Organizational Strategies

Engage PCPs in leadership

“Engaging our PCPs in the leadership process. Instead of finding new ways to tell physicians what to do, [we] engage them, give them a spot at table, help us to navigate out of this mess. . . as a result we’ve seen improved morale and improved measures of physician burnout and wellness.”

--HCE/CMO

Unload physicians’ administrative duties

“We try to limit their (PCP) administrative work . . . so physicians can do what they do best-care for patients.”

--HCE

Measure and monitor

“Our organization measures physician burnout quarterly with the Mayo Clinic Well-Being tool¹ and reports results to administration. I have a coaching conversation with physicians who score poorly, and the physician group uses a process improvement approach [with group results]. This has taken burnout from 60% to 18%, just below what a standard worker is in a non-health care setting.”

--HCE/CMO

Address isolation

“. . . to address the loneliness and isolation we sponsor regular gatherings to replicate what happened in the doctor lounge of old, where physicians have the chance to talk and support each other. . . we have other sessions for doctors and nurses together . . . to enhance teamwork. . . ”

--HCE/CMO

Continuous learning opportunity approach

“I use the Just Culture construct², I learned it from this patient safety work. When I approach a physician with a professionalism issue, I talk about it as a learning event we discuss: ‘What was within your control and what was not? What was your behavioral piece?’ The system factors need to be owned by me, the CMO . . . This has done a lot to elevate the level of discourse here. We don’t blame, we examine what needs to change. The individual needs to own their behavioral piece, self-reflection is important, but we also need to make system changes to support professionalism. . . What can we learn from learning events, which are not necessarily mistakes? . . . Highly professional individuals have an interest in continuous learning and use self-reflection to learn from these opportunities.”

--HCE/CMO

Independent Strategies

Maximize control where possible

“I may be more proactive than some colleagues, but I take it upon myself to interview office staff. I enjoy the administrative component. I rearranged the schedule template so that I maintain the every 15-minute appointment requirement, but it flows in a manner that works for me. I’ve balanced the needs of administration, my wife and myself.”

--PCP

Switch from revenue-based to flat salary

“I had revenue-based compensation—a challenge, you think differently and, there are different pressures. The administrators say, you should take as much time as needed with patients, but on the other hand you should see 25 people [a day]. There was a salaried position available at another clinic in the organization, so I moved.”

--PCP

Decrease clinical time

“I felt defeated at the start of the day and my frustrations were making it hard to be professional. Decisions are made by those above me. The CMO doesn’t do much patient care so she doesn’t get it. I had to do something. I was burned out. . . I decreased my clinic time to two days, and found an outside administrative job and I do some teaching. . . I recognized what I could control and what I could not.”

--PCP