Beating Burnout

Burnout contributes to increase employee turnover, reduced productivity, and most importantly, reduced patient satisfaction. Proactive management to reduce rates of burnout is critical for every office.

By Lucas Briggs, PT, DPT, CSCS

Burnout comes in all shapes and sizes, but it’s never pretty. The Merriam-Webster dictionary defines it as an exhaustion of physical or emotional strength or motivation secondary to prolonged stress or frustration. In the health care workplace, decreasing reimbursement rates from insurance companies for our rehabilitation services, increasing demands for accreditation and documentation, and rampant changes to health care, can easily result in prolonged, overwhelming job-related stress which, left unchecked, may end in burnout. This burnout, in turn, contributes to reduced patient satisfaction,¹ mental and physical illness, higher rates of staff turnover, and reduced productivity; in other words, it’s bad news for everyone.

So how can we combat it? With health care evolving so quickly, there is a lot to be said about being adaptable and handling change well. We need to discuss how to prevent and recover from burnout by maximizing engagement, creating a supportive culture with clear communication and feedback, and exercising good health practices.

Great teammates support each other and focus on utilizing one another’s strengths. They know their own strengths and those of their counterparts, and spend the majority of their workday doing tasks that they are good at. For example, I hate being on the phone and will spend 15 minutes working myself up before I call someone. A therapist in my clinic can’t stand math and will spend 15 minutes trying to compute a g-code that would take me 30 seconds to do. So we trade phone calls for g-codes, and we’re both happier and much more productive. This is a small example of utilizing strengths, but even this small exchange of service creates valuable social capital between teammates, not to mention the time saved and aggravation avoided.

Building social capital is crucial for the well-being of your team, retention of good employees, and prevention of burnout. Simple things go such a long way: taking lunches or breaks at the same time, holding staff parties, celebrating birthdays or other special events, taking the time to get to know each other personally. Social capital gives you a reserve to draw from when things get hard, and helps promote a kind of honesty that produces better decision making and problem solving. Real friendships can be formed in an office where people can both be honest and feel accepted. Individuals who report that they have a best friend at work are more likely to be engaged in what they do and less likely to want to leave their job.

Clear communication with regular and honest feedback is another vital component to preventing burnout. If you’re looking for a great way to lose a new employee, make sure that you don’t communicate your expectations clearly, and let promises made during the interview process fade as things get busy. Obviously, if you want to retain a new and highly talented employee that you spent weeks searching for, interviewing, and checking their social media pages and references, you want to set clear expectations and make time to keep your promises.

A good job can be a lot like a marriage: Open and honest communication can cover a multitude of sins, but it can’t all be negative. John Gottman’s pioneering research² on marriage suggests that a 5:1 ratio of positive to negative interactions is optimal, and that things can spiral down toward divorce when the ratio gets close to 1:1. Interestingly, it can be too heavily tipped to the positive side; Gottman found a negative effect when the ratio was as high as 13:1, indicating perhaps that a bit of challenge is important in a healthy relationship.

It’s important to provide regular and honest feedback to your staff, including recognizing the things they are doing well regularly, along with areas of needed improvement.

Providing criticism in a constructive manner makes a big difference as well. Don’t just tell someone what they’re doing wrong. Give them suggestions for ways to improve so they feel empowered to make positive changes.

Finally, as a whole staff, practice what you preach; establish a culture of good health in your clinic starting with your positive example. Demonstrate the importance of a good work-life balance by living it and talking about it. Encourage your team to exercise regularly, doing an activity that they love. Promote good food choices by keeping healthy snacks around. Free your team up to evaluate each other and keep one another accountable for performing their preventative exercise routines on a regular basis. Not only will practicing good health habits be great for the general happiness of your team, it will also take care of a lot of that wily cognitive dissonance that you’ll deal with if you’re not taking care of yourself as a health professional.

From a psychological health standpoint, promote self-awareness for your staff. Improving self-rated emotional intelligence was shown to reduce rates of burnout and improve patient satisfaction.³ I found it quite helpful for my team to take and discuss both the StrengthsFinder 2.0 and the Myers-Briggs inventory to promote understanding of ourselves, one another, and our clients. Last but not least, encourage your staff to take a mindfulness course and make it a practice in your office. A mindfulness-based stress reduction (MSBR)⁴ course will give your clinicians some great tools for your patients, and it has been shown to reduce burnout and increase job satisfaction in health care professionals.

Work stress can be overwhelming as budgets get tighter and changes continue to come around every corner. With great social support, open communication, and healthy habits, we can beat burnout and flourish, despite the odds stacking up against us.

References

1. Vahey DC, Aiken LH, Sloane DM, Clarke SP, Vargas D. Nurse burnout and patient satisfaction. Med Care. 2004;42(2 Suppl):II57-II66. doi:10.1097/01.mlr.0000109126.50398.5a.

2. John Gottman’s pioneering research: Gottman J. Why Marriages Succeed or Fail . . . and How You Can Make Yours Last. New York: Fireside; 1994.

3. Weng HC, Hung CM, Liu YT, Cheng YJ, Yen CY, Chang CC, Huang CK. Associations between emotional intelligence and doctor burnout, job satisfaction and patient satisfaction. Med Educ. 2011;45:835-842. doi:10.1111/j.1365-2923.2011.03985.x.

4. Goodman M, Schorling J. A mindfulness course decreases burnout and improves well-being among healthcare providers. Int J Psychiat Med. 2012;43(2):119-128.

Lucas Briggs, PT, DPT, CSCS, is a Private Practice Member (PPS) member and clinical director at South Sound Physical Therapy in Tacoma, Washington. He can be contacted at Lucas.Briggs@irgpt.com.