Pandemic Pivot: Strengthening Physician Wellbeing and Retention

We all are aware of the stress and challenges that the COVID-19 pandemic has had on healthcare workers and patients. For many healthcare workers, a response to these challenges has been to exit medicine entirely, reduce their hours, or take on administrative roles.

A new study by the American Medical Association (AMA) shows that 1 in 5 physicians and 2 in 5 nurses intend to leave their current practice within two years. The same study shows that approximately 1 in 3 physicians, APPs, and nurses intend to reduce their work hours.?

We are also seeing the effect the pandemic is having on medical students and their future.

A new report, “Clinician of the Future: Education Edition,” which was released by the health science and journal publisher Elsevier, surveyed 2,212 students from 91 countries between April and May of this year on how medical students view the future of their careers. It found that 1 in 4 aspiring physicians in the U.S. say they are considering quitting their studies, with many expressing concerns about their mental health and how they can find a study-life balance.

Among the surveyed medical students, 60 percent said they were concerned about their mental health, 69 percent said they were concerned about their income, 63 percent expressed concerns about experiencing burnout, and 60 percent were worried about how clinician shortages would affect them.

In addition to burnout, many employees don’t feel support from their employers.

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The Physician Workforce is Shrinking: Here’s Why You Should Be Worried.

The cumulative cost of turnover and reduced clinical hours due to physician burnout in the U.S. is estimated at $4.6 billion annually. The loss of physicians will have a tremendous impact on patient access and patient outcomes, especially in rural areas.

According to a Beckers Health Review report, there were 72 department closures or services ending in a number of healthcare organizations to shore up finances, focus on more in-demand services, or address staffing shortages.

One of Massachusetts’ largest healthcare systems, Mass General Brigham, says some of its Boston-based primary care practices have limited spots for new patients due to a shortage of primary care physicians to serve them.

Organizations like The Massachusetts Medical Society and The American College of Radiology are sounding the alarm. ACR is urging Congress to address “worsening” physician shortages in the U.S.

ACR recently voiced its concerns to the House Committee on Ways and Means, which is exploring how to improve access in rural and underserved areas. The college pointed to a report from the Association of American Medical Colleges, estimating that the country could see a shortfall of “other specialties” (including radiology) as high as 35,600 by 2034.

ACR Executive VP Cynthia R. Moran said in comments submitted to Ways & Means leaders on Oct. 4, “Physicians are a vital component of our nation’s healthcare infrastructure, and we have seen firsthand the worsening shortage of healthcare providers surrounding the impact of the COVID-19 pandemic. A large portion of the physician workforce is also nearing traditional retirement age, which will soon contribute to the magnitude of national workforce shortages.”

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What Physicians Are Saying

As an executive coach for physicians, I am seeing and hearing from physicians who express the following:

??I can’t take this anymore.

??It’s not sustainable.

??I don’t feel valued.

??I’m not being heard.

??I’m exhausted.

They are ready to leave; if not at that moment, often the wheels are already in motion for it to take place sooner than later. Some are at a crossroads and are weighing their options. Some want to change the system that is failing them and provide better outcomes for their patients.

When I coach them during this period of exploration, their decision or thought process about leaving is for several reasons:

?They lost the joy of medicine.

?The workload is not sustainable.

?There is a lack of work-life balance.

?The compensation is poor and/or there is no additional pay for hours worked above and beyond.

?They want to have time off and not feel like they’re paying for it once they come back.

?There is a lack of flexibility. Sick days, time to care for family members, and personal obligations often take a back seat.

?It’s time for a change- They have ridden the wave for as long as they could and need a new challenge.

So, first, we get clear about the reason for leaving and make sure it’s not a knee-jerk reaction to being fed up.

Then, we explore the what-ifs and what’s available. Then, we look at the feasibility of the transition.

?Sometimes, the answer is to stay.

?Sometimes, it’s to add a bit of excitement to their current situation.

?Sometimes, it’s to move into a leadership role to help their fellow colleagues and try to influence others to help and create change.

