HEALTHCARE PROVIDER BURNOUT: A COACHING APPROACH Zeina Ghossoub, PhD, PCC, CWC Vital Signs Vital Skills E: zeinag@viesaine.org Vie Saine
2 BURNOUT DEFINITION! Burnout is defined as feelings of lack of personal development, becoming cynical, loss of empathy, and gradual erosion of enthusiasm for work.! These come from feelings of confusion, lack of confidence and debilitating anxiety.! Burnout is characterized by exhaustion of emotions,a sense of lack of leaning in work, feeling ineffective,and a propensity to view patients and people as objects rather than human beings.
3 BURNOUT PATHOPHYSIOLOGY At the DNA/Genotype level: Burnout is a disease of emotions. Our resiliency Our coping abilities Our adaptive mechanisms Our humanity and empathy Phenotype Manifestations: Physical Emotional Mental (cognitive, skills) Psychosocial
4 Lack of Control BURNOUT CAUSES Unmet Expectations Burnout Insufficient Rewards Workload Control Reward Community Fairness Values
5 BURNOUT MALIGNANCY MODEL Environmental and Genetic Factors Time Lack of defenses and ability to detect Cumulative Effects
BURNOUT IMPACT: PHYSICIAN 6 Coronary Artery Disease Type II DM Infertility From: Stress and Burnout Among Surgeons: Understanding and Managing the Syndrome and Avoiding the Adverse Consequences Arch Surg. 2009;144(4):371-376. doi:10.1001/archsurg.2008.575
7 BURNOUT TREATMENT Goal of therapy: All physicians deal with stressful times in their personal and professional life and must cultivate habits of personal renewal, emotional self-awareness, connection with colleagues, adequate support systems, and the ability to find meaning in work to combat these challenges. Balch and Shanafelt, 2011. Mindfulness based techniques CBT, patient-centered therapy Peer support groups and programs Emotional Intelligence
Why EI? What providers do! 8
Government regulations Insurance Companies Leadership roles, setting standards 9 Personal demands Medical practice The 21 st Century Healthcare Provider Behavior EMOTIONS PIP BURNOUT Cognition Abilities/ Skills? Emotional Intelligence/ Wellness Business requirements, contract negotiations EMR s Law suits, scrutiny Professional society demands Institutional demands Educators/Mentors
10 WELLNESS Wellness protects against and treats burnout
Cognitive abilities, selfcontrol, Emotional Intelligence, IQ Choose how to respond to stress 11 DECISION MAKING Mindfulness/ Wellness/EI training Stress/Burnout Factors Positive Emotions/ Mood Hijack, loss of IQ, loss of will power, Lower EQ Problem solving and creativity Negative Emotions/Mood
Engaged 12 MASTERING THE MOMENT Physician Burnout Physician-Patient Interaction Mastering the moment Resiliency Coping abilities Adaptive mechanisms Humanity and empathy Emotional Intelligence Wellness 21 st Century Reality
RESEARCH 13 Emotional Intelligence Wellness Leadership Hospitalist Group Conroe, Houston, Kingwood, Huntsville Methodist Health Care System Houston Practicing physicians Program directors
PHYSICIANS 1. I am able to enjoy more my experience/interaction with my patients 14 RESULTS AFTER 9 MONTHS AVG/5 (5) AVG/5 (20) 4.6 4.3 2. I am better able to detect my burnout symptoms 4.8 4.6 3. I feel more equipped to handle burnout and decrease its effects on myself and my patients 4. I am more aware of my emotions and those of my patients and others around me 4.6 4.2 4.8 4.7 5. I feel more engaged in my practice of medicine 4.2 4.5 6. I understand the importance of self-care and am doing a better job at it 7. I am getting improved feedback from my patients and my coworkers 4.6 4.5 3.6 4.1 8. I am happier and more relaxed at work now 4.4 4.7 9. My work-life balance has improved 4 4.7
FINAL THOUGHTS Coaches Thoughts!