Practitioner burnout and joy at the National Academy and in Integrative Practitioner
March 29, 2018
by John Weeks, Publisher/Editor of The Integrator Blog News and ReportsEditor’s note: This analysis article is not edited and the authors are solely responsible for the content. The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of Integrative Practitioner.Hospitals and medical delivery organizations are faddish. Waves of interest roll through the industry. Heart centers. Women’s health. Patient-centered care. Complementary and alternative medicine. Value-based medicine. Social determinants of health.These interests of the day are sometimes pushed up by policy, sometimes by marketplace. They come into high focus with intense, acute engagement - webinars, conferences, summits, websites and white papers. Then they subside - sometimes leaving change in their wake.Rising and rolling into acute focus over the last three years is the chronic condition of practitioner burnout. A March 17, 2018 article from leaders of the Institute for Healthcare Improvement (IHI) that focused on promoting “joy” in the practitioner workplace reported that 37% of newly licensed nurses and 60% of medical doctors are considering leaving their professions.Integrative Practitioner has tracked multiple recent initiatives meant to create, through this wave of interest, a sea change. And on April 11, Integrative Practitioner will host a webinar from Nancy Gahles, DC, CCH, MBSR to explore the topic from a practitioner’s perspective. Gahles will focus on “Burnout Syndrome.”Challenges in relieving burnout are complex. A recent Integrative Practitioner column documented the Hackensack Meridian Health delivery organization’s 8-pronged strategy to increase wellbeing and resilience in its workforce. The level of commitment in this Lori Knutson, RN-led Full Court Press for Practitioner Wellbeing is thus far rare for a medical organization – but may become more common.That such a multi-factorial approach is needed reflects how intractable is the problem. Systemic forces allied against practitioner happiness will be the subject of an April 26-27, 2018 National Academy of Medicine workshop. The event, open to the public via webinar, will be co-led by frequent Integrative Healthcare Symposium presenter Mary Jo Kreitzer, PhD, RN, FAAN. (I covered this on Integrative Practitioner covered the announcement of the unique initiative a year ago in NAM to tackle systemic issues damaging wellness in medicine.)The founding assumption for Kreitzer’s planning committee – with which I have had an opportunity to be involved along with Kreitzer, Adi Haramati, PhD, Elizabeth Goldblatt, PhD, MPA/HA and others - is that treating burnout as primarily an individual responsibility won’t create and sustain well-being. No amount of mindfulness training, breathing instruction, or onsite massage, acupuncture or fitness facilities will resolve the crisis.In their column, the IHI team argues that success rests in shifting the focus from diminishing burnout to enhancing practitioner joy. This positive psychology reframing at IHI began with the organization’s co-founder Donald Berwick, MD. The former administrator of the Center for Medicare and Medicaid System has publicly shared that integrative health leader Wayne Jonas, MD and other integrative leaders mentored him in this direction. If one’s goal is transforming the medical industry, better to focus on creating heath rather than merely on managing disease. Point your mission in an affirmative direction. From “relieving burnout” to “enhancing joy” fits in the new construct.The recent column from the IHI leaders argues that “focusing on burnout is not enough.” IHI has developed the IHI Framework for Improving Joy in Work. The work begins remedially with lessons on why joy in work is important. Then it suggests a 4-step process:
- Ask staff what matters to them.
- Identify impediments
- Make joy in work a shared responsibility
- Use improvement science to test approaches