18 May Turning the lever down on burnout and turning up resilience, well-being and joy (Part 3)
The cost of physician burnout and why it’s urgent to find solutions
In a Harvard Business Review article, Eric Garton highlights that burnout signals a problem with the organization, not the person. In healthcare, leaders need a systemic approach to understand the joys and hassles of practicing medicine within their organization to best understand contributing factors and associated solutions for physician and nurse burnout.
The National Taskforce for Humanity in Healthcare (NTH) has identified the cost of burnout related to physician and nurse turnover. The taskforce also points out the need to address the problem at the organizational level – without placing blame on individuals.
“It’s important for organizations to have open conversations about the cost of burnout on patient and provider experience, and the toll burnout takes on their ability of provide services safely and efficiently,” says Jennifer Krippner, NTH member and Chief Experience Officer at IHE.
The taskforce report points out that beyond the psychological and physical problems of burned-out physicians and nurses, the costs of providing services can be far greater when you look at low productivity, high turnover, loss of talent, and lower quality.
Thirty-three percent of new RNs seek another job within a year of employment. Fifty percent of physicians have symptoms of burnout, and the turnover rate for burned-out physicians is 21 percent. Replacing and onboarding one physician costs more than $1 million. Extended to include the population of 954,000 U.S. doctors, the cost of burnout-related turnover is 17 billion.
For nurses, the burnout-related turnover cost for hospital-based nurses is estimated at $9 billion. Extrapolating to all 2.9 million nurses in the U.S., the total cost of nurse turnover in the U.S. is $14 billion.
“The loss in productivity, turnover and replacement cost is not only a gap in revenue, but a limitation on what we could be investing in improving the patient-family experience, and in helping care team members reach their highest healing potential,” says Liz Boehm, NTH member and Director of Research for the Experience Innovation Network.
“Any of that would be more productive than simply churning through physicians and nurses. It’s difficult to achieve culture transformation in healthcare if we’re in this mode,” says Boehm.
Boehm points out that, in healthcare, “you have people who are dedicated, smart, knowledgeable, and want to help others heal — and a system that chews them up. We’re not getting the full benefit of the healing and we’re burning through resources.”
Considering that every person is touched by healthcare in some shape or form during their life, the ripple effects through our economy cannot be overestimated.
“Right now we have a healthcare system that systematically breaks nurses, physicians and other care team members,” Boehm says. “We need to change the system – not just the individuals – in order to give Americans the healing they need and strengthen everything else in our society.”
There’s a cost that is not widely talked about. The suicide rate of physicians is twice that of the general population, and many physicians fear seeking help over licensing issues and other punitive actions.
“The question becomes, how do we support the medical profession in a fundamentally different way? How do we detox the system and provide the tools and leadership our medical professionals need to make things better for all of us?”
In this article series, we’ve looked at the cost of burnout-related turnover, solutions to burnout from an organizational perspective, and solutions from an individual viewpoint. Members of the NTH are looking at burnout and well-being from a new angle necessary to address urgent, system-wide problems. Its members propose a three-pronged approach:
- Change the dialog around burnout from one that sees burnout as a personal psychological failing to acknowledgement of a system in distress. Through this reframing, shift the aim from burnout prevention to creation of a system that supports resilience, well-being, and joy.
- Adopt a metric for humanity that focuses less on deficit measurement (burnout), and more on understanding the causes and consequences of emotional thriving and emotional resilience.
- Create a blueprint for change that supports a systematic shift in culture towards a human-centered care system. Change must occur at all levels within organizations and cascade across all decisions related to people, processes, and technology.