Of all of the targets for intervention to alleviate the national physician burnout situation, Jeffrey Selzer, MD, said organizational change is perhaps the most important.
“When someone is truly burned out and when a population of people is burned out, it has negative effects on an organization. Turnover, absenteeism and patient satisfaction are all affected by this,” said Dr. Selzer, program director at Northwell’s Physicians’ Resource Network (PRN). “The impact is significant.”
Significant enough where Northwell Health has opened communication on how to alleviate physician burnout and improve the health and wellbeing of its employees. Changing the culture is essential, and the health system has various initiatives in place to assist.
The Physicians’ Resource Network, for example, is a free, safe and confidential counseling service for members of the medical staff, residents and students. In-service training is offered on site and helps employees learn techniques for stress reduction, burnout prevention and anger management. PRN provides individualized assistance with professional difficulties, distressing relationships, depression and anxiety, and substance misuse — all of which are associated with burnout.
"To me, the Physicians’ Resource Network shows the health system is putting its money where its mouth is on physician wellbeing,” said Dr. Selzer, who oversees PRN. “I present throughout the health system and meet with the incoming class of residents, as well as class of medical students. I convey the message that Northwell is interested in your wellbeing.
“If any problem is causing you distress, it may be beneficial to discuss the distress in a confidential relationship and explore your options to relieve the distress.” Regardless of the problem or its severity, I am happy to meet with any medical staff member or trainee.. The majority who actually reach out to me are residents.”
Studies show that burnout is common among medical students and residents. A main contributor is the individual’s previous successes being halted due to various external forces they feel they can’t control or weren’t aware of before pursuing a career in medicine.
The question becomes, how are they dealing with this stress?
“We suggest new ways to manage it,” Dr. Selzer said. “In some cases, I identify when someone is depressed or drinking too much. I’ll do my best to connect that person with help.
“A real barrier to students, residents and attending physicians accessing our services is concern that our services aren’t truly confidential and somehow their difficulties will be reported to their supervisor. Worse yet, some may worry that our meeting will result in licensing or credentialing difficulties.. Northwell is committed to creating an environment that encourages physicians to get help.”
During Dr. Selzer’s counseling sessions, he focuses on the issues causing difficulty and works with the doctor to develop a plan for solution. When the solution may be organizational change, many physicians aren’t aware of opportunities to become involved in governance where concerns can be voiced and change initiated.
“Often it’s a matter of how you present your perspective on the nature of problems and what solutions you might propose,” Dr. Selzer said. “Some people find that a bit of activism itself is rejuvenating.”
Along with the Physicians’ Resource Network, Northwell’s Employee and Family Assistance Program (EAP) provides similar services to all employees, including nonclinical staff.
Curtis W. Reisinger, PhD, corporate director of the EAP, has numerous interactions with people needing help for a wide range of issues.
“We don’t always deal with glorious situations,” Dr. Reisinger said. “We try to prevent situations from happening, personal crises that interfere with their career — family, kids, divorce. That’s what we are all about. We try to help people cope with events that can add up to burnout.
“When the stress never eases up and you lose hope with what your career is about, that’s when they come to us. A lot of people say ‘bring back the joy of being a physician.’”