Leadership, Engagement, and Well Being

A Demanding Health System

A recent article by Simon G. Talbot, MD, a plastic and reconstructive surgeon at Brigham and Women’s Hospital in Boston, and Wendy Dean, MD, a psychiatrist in Carlisle, Penn., entitled “Physicians aren’t ‘burning out.’ They are suffering from moral injury,” shines profound truth on what we are experiencing today (Statnews.com. Published July 26, 2018.). They define “moral injury” as “a deep soul wound that pierces a person’s identity, sense of morality, and relationship to society,” and say that the moral injury of healthcare is being unable to provide high-quality care and healing in the context of healthcare.

Developing our own competency as a leader and having an organization focus on the competency of those who are in leadership positions is critical as we hope to not only survive but thrive in the face of the burnout epidemic.

Many of you probably practice in very large and complex health systems, whether in academic centers or hospitals. Even if you are in private practice, we all face similar challenges in the following areas: billing/coding/clinical documentation improvements, ever-increasing budget/RVU/productivity demands, joint commission readiness, EHR meaningful use/requirements, and all related daily demands (your epic inbox, results review, patient calls, medication orders, FMLA paperwork, DME orders….). Our reality as we approach “value-based care” will likely continue to mean that frontline physicians are under-resourced in FTEs and/or equipment to do our work and have inadequate time to communicate (with partners, nurses, advanced practitioners, patients, colleagues inside and outside of our institutions to optimize care for our patients, the physician and non-physician leaders we report to, those who report to us, our schedulers, and everyone whose existence impacts our “realm” and day-to-day experience). 

With so many continuous, constant, and often unannounced changes, there are countless reasons why a physician becomes disengaged, frustrated, angry, and inefficient, and feels constantly like a “victim” instead of the empowered healer we set out to be when we entered medical school. There is simply too much that is out of our individual control.

Our reality is why leadership and engagement are so critical for our individual and organizational well-being. If we individually are not well, then the organization will likely be neither well nor poised to deliver the safest and highest quality care nor the optimal patient “experience” that every organization is focusing on, Press Ganey or not. I’ve listed my core beliefs on leadership in “Leadership Principals”.

Explore your leadership, gain self-awareness, and embrace your leadership potential. I wish you an incredible leadership journey, but most importantly, you must believe in your own ability to heal yourself first and then all those around you. Today is a brand new day and anything is possible.