I was scrolling LinkedIn the other day and saw a post from a hospital CEO proudly touting the overused healthcare mantra that’s now the slogan for their marketing campaign: “We put patients first!”
While it’s well-intentioned, this tagline is destroying our healthcare system.
I cringed and considered commenting on his post, then I stopped myself and continued scrolling. Is it even possible to change someone’s mind with a social media comment anyway? But I haven’t been able to get it out of my head.
I want to ask this CEO: What about your staff?
- What’s the rate of employee and physician burnout?
- Are you fully staffed?
- How engaged are your team members?
- Do your providers feel like they’re on a hamster wheel?
- How many layers of administration and bureaucracy do you have between patients and decision-makers that affect their healthcare?
The “patients first” mantra amounts to no more than lip service in the healthcare industry.
A better term would be patient-centric which puts the patient at the center of the decision-making process but places an equal emphasis on employee well-being, profits, and operations, etc.
When you put patients first, by definition, other things have to come second, third, and so on. It’s a linear prioritization that isn’t helpful. It results in the well-being of employees getting neglected, falling somewhere behind profits for the healthcare organization and many other factors.
Healthcare systems are still primarily driven by the volume of patients and procedures they deliver, which is actually more of a “profit-first model of healthcare” and doesn’t consider the effects on patients or providers.
Patients can’t be “first” when our caregivers are in survival mode — burned out, short-staffed, disengaged, and squashed by the daily bureaucracy of the system.
We should focus on creating an environment where our employees and providers can thrive. From that place, patients will receive the best care.
If administrators really want to prioritize patient care and outcomes, they need to start by prioritizing their staff and providers.
It has moved beyond band-aid solutions. Healthcare organizations need a major redesign.
After 25 years working in healthcare, I’ve come to the conclusion that our system is not only broken — but cannot recover if left to its own devices. It’s time for a fundamental shift.
The current system is plagued by burnout, staffing shortages, growing bureaucracy, and employee disengagement as discussed below, along with questions for us to consider.
Burnout Has Become an Epidemic
The majority of doctors and healthcare providers went into medicine because they genuinely want to help people. They’re often willing to sacrifice their own well-being and work long hours to care for others. When they’re depleted enough times, there comes a point where there’s nothing left to give.
It’s estimated that 54.4% of doctors report some symptoms of burnout.(1) Burnout also affects other workers in the organization, whether it’s nurses, other practitioners, or administrators.
While healthcare systems try to respond to this burnout with minimal efforts such as mindfulness and wellness programs, very few are actually changing the system.
The average primary care visit with a doctor is still less than 20 minutes. Physicians and healthcare workers are on a treadmill driven solely by the number of visits and patients they can see in a day. They are often required to be “on-call” nights and weekends with very little actual downtime.
My family and I saw the effects of provider burnout firsthand. In 2020, my mom was diagnosed with stage 3 colon cancer. She was blessed with an amazing oncologist, Dr. Smith (not his real name), who made her feel important and gave her hope that she could overcome this disease. He supported our entire family through the process. After chemo, radiation, and surgery, my mom survived and is still cancer-free today.
Near the end of her treatment, Dr. Smith told us he was leaving medicine. He was burned out and exhausted. It was affecting his health and his family relationships. What a loss to the patients who would have benefitted from his knowledge and caring demeanor.
Lily Tomlin said it best: “The trouble with the rat race is that even if you win, you’re still a rat.”
There’s no winning today’s healthcare rat race. It’s time for change.
Question to consider: How can we design a system that prioritizes the well-being of our providers and team?
