The healthcare story we still need to get right

"Healthcare workers are quitting in droves because they are burned out." That's the convenient story. But is it the right one? 

That's the question on my mind daily as the Becker's team covers the healthcare workforce on a local, state and national level. I speak with physicians who are dead tired and frustrated (usually to a degree that demands a new word besides "frustrated").

The next day, survey results based on 1,170 responses cross my desk, showing only 23 percent of healthcare workers anticipate leaving the field in the near future ⁠— and 80 percent report being somewhat or very satisfied with their jobs. 

This is just one example of personal experiences conflicting with data, which is hardly uncommon. A lot of rich, valuable stories are born from this disconnect, in fact. One side doesn't necessarily cancel the other out. 

But if the pandemic has taught me anything, it's that many people struggle to hold two or more things true at once. Without more extensive research and responsible reporting, one side of the story about what is happening to the healthcare workforce may dominate — and the opportunity to better understand and repair may be missed. We like to oversimplify, to package things up neat and tidy, to think we've reached the bottom line. 

Our healthcare workers deserve more than that. 

Here are a few things that seem to be playing out at the same time: We have a lot to learn about patient safety throughout the pandemic, but early data does not look good. Few healthcare workers are getting significant pay raises. There are front-line workers who don't even know what hospital CEOs do. No medical specialty is immune to burnout, with even a third of dermatologists reporting fatigue. Violence, threats and incivility are on the rise against healthcare workers, with systems taking out ads pleading for people to be kind and states working to elevate offenses to felony status. There are more dynamics unfolding daily in many hospitals and health systems throughout the U.S. that may not make national headlines, but are worthy of exploration. 

Some institutions are taking action to better understand the root causes of healthcare's staffing fragility. This week, the University of Pittsburgh School of Social Work rolled out the city's largest survey of hospital workers conducted to learn why they are quitting.

"Hospital workers are burned out, forced to care for increasingly sick patients with less support and fewer staff, while managing crisis after crisis," Jeffrey Shook, associate professor of social work at the university, shared in a statement. "The survey will investigate the working conditions in Pittsburgh hospitals and, we hope, provide the mayor, city leadership and the public with an understanding of what Pittsburgh's hospital workers face and what can be done about it."

This is good news for Pittsburgh. Will we see more studies like this in more cities? Can governmental agencies, medical associations and higher education institutions look more closely in their own backyards to help? I hope so. We seem to be at a crossroads where market-level research is needed, and 1,170-respondent national surveys like the aforementioned are too vague to drive change. 

Can we also use some rigor in how we talk about healthcare workers' experiences today? Burnout doesn't cut it anymore. The term, coined in 1974, surely served a purpose. But now it reminds me of a friend who once labeled every less-than-great emotion as that of feeling "tired." The acuity ranged from slightly dehydrated to severely depressed. Something similar is unfolding in healthcare, where we overuse the term "burnout" to convey a lot of different information, contributing to an apples-oranges effect that can stall the isolation of root causes and effective problem-solving. Every use of burnout should be followed with a request: "Tell me more about that." 

A motto in journalism is: "If your mother says she loves you, go check it out." Verify everything, especially the stories that seem too simple to be true. 

We need more to check out. We need stronger data, better surveying, greater curiosity and a larger challenge to the oversimplified assumption that "healthcare workers are quitting because they are so burned out." That idea got us from there to here. Now where do we go? How will we better understand the precise root causes of their fatigue in order to find solutions? 

Healthcare professionals devote their lives to diagnosing and solving problems. Let's do the same, this time for them, so they can continue their important work and feel seen, understood and validated.

Something's unfolding in healthcare, and we still need to get the whole story right. 

I look to readers in the field to share their ideas, thoughts, or suggestions. Please feel free to write me: mgamble@beckershealthcare.com



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