?Sometimes, it’s having a plan to ask for what they need and want.

?Sometimes, it's coaching them around strategies to improve workflow, the patient experience and manage expectations.

?Sometimes, it’s to leave- I don’t make them feel guilty, judge, or influence their decision. It is their decision to make.

The physician workforce is shrinking.

It is no longer just talk, an assumption, or speculation. There are tens of thousands of physicians actively looking for alternate careers.

?We can’t turn a blind eye.

?We can’t say it’s just a few.

?We can’t make physicians feel guilty about their feelings or choices because they can no longer sustain the current work environment.

?We can’t believe that physicians are replaceable because that’s not a long-term or safe strategy.

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Most physicians don’t want to leave; they feel like they have no choice.

Think about it.

Who wants to leave a profession where they’re deep in debt and have spent their young formative years training and sacrificing themselves?

How to Make Employees Feel Valued

It’s no surprise that healthcare workers who feel valued are less likely to leave their place of employment.

In order to address employee retention and satisfaction in the healthcare setting, here are some methods to consider:

Leaders need to be A.W.A.R.E

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A- ask the right questions and don’t assume you know why. Ask for feedback from your employees and then act on it.

W- witness what’s really going on and join them in the spaces they work. Have you ever followed in the footsteps of a physician? Spend a day with them on the front lines. This will help remove barriers that create roadblocks to productivity.

A-attentive – Adopt active listening, look at numbers, and forecast. Pay attention to your employees for the hard work they are doing and celebrate them.

R- retention strategies – Develop the right retention strategies. Not just the ones that put a band-aid on the situation. Performance pay, hazard pay, healthy work-life balance, professional development opportunities, leadership development, investing in diversity and equity, and promotions from within and not outside are all strategies to consider.

E- empathy - put yourself in the shoes of those working on the frontlines. Imagine what it’s like not to have a lunch break, to treat a bathroom break like it’s a golden ticket for a reprieve, not to have any say about your schedule, to have to negotiate time off for your own health, not to receive fair compensation, to routinely witness life and death situations and have no place to debrief or anyone to talk to about it, to have your concerns minimized and trivialized.

Why One Pediatrician is Grateful for Her Organization’s Support and Response to the Pandemic.

Dr. Randi B. Nelson, MD, MBA, FAAP , a board-certified pediatrician who worked through the pandemic, shares with me in our recent podcast interview about how her organization was able to pivot quickly, and she did not have to deal with a change or decrease in her compensation. She stated that they were supportive during this time.

I can only imagine that this made all the difference in the world to Dr. Randi and speaks to her continued commitment to her role as a pediatrician working for the underserved. She is also now able to pour her passion into other projects that continue to fuel her journey toward preventive health for children. She is preparing for a medical mission trip to the Gambia to continue her journey toward healing the most vulnerable population: our children.

A Shrinking Healthcare Workforce Creates Disastrous Results.

From lack of access to rising maternal mortality rates and poor outcomes due to qualified health professionals to fill the gaps, this imbalance of demand and supply will ultimately lead to more adverse outcomes and complications.

A successful strategy to recruit, onboard, and retain employees is to treat them with respect and dignity, to create a safe working environment, and to have them stay engaged and passionate about their work. They want to see themselves as part of the solution.

Meaning and purpose create happiness, inspire creativity, and drive collaboration.

Dr. Lisa Herbert is the Founder and CEO of Just The Right Balance LLC. Impacting the world through global healthcare leadership is the next journey for Dr. Herbert, whose mission is to help increase the number of diverse physicians in leadership roles by equipping them with the personal and professional development skills they need to succeed. A diverse leadership workforce creates the pipeline for future leaders and improves the delivery of care to the communities they serve here and abroad.

If you’re ready to take the steps to stop the great resignation happening across healthcare and in your institution, schedule your complimentary organizational consult here. Together, we can help you get clear on a strategy to build, support, and retain physician leaders.

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