Healthcare Staffing Shortages Are a National Emergency
This is only made worse by extreme staffing shortages. In a letter sent in March to the House Energy and Commerce Committee, “the American Hospital Association called the workforce shortage hospitals were experiencing a ‘national emergency,’ projecting the overall shortage of nurses to reach 1.1 million by the end of the year. And it’s not just nurses: Professionals from medical lab workers to paramedics are in short supply.” (2)
“With fewer clinicians working in the field, practitioners are finding themselves responsible for a larger number of patients, fueling soaring burnout levels that experts say raise the risk of medical errors and, consequently, potential harm to Americans.” (4)
U.S. physicians are leaving the workforce in record numbers. According to the AMA, more than 3,272 physicians left the workforce between 2019 and 2021, even before the Omicron wave hit intensive care units. One in five physicians say it’s likely they will leave their current practice within two years.
Question to consider: how can we make healthcare a more desirable place to work and retain more of our caregivers?
Growing Bureaucracy in Healthcare
Our healthcare system is bloated and buckling under the bureaucracy. The ratio of doctors to other healthcare workers is now 1:16.
“Of those 16 workers, only 6 are involved in caring for patients, such as nurses and home health aids. The other 10 are purely administrative roles.”
Caregivers are being pushed farther away from the tables where decisions are made while the bureaucratic burden of preauthorization and electronic medical record system data entry and other control and management measures are rising.
How can we design a system that better engages our providers and frontline caregivers in the decision-making process?
Question to consider: Are there ways to create opportunities for remote work and leadership and management duties for those that have an interest and to reduce the top-heavy bloat in our organizations?
Employees Are Disengaged
Employee disengagement in the workplace is on the rise. This trend appeared before the pandemic and is only getting worse.
In a 2018 survey, Gallup found that:
- Barely 1/3 of employees were “fully engaged” in their work
- 53% were not engaged
- 13% were actively disengaged
In recent months, the term “quiet quitting” has become the buzzword for disengagement after the concept went viral on TikTok. Quiet quitting is when an employee only does the bare minimum at work to avoid getting fired, saving energy and focusing on outside interests and personal time. It goes beyond boundary setting and represents an emotional detachment from the job and the outcome. They may also be looking for another job.
According to Gallup in a September 2022 article, “quiet quitters” now makeup at least 50% of the U.S. workforce — probably more. Disengagement has become more common among managers, as well as remote Gen Z and younger millennials.
Question to consider: How can we more fully engage our existing staff? Are there ways to give them more “ownership” of the process and their impact?
Stop Saying “Patients First”
What can that CEO do instead of touting a flawed “patient-first model”?
Make Employee and Caregiver well-being a top priority. While this seems like a small change, it’s actually a major shift in culture and mindset. It’s asking difficult questions like, “how do we create an environment where our staff can thrive?” It adopts the underlying belief that a thriving staff will be able to provide better care to their patients.
In a recent Gallup poll, fewer than one in four U.S. employees feel strongly that their organization cares about their well-being!
Begin to have those discussions with your staff and caregivers to see where changes would make the biggest impact, then take action!
While this may seem radical to some, there are organizations already making this shift, including home healthcare leader, Buurtzorg, which is based in The Netherlands and has designed a highly-effective care delivery model.
Take a systems approach to improving organizational culture, reducing workload, and creating supportive environments for staff. Small tweaks aren’t enough. We need to look at the whole system and how we can improve it.
Identify and remove bureaucracy that hinders provider care, causes unnecessary caregiver stress, and doesn’t provide value to the employees or patients.
How many times per day are your caregivers pulling their hair out due to some cumbersome policy or workflow? It doesn’t have to be this way.
Begin to experiment and test new ways of working for your team. Do employees really have to work five days per week? Are there ways to give providers more flexibility? More input in the system?
Get curious and discuss possibilities with your team. Small-scale and time-bound experiments are a great way to try new things without too much disruption.
Begin to measure burnout, well-being, and employee engagement, create accountability for the leadership team, and take action to improve: There are many great tools out there. Find one that will work best for your organization, create a baseline, and actively work to improve your workplace culture. If your organization is already measuring some or all of these things, it’s time to set aims, take action, and create accountability for improving conditions.
It’s time to change how we work and create systems where people can share their talents and thrive.
Not sure where to start? Contact us for a free 30-minute consultation.
This article also appeared on Medium.com.
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