Are You a Clinician Exploring Well-being? Think Inside the Box!
A few years ago, I was leading the training workstream of a multi-million-dollar EMR implementation. The platform included 25 applications, from scheduling to revenue collection, and we trained over 17,500 employees in 12 weeks prior to go-live. A significant part of the training effort included 4100 clinicians (Clinicians, house staff, medical students, allied health) across 137 specialties in both inpatient and ambulatory workflows. Many of them needed multiple specialty apps to support their clinical practice, which necessitated over 32 hours of training in the classroom. The new system shifted coding work, previously the responsibility of a dedicated coding group, into the Clinician’s hands directly and provided a new internal and patient communication platform that was unfamiliar.
As you can imagine, the go-live period was chaotic, upending decades of muscle memory for clinician workflows, and changing fundamental interactions with patients and colleagues. There was not much of a planned decrease in expected revenue or patient pipeline during the first 90 days. A few months after going live we started holding debrief meetings with the clinicians. They were exhausted and confused, felling angry and helpless. The word burnout was an understatement.
In those meetings I frequently heard senior medical officers say to the room, “we can survive this and succeed…we just have to start thinking ‘outside the box’ regarding these new demands.” I did not think that statement was particularly helpful to these overworked, weary colleagues. Given the response in the room, they did not find it helpful either.
Over the past decades, Clinicians are facing increasing demands on their time and energy aside from the EMR and patient documentation: increasing revenue; attending committees; mentoring, teaching, and education; doing research; and publishing. For Clinician leaders there are additional leadership responsibilities, budgeting, and space management as well. Much of this added responsibility has come at the cost of personal time, well-being, adequate sleep, and rest and recovery. And Clinicians are the last to ask for help when they need it, which is evidenced by increased burnout and an escalating suicide rate. Add the COVID-19 pandemic, and I believe we will soon experience a major shift in how clinicians view their work, and how they find meaning in their lives and careers. This could create a crisis in healthcare, as clinicians decide to pursue more meaningful roles outside of hospital systems. How can we help you?
Asking clinicians to think “outside the box” is not supportive when many of them do not know what the box looks like, or what is inside. It also can make them feel as if the responsibility for their current situation is entirely theirs, or that they are doing something wrong. These resourceful, smart, and caring clinicians are lucky enough to get through the day or know who they are talking to in their next encounter or meeting.
Clinician wellness is an ecosystem of support, not a solitary endeavor; the institution, Clinician leadership, wellness teams, and coaches should help clinicians think “inside the box.” Inside the box are the conditions within which you must find meaning and achieve balance if they and the organization hope to succeed long term.
Exploring your current “box” is the first step.
What are my current responsibilities both professionally and personally?
Which ones focus on people interactions and which are more administrative and task-oriented?
Which ones are important to me? To the institution?
How effective am I at the ones that are important?
Once you have defined your “box,” you can then begin to refine it and make decisions that can support your wellness and balance going forward.
Are my responsibilities balanced between people-oriented interactions and administrative tasks?
What is in the box that does not add value, that I can let go? Can I delegate it or outsource it
Am I doing things just because I have always done them?
What is missing that I desire?
Doing this type of exercise helps you define and refine your current box so that you understand your existing scope and can make room for what is necessary and meaningful. You may discover that some of what is in the box is not helpful for you any longer. That is ok…for you and the institution. Wouldn’t we rather have clinicians who are happy and engaged staying for the long term rather than those who are slogging through the day? Perhaps there is another role for you in the organization, or another way to shift some of your responsibilities?
Clinician wellness must be a strategic imperative, and is a partnership between the clinician, the leadership, and the institution. However, you, the clinician must first take the opportunity to explore thinking “inside the box!” To help, I have created a free Inside the Box Tool that outlines the process. The tool includes the Inside the Box Worksheet, the instructions, and follow up questions to invite reflection and next steps. The Inside the Box Tool is not meant to provide answers, but can help you, the weary clinician, take a few valuable moments to reflect, and discover your own innate wisdom about what is necessary and meaningful in your life and career. Once you have taken this step, when you are ready you can then explore some “out of the box” thinking toward an eve more fulfilling career and life.
Contact me for the free tool at cory@inflectionpointcoaching.net! I am a coach who builds cultures of care for those who care most. How can I help?