How an Indiana health system addressed physician burnout through culture transformation

Burnout among physicians remains a crucial factor affecting healthcare settings in the U.S. A joint study released in 2019 by the American Medical Association, Stanford (Calif.) University School of Medicine and the Rochester, Minn.-based Mayo Clinic found 43.9 percent of physicians in this country exhibited at least one symptom of burnout in 2017, and burnout remains significantly higher among physicians than other U.S. workers.

During an Oct. 20 webinar, sponsored by Cigna and hosted by Becker's Hospital Review, Catherine Dimou, MD, Midwest market medical executive for Cigna Health Care, moderated a panel of three experts about how Community Health Network, a nine-hospital health system based in Indianapolis, is addressing the issue. Panelists from Community Health Network were:

  • Kevin Coss, MD, chief wellness officer
  • Tricia Hern MD, vice president of improvement and physician leadership
  • Ann Ostrom, director of physician leadership and well-being

Here are five takeaways from the discussion.

1. Leadership buy-in is necessary. Community Health Network senior leaders supported resource work related to addressing physician burnout and knew the health system needed to address well-being, as well as leadership development, according to Dr. Hern. "They realized if we didn't do work in this area, we were going to be at risk for losing providers due to them deciding to exit the workforce, and we needed physicians engaged in the work of improving our organization," said Dr. Hern. "It's hard to have engaged physicians when they're feeling burnout." With leadership support, Community Health Network founded its Center for Physician Well-Being and Professional Development in 2017. The center aims to alleviate stress for providers, improve work-life integration, provide opportunities to develop physician leaders, and restore the joy of practice so physicians experience satisfaction.

2. Supporting physician well-being involves comprehensive organizational, cultural and systemic change, according to Dr. Coss. At Community Health Network, officials designed a well-being strategy around what is known as a career fulfillment model. Dr. Coss said the health system's model builds on the Stanford Professional Fulfillment Model by adding a physician leadership development component, in addition to three other domains of influence: exceptional practice experience, wellness culture and personal resilience. "By adding this leadership development program, we create great synergy with other domains," said Dr. Coss.

3. Physician burnout should be a strategic priority. Community Health System Network achieved this by identifying key stakeholders, including leaders in marketing, IT, informatics and its foundation, and educating them about physician burnout, said Dr. Coss. For example, stakeholders attended a dinner and keynote focused on increasing self-awareness of how to recognize burnout, as well as understanding how burnout affects physician professional and personal lives. Community Health Network also established a well-being advisory council of physicians to help set strategy, identify well-being gaps and host events.

4. Culture transformation requires physician engagement. For example, physician engagement was part of the work by Community Health Network's provider communication council. "We know every interaction with our physicians needs to be effective," Ms. Ostrom explained, so the council surveyed physicians, and found that email is their most relied upon information source and that their communication preference is email. The result was a provider newsletter produced each Wednesday at 7 a.m. (when most physicians read email), which she said is concise and easy to read on mobile devices.

5. Culture transformation also requires combatting isolation and providing educational opportunities. Community Health Network combined educational opportunities and interests with social events, according to panelists. This included regional social events organized and hosted by the network's well-being and advisory council, as well as a physician well-being retreat in 2019 focused on financial literacy. In-person events were canceled earlier this year due to COVID-19, and Community Health Network has moved to options like virtual affinity groups, virtual physician lounges and virtual focus groups. The health system also moved to virtual learning for its one-year Physician Leadership Academy, which provides formal training to physicians seeking to boost their leadership skills and opportunities.

To access the webinar, click here. To learn more about Cigna, click here.

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