154. How Can These 2 Leadership Power Questions Effectively Prevent Physician Burnout?

In this episode, I'll show you two power questions that can safeguard the health and well-being of your colleagues on the front lines — especially if you're a senior physician leader who finds themselves the only doctor in the room regularly in the course of your leadership role.

When you became a leader, I know you didn’t go over to the dark side. You're not Darth Vader. These two questions allow you to continue to safeguard the health and well-being of your people from your leadership position — in a way that calls the administrative side of the house to task for physician wellness every time you say one of these questions.

Check them out. Add them to your wellness leadership toolkit and get ready to use them early and often.

Dr. Dike Drummond here from our home in beautiful Seattle, Washington, with the latest edition of the Stop Physician Burnout podcast. Thanks so much for taking some time out of what I know is your busy whirlwind of a day to give me 10 minutes of your attention for a very, very important topic.

Today, let me share with you something I’ve learned from my own personal experience to be the most effective pair of questions to make sure that you — as the physician in the room — are always keeping track of the health and well-being of the workers on the front lines. The doctors. The nurses. Anybody who touches patients.

ve got to go back to the year: 2008

The brainiacs at the think tank of the IHI looked at the fact that the USA spends way more than any other country per capita on our healthcare system — I'm using my air quotes here, “system” — and we don’t get much in return. We have the worst population health of any first-world nation. Healthcare disparities are nationwide, with huge differences between various zip codes and states. And the patient experience and the quality of the care they receive is in no way uniform across the nation.

So what they developed was an urge, a drive, a recommendation that people focus on just three things. The healthcare industry needs to focus on three things. Guess what they are? Cost, quality, and population health.

And the IHI preached this continuously for years, saying we need to focus on cost and quality and population health — and that’s what’s going to fix American healthcare.

Watch out what you focus on. Because remember, there are human beings running the system. In fact, what happened was the single-minded focus on cost, quality, and the patient experience led to increasing levels of burnout in the providers of care — the doctors, nurses, everybody who touches patients in the course of their work week.

So in: 2014

What was the fourth aim? Well, you can’t focus on cost, quality, and the patient experience without also simultaneously focusing on the health and well-being of the workers providing the care. If you don’t hold that as an equal principle, the first three will destroy the fourth.

As a physician leader in a healthcare delivery organization, we are the watchdogs — the early warning sign of challenges to the health and well-being of the physicians and staff that offer care to our patients every day.

So let me give you some questions that you can ask — especially if you're in senior leader meetings where you're the only doctor in the room. This is an especially important place for you to stand up for the health and well-being of our people and your colleagues on the front lines.

Question Number One is the most common one. You’ll use it maybe every day, depending on what level of the organization you’re in. What it does is back-check the organization, so it does not make decisions without ensuring that decision preserves the well-being of the people providing care.

It works very easily. Before any decision is made and finalized — the last (and unfortunately, it usually does end up being the last) consideration will be your question, which goes like this:

“What effect will this decision have on the health and well-being of our people?”

And if you need to, point out the difference between the Triple and the Quadruple Aim. Also, you might mention that if we improve cost or quality or population health, but we sacrifice the health and well-being of our people, we can see right away it’s going to put more stress on our people, make burnout worse — and we’ve shot ourselves in the foot and violated the Quadruple Aim.

Since you’ll be asking this question repeatedly over the years of your leadership role, get used to the fact that somebody eventually is going to say:

“Oh, you’re such a pain. Why did we let you in this group in the first place?”

Well, you’re there to be a watchdog. To make sure they aren’t sacrificing the health of the miners to the profit of the mine. Physicians and nurses and their burnout rates are the canaries in the coal mine of medicine.

If it turns out that this decision will have a negative effect on the health and well-being of your people — that it does add action steps and stress to their workday — the next question is very simple:

“How can we engineer this negative effect on well-being out of this decision?”

How can we do things in a new way that doesn’t add to their already overwhelming workload?

Remember, burnout rates are about 50% in all doctors and all nurses, everywhere, on every shift. This is not a trivial consideration.

Now, Question Number Two is a more global question. It tests the organization for its willingness to actually have a wellness strategy.

It’s a question that I’ve asked every CEO, every CMO, that I’ve ever talked to who’s called me about physician wellness. I’ve talked to hundreds of CEOs and CMOs.

The first thing I ask them when they call me and say, “Dike, we want to help prevent burnout. What should we do?” — is I do this check question. It gives me a basic idea of their values with regard to the wellness of the workers.

Here’s the question — ready?

“What role do you believe the health and well-being of your people plays in the quantity and quality of care that they provide?”

Let me say that again:

“What role do you believe the health and well-being of your people plays in the quantity and quality of care that they provide?”

Now, oftentimes I’ll get, “Well, of course it’s important,” or something like that.

Then I ask a follow-up question. Here’s the follow-on:

“What is your proactive strategy to optimize the health and well-being of your people?”

And that’s when all I get is:

“Oh, well, we’re working on something…”

And that’s when you realize — they’re not working on anything.

If you believe that the health and well-being of your people is critical to the quantity and quality of care that they provide — yet you have no proactive burnout prevention or wellness strategy — everybody can see you don’t walk your talk.

Your reputation will suffer. Your people will suffer needlessly. And your day-to-day operation of your organization will be a struggle.

And I’m telling you why right here: You don’t respect the health and well-being of your people enough to do anything to optimize it.

________________________________________

We’re almost done for today. Let’s go over those two questions one more time:

Question Number One — in the routine day-to-day decision-making of the organization, your question before anybody votes is:

“What effect will this decision have on the health and well-being of our people?”

And if there’s clearly an additive effect to their stress levels:

“How can we engineer out this negative effect on well-being before we make this decision?”

And — are you willing to kibosh the decision if we can’t do it without increasing the stress on the people?

Question Number Two:

“What role do you believe the health and well-being of our people plays in the quantity and quality of the care that they provide?”

And if the person answering the question is supportive of well-being, the next question is:

“What is your proactive strategy to optimize the health and well-being of our people right now?”

If you think wellness plays an important role in the performance of the organization, you must have a proactive, comprehensive strategy to optimize the health and well-being of your people — in action — every single day.

My experience in asking these questions hundreds of times to senior leaders is this:

None to date has denied that there’s a role to be played in the performance of the organization by the health and well-being of the people who touch the patients today. But only once or twice has anybody had an actual strategy to optimize that health and well-being. And none of them measured its effectiveness.

The state of proactive wellness leadership — at least in U.S. healthcare — is abysmal.

I encourage you to grab a discovery session. I’ve got the link in the show notes if you’d like to talk about what a proactive wellness strategy would look like in your organization.

That’s it for now. Until we’re together again — keep breathing. Have a great rest of your week.