The Surgeon General wants to address toxic workplaces. Healthcare could be a place to start

When Surgeon General Dr. Vivek Murthy issued a report last week on unhealthy workplaces , he wasn’t singling out the healthcare industry in particular. And yet for healthcare professionals, the past few years have been Exhibit A for how an unhealthy workplace can contribute to mental health issues, with scores of frontline workers struggling with anxiety, depression and post-traumatic stress disorder.

Murthy’s Framework for Mental Health & Well-Being in the Workplace is a response to larger cultural shifts that have been occurring in the post-pandemic era, namely trends such as “quiet quitting” – where employees put in the bare minimum and reject hustle culture – and the Great Resignation.

But healthcare’s Great Resignation has meant the exodus of more than 334,000 clinicians , including 117,000 physicians, at a time when health systems are already struggling to fill positions. LinkedIn’s own data has shown a spike in the number of clinicians who made job transitions last year compared to 2019. (We defined a job transition as taking an entirely new role, not just joining a new employer.)?

Here are the core components that the Surgeon General identified as key to a healthy workplace:

• Protection from harm
• Connection and community
• Work-life harmony
• Mattering at work
• Opportunity for growth

Those were some of the same indicators that researchers looked at earlier this year for a study published in the journal Critical Care Nurse – when they found that working conditions for nurses have deteriorated significantly . More nurses say that their safety is not taken seriously. And they don’t feel like they matter: Less than 20% of nurses surveyed reported “good” or “excellent” communication with administrators, and less than 50% could say the same about their frontline nurse managers.

Rather than intending to stay and grow with their organization, two-thirds said they’re planning to leave their position in the next three years.

I’ve written before about how many clinicians view “burnout” as an inadequate term for what they’ve been going through. Instead, they’ve been struggling with the types of mental health conditions that the Surgeon General is highlighting. And yet there’s a strong stigma around seeking support for mental health concerns, not least of which is related to fears that having a mental health condition could impact their licenses .

Here’s my question: Are there ways to determine whether a workplace is a toxic environment before accepting a job? I may feature some of the responses in an upcoming edition of Path to Recovery. Tell me in the comments below.

Interestingly, Walgreens this week said it would do away with task-based performance metrics for pharmacists, which would allow them to practice at the top of their license, while also increasing pay. The talent war for pharmacists – who made more job transitions than any other group LinkedIn looked at – was one of the key themes that came out of our report earlier this year.?

Below, I chat with Dana Udall, Ph.D. , chief clinical officer at Headspace Health – and a psychologist herself – on what the Surgeon General’s report means for clinicians and how Headspace is addressing its own employees’ mental health. Telehealth platforms have been competing head-to-head with traditional healthcare for clinicians, dangling incentives like higher pay, more flexibility and opportunities for growth.?And clinicians are taking the bait .

The transcript below has been lightly edited for length and clarity.

LinkedIn News: How would you define a toxic work environment in healthcare?

Udall: A toxic environment is one in which the mental health needs of staff are not taken into consideration. It might mean that they are expected to see too many clients, that they don't have the support when it comes to case consultation or managerial support, that they don’t have opportunities for learning and development, and that they are highly isolated. A lot of the toxicity is the sense of I'm dealing with this intense clinical situation, I’m by myself, and I don't know where to go.

LinkedIn News: How does working in a toxic environment impact clinicians?

Udall: What we know is that it can lead to higher levels of stress over time. It can lead to compassion fatigue, it can lead to vicarious trauma, and even be associated with burnout over time.?

It’s incumbent upon all of us to have really good self-care rituals. That might mean maintaining certain boundaries around work times, that there are certain times of the day that we need to be with our families, or that we cannot be at work. It might mean getting regular exercise, focusing on sleep and nutrition. It might be engaging in a daily meditation practice. At Headspace, we start many of our meetings with meditation; we encourage our managers as well as our clinicians to meditate on a regular basis.??

But what’s also important is that we’re not putting the onus on the care providers, that we’re not saying, it is your responsibility to solve this. We also have to look very broadly at the workplace environment: What are we doing? Are we supporting mental health? Are we giving people autonomy and flexibility and opportunities for self-care on a regular basis?

LinkedIn News: If you’re a clinician who’s working in an environment where you’re running from patient to patient with little downtime, how do you carve out that time for self-care?

Udall: It’s amazing that you don’t necessarily need that much time to feel the impact. We think of things like micro-breaks which literally might be only a few seconds or ideally a few minutes, in which, for example, people are doing breathing [exercises]. That ability to calm down and center and regulate the nervous system can be profound. What it means is that healthcare professionals are probably going to be better in terms of their patient care, and they’re going to leave at the end of the day likely feeling not as exhausted or as spent.?

LinkedIn News: You talked about what a company like Headspace has been doing, but what about hospitals and other healthcare employers?

Udall: I think hospitals and healthcare systems have to take this very seriously. In our research, we found that 53% of those who were in the healthcare and pharmaceutical industries said that they had had high or extreme stress in the last year. We know these are industries that are really tough to work in.?

It’s important that healthcare organizations are regularly surveying their people and understanding the rates of burnout. One of the things we regularly do at Headspace Health is survey our coaches, our therapists and our psychiatrists to understand how they’re doing. That’s important because it allows us to see what changes over time. We’ve rolled out some initiatives that have really made a difference. For example, we’ve specialized some of our roles. We’ve created a more narrow scope that has helped people feel as though they’re able to succeed, and they don't have to do so many tasks.

We’ve also reduced our care contribution targets for our therapists. We got feedback that doing therapy through Zoom, for example, is pretty draining, so we took those [targets] down in response to the feedback we were getting.

LinkedIn News: Is there anything else that stood out to you from the Surgeon General’s report?

Udall: This is a big one, and it’s also something that healthcare systems need to take seriously. It’s about how staff are organized. At Headspace Health, for example, we have a pod system. Each pod has its own manager. Many of them have their own logo, their own song, their own name. This is a really connected group of people, so they come to each other for case consultation support, learning, growth and just fun. Those opportunities to bring people together and offer connection are incredibly important. And there’s a lot of research to suggest that that can help decrease levels of burnout if people are really feeling connected and supported in their workplace. And [conversely], one of the things that we have found is that when people don’t feel like they know who to go to for an answer, that can increase levels of stress and be correlated with burnout.?