In the past month working at the National Academy of Medicine, I’ve learned a lot about health policy and medicine and their far reaching implications for not only patient health, but also for clinicians’ well-being and overall healthcare efficiency. I’m grateful for the opportunity to learn and work in a different academic and professional sector than what I am typically exposed to, at school. More than anything, this internship has taught me that a seemingly straightforward and noncontroversial goal is always much more complicated than it seems.
The project I am working on focuses on Clinician Wellbeing and Resilience, which aims to address the burnout epidemic among physicians. Despite almost all major medical associations and medical centers across the U.S. pledging their commitment and participation towards NAM, the methods and process to actually change the systematic factors contributing to burnout is complex and difficult. One major consideration is the increasingly digitized healthcare system, spearheaded by the electronic health record. Although the EHR has numerous benefits, especially for organizing large amounts of patient data, the tedious process of inputting data dehumanizes interaction within the medical profession and deemphasizes attention towards the patient in exchange for a computer or tablet. It can take 32 clicks of a mouse to enter in a single flu shot. A Wall Street Journal article compared EHR data entry to a world-class chef having to document each time he adds an egg or a pinch of salt. The minutiae of documentation diverts limited focus and energy and diminishes clinicians’ sense of purpose or efficiency, leading to turnover, burnout, and depression.
The case for investment towards wellness is similarly complex. Tait Shanafelt, MD, is a member of NAM’s Action Collaborative on Clinician Wellbeing and Resilience, and became the first Chief Wellness Officer at Stanford University. The organizational and internal dynamic and culture of any workplace, especially that of a hospital is crucial in determining the efficiency, satisfaction, and well-being of its workers. The argument for creating and funding such a position in the C-suite is often overlooked and underappreciated, especially because wellness is not an immediate, tangible qualification. However, the long term benefits in investing in a CWO, especially within a healthcare system, is clear. Any salary and additional costs of the implementation of a CWO is overtaken by one physician turnover caused by burnout, which can range from half a million to a million dollars.
Other themes that the Action Collaborative and similar initiatives grapple with include gender and sex differences among physician burnout, validity of measurement tools, personal and social factors, and patient data privacy, transfers, and ownership. I’m excited to further learn about this issue throughout the next 4 weeks here in D.C.!