Physician Wellness Services and Cejka Search : Cause, Effect, Cost and What You Can Do About It Alan Rosenstein, MD, MBA Medical Director Physician Wellness Services Vivian M. Luce, MBA Vice President Cejka Search 1 Our Presenters Alan Rosenstein, MD, MBA Medical Director Physician Wellness Services Vivian M. Luce, MBA Vice President Cejka Search 2 What do you want to learn from this session? 3 1
Roadmap for the Discussion Impact of physician stress and burnout on recruitment and retention Drives turnover Turnover and recruitment are costly Much harder to recruit into a burned out/toxic environment Key findings and recommendations Causes and effects How physicians currently deal with stress and burnout 3 things organizations can do Close Discussion poll recap 4 How Has a Stressed Environment Impacted Your Organization? What percentage of your physicians have left your organization due to stress/burnout? Do you quantify the cost of turnover? Do you have wellness programs to address stress/burnout? Do you have a retention program? 5 How To Vote via Texting EXAMPLE 2
How To Vote via PollEv.com EXAMPLE Prevalence of Stress Almost 87% of physicians identified themselves as moderately or severely stressed and/or burned out 37.7% identified themselves as severely stressed and/or burned out 70.4% scored themselves in the upper 50 th percentile 7 Left Practice Due to Stress and/or Burnout? No 85.9% Yes 14.1% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0% 100.0% What does it cost you to attempt recruiting into a stressed environment? 9 3
Business Case for Retention Cost of Turnover Cost of Turnover and Prolonged Vacancy Annualized loss of downstream revenue per FTE* $990,034 Estimated recruiting cost per FTE** $88,116 Average annual start-up cost per FTE* $211,063 Total turnover cost per FTE $1,289,213 $100K per month *Trinity Mother Frances Hospitals and Health Systems **AMGA and Cejka Search Retention 10 Methodology Web-based survey deployed in September 2012 to nationwide, multispecialty panel of 115k 2,069 completed surveys representing 99% confidence level, +/- 3% margin of error against 750k active physician population in the US Slight skew to non-primary care physicians Skew more female, somewhat younger than active physician population; average age 45.3 years Average years in practice: 13.1 Employed by hospitals (41.3%), single or multi-specialty practice (41.0%) 10 Not at all 1 1.8% 2 3.8% 3 7.5% Stress Level 4 5 7.4% 9.0% 6 12.3% 7 20.4% 8 22.4% 9 11.2% Extremely 10 4.2% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 11 4
Change vs. 3 Years Ago 62.3% of physicians identified themselves as more stressed and/or burned out compared to 3 years ago Largest number of respondents (34.3%) identified themselves as much more stressed than they were 3 years ago 13 Much more stressed than I was 3 years ago 34.3% Stress Compared to Three Years Ago Somewhat more stressed than I was 3 years ago About the same level of stress as 3 years ago 18.5% 28.6% Somewhat less stressed than I was 3 years ago 11.2% Much less stressed than I was 3 years ago 7.5% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 13 External Factors Causing Stress and/or Burnout Top 3 external factors causing stress: State of the U.S. economy, in general (51.6% of all respondents ) Healthcare reform (46.4%) CMS policies (41.2%) 15 5
Work-Related Factors Causing Stress and/or Burnout Top 3 work-related factors causing stress: Paperwork and administrative demands (39.8% of all respondents) Too many hours of work (33.3%) On-call schedules and expectations (26.2%) Only 1.1% of respondents indicated nothing in their work environment was causing stress and/or burnout 15 Personal Life-Related Factors Causing Stress and/or Burnout Top 3 personal life-related factors causing stress and/or burnout: Not enough time to relax or for leisure/ recreational activities (52.6% of all respondents) Not enough time for exercise or wellness activities (50.6%) Concerns about work/life balance, in general (45.0%) 17 Work-Related Impacts of Stress and/or Burnout Top 2 work-related impacts of stress and/or burnout: Lower job satisfaction (51.2% of respondents) Desire to work fewer hours (41.2%) Next cluster indicated overwhelming desire to do something different joband career-wise: Retire early (29.9%), Leave practice of medicine for another career (27.6%) Switch jobs (21.8%) Switch to new practice (15.9%) 17 6
