my own organization, working with nonclinical and clinical staff. 

The compassionate leadership approach of leading with love validates the inherent humanity in each person we lead and work with and acknowledges that although we come to the table with different experiences, we all are looking for a sense of belonging and acceptance. When we lead with love, we foster an environment where all people, including physicians, feel psychologically safe to be seen and heard and feel valued and respected, and we create a culture of care where everyone is celebrated for their achievements and supported during challenging moments. Ultimately, we see people for who they truly are, the challenges they face and the aspirations they hold dear.

At Tampa General, we deploy leading with love through a leadership model, AKTiVe, built on four qualities of leaders and leadership: authenticity, kindness, transparency and vulnerability. When these qualities are embraced and enacted by leaders, it creates a more positive and psychologically safe environment for physicians, team members and patients. In fact, we launched AKTiVe in 2022 and we are seeing both quantitative and qualitative positive effects of this work. Six months after team member participation in AKTiVe leadership training, we saw a measured increase of 5 percent in participants in relation to their feeling psychologically safe. They felt freer to be themselves, speak up and voice their opinions, take risks and make mistakes. 

This feeling of psychological safety is important not only for the health of the individual and their engagement, but studies have shown, including the 2016 Project Aristotle study out of Google, that there is a direct correlation between psychological safety and innovation. The more team members feel free to take risks and speak their minds, the more prone they are to innovation and creativity. They are also more likely to feel a stronger sense of engagement. This has certainly been true at Tampa General, where we have unofficially been practicing tenets of AKTiVe for several years and have seen our team member engagement scores (as measured by a third-party vendor) rise from the 40th percentile to the 87th percentile.

In addition to the three steps I have suggested, there are countless other ways we can and must address the state of physicians in healthcare. At the end of the day, it is high time that we, as a society, recognize the vital role physicians play and show them the respect and reverence they deserve. Our health and well-being depend on it.

John Couris is president and CEO of Florida Health Sciences Center/Tampa General Hospital. You can engage with him on LinkedIn here.

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