What About Staff Burnout?

There has been significant buzz around the topic of Physician burn-out due to the upswing burden of administrative tasks. While I do not disagree with this issue, I must ask the question: How about the burn out of the providers office staff?

The ebb and flow of the medical office has changed dramatically over the last few years. Documenting in the paper chart has been modernized with electronic medical records, flow sheets and task lists. Phoning in prescriptions has been updated with escribing and medication reconciliation. Even having a receptionist answer the phone has been replaced with an automated service with the option to press one to schedule an appointment or press two to leave a message for the nurse. While all the updates have their benefits, these changes also have put a burden on the medical office staff.

When a change in daily operations is handed down to the office –  implementing a new EHR, collecting quality measure data – the providers are aware that these changes are going to take place, however it is typically the office and support staff that hit the ground running to make the necessary adjustments. The initial wave of these tsunami-like changes hit the staff first. There will be multiple behind the scenes brainstorming sessions with management, IT and other key support staff members. Working through each and every detail to create the most efficient workflow to be successful for the entire organization. You may find some providers participating in these brainstorming sessions, but not too many. Staff will usually work through all the glitches to present the providers with a final product, free of defect, so that they only feel a tiny ripple in the pond.

Most offices are going to try to protect their providers from too much stress, they will work through all the problems so that the provider can concentrate on seeing patients. After-all, I would rather the provider concentrate on patient care and the support staff handle daily operations issues.  Navigating the choppy waters of change is not something that a provider usually volunteers for, they have their support staff do it for them.

As a practice manager, constantly working through the changes that have been happening in healthcare can be a challenge. Managers are constantly asking support staff to change their workflow, collect more data for the endless amount of reporting or implement a new software program, in perpetual fear that if they ask their team to do just one more thing they are going to walk out the door. As a front-line staff member, your day to day routine is a never-ending trial and error session to find that perfect “lean” way to complete the task. Should we not be worrying that these team members are also feeling the burn?

The term “burnout” was identified 30 years ago to describe a state of fatigue and frustration among health and service workers arising from excessive demands on their resources. According to Maslach and Jackson, burnout syndrome has been most consistently described as a multidimensional process with 3 central constructs: emotional exhaustion (feeling emotionally drained and exhausted by one’s work), depersonalization (negative or very detached feelings toward clients or patients), and reduced personal accomplishment (evaluating oneself negatively and feeling unsatisfied with positive job performance and achievements). Common signs and symptoms of burnout in the work setting include a decrease in general efficiency, tardiness at meetings, increased absenteeism, high staff turnover, and low morale and job satisfaction.

Practice managers have to be trained in “crucial conversations” to be able to appropriately discuss unpleasant situations with unhappy staff. Staff is constantly needing reminders to “be nice to the patients”, “use your AIDET skills”.  Question: When did this become necessary that we actually need to remind people to be nice? Answer: When the everyday stress of the job left you too exhausted to care. It doesn’t have to be this way. Recognize the signs of burnout and help your team work through these issues. Focus on the positive and find ways to lift each other up. Sometimes the smallest gestures make the biggest difference in someone’s day.

With all the waves that are rolling in with Healthcare Reform and the push towards quality reporting it is the staff that are meeting behind the scenes, creating reports, data-mining and making changes to the current workflow to efficiently support the new needs of the office. Do not lose sight of those on your support staff. Focus on the positive and keep in mind that each change is for the good of our patients and the future of healthcare.

Source: Burnout: The Health Care Worker as Survivor, Craig Demmer, EdD