Personal Life-Related Impacts of Stress and/ or Burnout Top 3 personal life-related impacts of stress and/or burnout: General feelings of tiredness (41.4%) Less sleep or problems sleeping (36.7%) General feelings of irritability and moodiness (33.9%) Next cluster: Impacts on personal health (24.7%) More conflict with a spouse or partner (22.6%) 18 Physicians Are Suffering From a Number of Effects of Stress Decreasing job satisfaction Decreasing productivity Insufficient work/life balance Conflict at work and at home Feelings of irritability, moodiness, anger and hostility General tiredness, lack of sleep and difficulty sleeping Negative impacts on physical health Negative impacts on mental health such as depression and anxiety, or symptoms such as apathy and cynicism, less interest in engaging with others, or in normal activities Patient safety-related concerns such as difficulty making decisions, communicating effectively with others, and increased risk of medical errors 20 What Physicians Are Doing to Combat Stress What are physicians doing for themselves to combat stress and/or burnout? Top 2 choices: Exercising (62.8%) Spending time with family and friends (56.9%) Next cluster: Taking vacation or time off (47.8%) Watching movies or listening to music (44.3%) Reading (38.0%) Getting more sleep (35.8%) Several respondents noted that finding the time or money to do things to relieve stress was a challenge 21 7
Desired Organization- Sponsored Initiatives to Address Stress and Burnout What organization-sponsored initiatives would physicians like to help address their stress and burnout? More ancillary support, such as physician aides, to deal with things like paperwork and charting (63.0%) Onsite exercise facilities or classes (38.9%) Next cluster: Wellness initiatives (27.8%) Workshops and education on managing and coping with stress and burnout (23.8%) Concierge-type services (19.8%) Coaching and mentoring resources (18.5%) 21 Top 3 Things to Help Reduce Stress and Burnout Open-ended responses for top 3 things that would reduce stress and burnout: Better work hours and/or less call (32.5% of respondents) More or better work/life balance (30.7%) Improved finances, compensation, reimbursement (29.0%) Generally, throughout the survey, financial-related factors were far down the list relative to other factors 23 What Do Physicians Need the Most? 3 primary areas where physicians asked for help: More opportunities for self-care, such as exercise and other wellness activities More support in helping them more effectively deal with the stress and burnout in their lives More time and more control over their time for the things that are most important to them at work, and to carve out more time for their personal lives and interests 24 8
What Can Organizations Do? 1. Physicians need more opportunities for and assistance with taking better care of themselves, and to understand and practice better selfcare: Onsite exercise facilities or classes Workshops Facilitated support groups Physician wellness committees Individual coaching Time to take advantage of all resources Easy accessibility times, locations 25 What Can Organizations Do? 2. Physicians need support on multiple levels in dealing with stress and burnout in their lives: Physician-specific employee assistance program (EAP) counseling resources, coaching and mentoring, concierge-type services Strong Physician Wellness Committee Education grand rounds, workshops Cultural change through training and facilitated discussions communication skills, stress and anger management, dealing with workplace conflict, building resilience, etc. Normalizing work/life balance 26 What Can Organizations Do? 3. Physicians need greater flexibility and control over their working hours to mitigate burnout and stress: Flexibility Four-day work week Part-time Teamwork Job sharing Hospitalist programs Advanced practitioners Technology EMRs for remote access and communication 27 9
Consequences for Healthcare Organizations Increased turnover and retention challenges Patient safety and quality issues Lower productivity Disruptive behavior and lower morale 28 What did you learn from this session? 29 Questions? For more information: Physician Wellness Services James Grimm 888.892.3861 www.physicianwellnessservices.com Cejka Search Vivian M. Luce 314.495.3939 www.cejkasearch.com 30 10