EFFECTIVE ADVOCACY
Become the Local Expert
If you don't know the facts on the ground or the research in publication, it's time to dive in. Start with some books, articles and tools that are well documented.
- The Truth About Burnout" is a great starting point from the Queen of the Maslach Burnout Inventory: Christine Maslach and Michael Leiter. But don't stop there.
- Pick up Drs. Paul Dechant and Diane Shannon's "Preventing Physician Burnout" or "Healing Physician Burnout" by Quint Studer and George Ford, MD. Both have a lot of references to dive into.
- Subscribe to Dike Drummond's thehappymd.com blog and read his very practical book "Stop Physician Burnout." Set up a Google Alert and have it send you a daily report on keywords like "Physician Burnout" and you'll be inundated with the latest news.
- Dig into AMA's Steps Forward modules and look at the research behind their suggestions.
- Familiarize yourself with concepts around mindfulness, resilience, and compassion fatigue.
Find Co-Conspirators and Inside Champions
If you care a whit about physicians and other clinicians, you will start sharing this material with everybody you know. You won't stop talking about it. And that is going to lead you to other people who have been on the same path.
- So start joining forces. Get together and share what you've read, find out what is happening in the hospital across town, figure out ways you can work together.
- Buy copies of the books or make copies of articles or chapters that you've gleaned the most from and casually hand them off to multiple decision makers and especially those friendlies you know who have inside leadership influence, positional or otherwise. Eventually they'll start referring to the material in their own discussions and the cross-validation will have powerful influence when somebody says, "I read that too."
- Join committees, workgroups, and coalitions at the local, state or national level
- Coalition for Physician Wellbeing - A growing national group of those interested in this conversation; hosts an annual conference.
Make a Business Case for Change
Big business and evidenced-based medicine has forced all of us to up our game when it comes to making a pitch for change with the VP of Medical Affairs or CEO. While we would all like to think we know instinctively what is good for doctors, you are going to have to start to speak the language of administrators to get any real change to happen. Remember: physicians think of a patient's needs; administrators think of patients' needs. Where you put the apostrophe really matters.
What is your leader's highest values: profits? safety and patient outcomes measures? organizational values? community reputation? the shiny trophy in the case? All of the above. Find out how to pitch your point in the language they speak. There is plenty of research and resources for any of these.
What is your leader's highest values: profits? safety and patient outcomes measures? organizational values? community reputation? the shiny trophy in the case? All of the above. Find out how to pitch your point in the language they speak. There is plenty of research and resources for any of these.
Refer to Stated Organizational Values
Some organizations are more missionally-driven then others and the faith-based hospitals have a little bit of an edge here with stated values like "the dignity of all humans" and "reflecting the healing ministry of Jesus Christ." But even secular institutions have statements around compassion, care, and love and when you're talking to the C-Suite or board, gently reminding them of those stated values and any dissonance can be powerful if done effectively.
Pick the Low-Hanging Fruit
You probably aren't going to get a facility redesign or medical scribes right away, so try to identify the things that would be the most useful and least expensive or challenging to implement. For some this could be a statewide resolution that supports supplanting the Triple Aim with the Quadruple Aim. But it could also be the hospital making sure the soup doesn't run out in the doctors lounge or installing card-readers to replace typing in passwords or getting a printer installed in every patient room.
Tell Everybody What You Are Doing and Why
At some point, you have to start shamelessly self-promoting what you're doing either through social media, a blog, a newsletter, or chatting everybody up in the doctor's lounge. Once you've established that this isn't going away until somebody does something to change it, then your credibility will start going up and people will come to you to be part of the solution.
Become a Channel for Angst
Hang around long enough and eventually people are going to start telling you some awful tales of personal crash and burn, organizational abuse, and employment practices that defy rational and ethical behavior. You are going to have to decide what to do with these stories while maintaining confidentiality and finding the right way to air these grievances. When you can identify organizational patterns and have the chutzpah to do something even at personal risk, then you're really in the game.
Check your Motives
Shameless self-promotion aside, if you're doing this to make you or your organization famous and you have an ego to stroke...
if you think you have the corner on burnout...
if you think you're the only one who cares about this issue...
if you're doing this primarily to supplement your income...
if you're doing this to get revenge on administration...
...eventually it is going to emerge what your real motives are and that is not going to help you or the cause at large.
if you think you have the corner on burnout...
if you think you're the only one who cares about this issue...
if you're doing this primarily to supplement your income...
if you're doing this to get revenge on administration...
...eventually it is going to emerge what your real motives are and that is not going to help you or the cause at large.