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Organization-Level Interventions to Promote Physician Health and Well-Being: From Taking Care of Physicians to Giving Care to Patients

  • Kirk J. BrowerEmail author
Chapter
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Part of the Integrating Psychiatry and Primary Care book series (IPPC)

Abstract

Physician burnout is not simply a problem of problematic physicians. It is a worldwide, workplace-related phenomenon, shaped by systemic and individual factors. To address modifiable risk factors and promote physician engagement, satisfaction, and well-being, both individual and organizational interventions are needed. Enhancing individual resiliency is necessary but not sufficient, and it can inadvertently shift sole responsibility onto physicians. Conversely, when organizations visibly acknowledge and address workplace factors, they legitimize the burden on physicians and share responsibility for mitigating those factors. Organizational interventions target six major work-related factors: (1) work overload relative to the time available, (2) insufficient autonomy with loss of both discretionary time and input into decisions affecting patient care, (3) a non-supportive interpersonal work environment, (4) incentives tied to productivity, based on increased fiscal and performance monitoring, with diminishing respect and appreciation, (5) perceived organizational injustice, and (6) misaligned values between physicians and their organizations. Organizational culture and individual physicians differ across healthcare systems and clinical units. Thus, while burnout is global, interventions are local. Participatory organizational interventions are effective and address local conditions. They are designed, customized, and implemented by physicians based on the work factors they identify as being most important to the functioning of their clinical units and well-being. Leaders have good reason to support organizational interventions, because engaged and healthy physicians will support their triple aim of improving the healthcare of populations, enhancing their patients’ experience of care, and reducing costs. The fourth aim of improving the experience of providing care calls upon organizations to embrace physician health and well-being as a core value and goal.

Keywords

Burnout Healthcare Quadruple aim Job satisfaction Patient safety Duty hour reform 

Notes

Acknowledgments

To Drs. Jack Billi, Jane Lemaire, Mark Linzer, and Vita McCabe as well as Claire Weiner for their helpful comments and reviews of this chapter.

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© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborUSA

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