How to avoid being burned by staff burnout

A column about keeping your practice in good health

By — Posted March 21, 2011.

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Many workplaces, including medical practices, tried to accomplish more with less during the recent economic recession. Employees were laid off. Open positions went unfilled.

With a larger burden placed on the remaining employees, experts warn that steps are needed to reduce burnout -- if for no other reason than to reduce the risk of losing employees as more jobs become available in a recovering economy.

"If staff burn out, that's such a waste of money spent training these people who walk out the door," said Jessica Graves, operations manager at the Cincinnati Eye Institute, which has 56 physicians and 464 employees.

A survey released Jan. 17 by CareerBuilder, an online job search and recruitment company, found that 37% of the more than 240 health care employers surveyed expressed concern that top-performing staffers would leave the organization when the economy improves. In addition, 36% worried about staff burnout.

But burnout is not viewed as bad just because it leads employees to leave. Such staffers tend to make more mistakes and call in sick more often. Patients may be turned off when greeted by emotionally drained employees.

"When a patient walks into your medical facility, they can smell if your staffers are overwhelmed," said Susan Fletcher, PhD, a psychologist in Plano, Texas, who practices and consults on productivity-related issues.

Practices will need to find solutions for maintaining morale and preventing burnout that are effective for them, experts say, although several steps can be taken to figure out what those are.

The first step is to monitor how staff members handle their work. Staff burnout and engagement is a problem that never really goes away for any business, even when the economy is doing well. Monitoring can be carried out in regular one-on-one meetings or by periodically walking around the office and asking how things are going.

"You want to find out what is working and what is not," said Kristin Baird, RN, president and CEO of the Baird Group in Fort Atkinson, Wis.

People who run a practice should take the opportunity to ask staffers what motivates them. The answers may be surprising. For example, Gregory Buford, MD, a cosmetic plastic surgeon who works with two partner physicians and one locum tenens in Denver, regularly talks to his 15-member staff about what keeps them performing at their best. He discovered that they are less driven by a bonus structure than by time off. He tries to be more flexible with the hours needed in the office and makes sure that everyone takes the vacations they are due.

"Simply throwing money at this problem doesn't solve it," Dr. Buford said.

Adding staff may not be the solution, either. If staffers say the workload is a problem, maybe it can be allocated more equitably. An analysis of what a staffer is doing may reveal duties that can be dropped, or ways to better utilize available technology to relieve some of the pressure.

"There's always new ways of looking at old systems," Baird said. "Are there ways of distributing jobs that will better engage staff?"

Medical practices that have tried to address burnout among staff have found that some degree of autonomy, such as control over schedules, may help. For instance, Graves lets the technicians she supervises work out among themselves when they come in and leave for the day. The front desk staff needs to have set hours, but their shifts rotate.

"They have lives, too," Graves said. "If they get their 40 hours done, if the doctors are not complaining, if the patients are not complaining, I let them adjust their times as long as it works. I expect we are all grown-ups."

Many practices find that common courtesies and public acknowledgement can reduce burnout. For example, Graves said one of the most common requests she receives from staff is for a physician to say, "Thank you." Dr. Buford tries to make it clear to patients that he works in a team, and that his staffers play a significant role when patients have good outcomes.

"Doctors get a lot of praise when there is a great result. What I try to emphasize is that I did the surgery, but I'm not the only piece of the puzzle," Dr. Buford said.

Importance of physical well-being

Experts suggest that a practice emphasize self-care, for both staffers and physicians, to ensure that outside issues such as a poor diet and lack of physical activity are not contributing to burnout. Taking breaks, as appropriate, eating healthier and exercising should be encouraged. For example, the Cincinnati Eye Institute is in a building that hosts periodic short walks around the area, and employees are urged to participate.

"Physicians are so focused on the health of the people coming in the door that sometimes they forget to focus on the workers behind the desk," said Deborah Brown, PhD, a business coach and psychologist in Deerfield Beach, Fla.

Self-care is particularly important for physicians and others who lead the practice because burnout easily spreads from the top down.

"If a physician is burning out, his or her support staff may be experiencing very similar types of symptoms," said Gabriela Cora, MD, president of the Executive Health & Wealth Institute and managing partner of the Florida Neuroscience Center in Miami.

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