burnout proof - western carolina medical society (wcms) · 5 burnout symptoms maslach burnout...

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Burnout ProofLower Stress, Prevent Burnout, build a more Ideal Practice

©www.TheHappyMD.com Dike Drummond MD @thehappymd

Dike Drummond MDd

DisclaimerThis presentation and accompanying handout are ©2011 - 2015 TheHappyMD LLC. All rights reserved.

The material in this presentation and accompanying handout is protected by U.S. and international copyright and trademark laws, and may not be reproduced, republished, distributed, transmitted, displayed, broadcast, or otherwise utilized in any manner without the express written permission of Dike Drummond MD and/or TheHappyMD LLC.

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Today’s ObjectivesIdentify the #1 threat to doctors in these

chaotic timesFill a gaping hole in your medical

education around burnoutLearn my top six burnout prevention

tools – for results this week

Dike Drummond – TheHappyMD.com

MD Mayo Medical School 1984

Family Practice Residency, Redding, CA

40 doc multispecialty group, Mount Vernon, WA

‐ Executive Committee Chair

‐Managed Care Medical Director

Career ending burnout 1999

Copyright 2011-2015 The Happy MD, LLC all rights reserved

Burnout Proof WCMS 8/15/2015

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Dike Drummond – TheHappyMD.com

Executive Coach ‐ Entrepreneur

2011 TheHappyMD.com Launch‐ 6118 physician members in 63 countries

Training and Individual Coaching for Physicians

Burnout Prevention ‐ Leadership Development

~ 1400 hours of 1 on 1 physician coaching

Consulting for Healthcare Organizations

Physician Wellness, Leadership & Engagement

#1 Threat to DoctorsIt is NOT

EMR – ICD10Healthcare ReformThe Tidal Wave of New PatientsVolume => ValueACO’s and Industry Consolidation

It IS …The epidemic of Burnout ALL this

chaos is causing in ALL front line providers

Doctors – NP/PA’s – NursesMA’s – Reception - Admin

#1 Threat Burnout Prevalence

“Numerous global studies involving nearly every medical and surgical specialty indicate that approximately 1 of every 3 physicians is experiencing burnout at any given time.”

JAMA. 2009;302(12):1338‐1340.

Tait D. Shanafelt, MD


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Burnout EffectsLOWER

Patient SatisfactionQuality of Care

HIGHERMedical Error RatesMalpractice RiskPhysician and Staff Turnover

Where is the CFO?

Burnout ComplicationsINCREASED

Disruptive BehaviorPhysician Divorce Alcohol and Drug Abuse / AddictionSuicide

BURNOUT IS …

BAD FOR THE DOCTORBAD FOR THEIR PATIENTSBAD FOR THEIR STAFFBAD FOR THEIR FAMILIESBAD FOR THE ORGANIZATIONBAD FOR THE COMMUNITY

AND BURNOUT IS EVERYWHEREALL THE TIME

BAD BURNOUT

Even though it is COMMON, Burnout is NOT NORMAL - Identifiable- Preventable- Treatable


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Stress vs. BurnoutENERGY

Able to RecoverVs.The Downward Spiral[ loss of homeostasis ]

Good Stress??

Burnout Symptoms

Maslach Burnout Inventory

1)Exhaustion“I am not sure how much longer I

can go on like this”

Burnout Symptoms


2) “Depersonalization”Cynical | Sarcastic | Venting“Compassion Fatigue”

A Dysfunctional Coping Mechanism


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Burnout Symptoms


3) “Lack of Efficacy”“What’s the Use?”My work doesn’t serve a purpose

or make a difference

Burnout Pathophysiology

Burnout PathophysiologyAn Energetic Bank Account

FULL

EMPTY

MAINTAIN A POSITIVE BALANCE

1st Law of Burnout“You can’t GIVE what you Ain’t GOT”- Patients- Staff- Family

Burnout PathophysiologyNot just one account … An account for each of the MBI Burnout Symptoms

PHYSICAL EMOTIONAL SPIRITUAL


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1) Exhaustion

Physical Energy AccountDeposits: Rest/nutrition/exercise/balance


2) Compassion fatigue

Emotional Energy AccountDeposits: Healthy relationshipsQuality time with the important people in

your life


3) “What’s the use”

Spiritual Energy AccountDeposits:A practice of connecting with your

purpose/meaning


EEE

Physical SpiritualEmotional What are Your Balances?


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Burnout Causes

The PRACTICE

Your JOB

LIFECONDITIONING

STRESS

Burnout Causes

1) The PRACTICE

The practice of clinical medicine is stressful

Sick – Hurting – ScaredSometimes BAD things happen

Burnout Causes

2) The JOBYour specific job position adds multiple layers of stressThe work environment is often designed by non-physician administrators

Burnout Causes

ThePractice

The JOB


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Burnout Causes

3) LIFE“Real Life” begins after residencyYou either balance and recharge

or Not …

Burnout Causes

3) LIFELife issues can show up as burnout at workRecent work-life conflict26% -> 47% Burnout Rate

(J Gen Intern Med 2013 Sep 17)

Burnout Causes

4) Conditioning Workaholic Superhero Emotion Free Lone Ranger Perfectionist

No one shows you the

“OFF” Switch

Supposed to be TOOLS but …

Burnout Causes

4) Conditioning

But Wait … There’s MoreTwo Prime Directives“The Patient Comes First”“Never Show Weakness”


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Burnout CausesThe Well Trained Physician’s Subconscious Conditioning

WorkaholicSuperheroEmotion FreeLone RangerPerfectionist

“The Patient Comes First”“Never Show Weakness”

Burnout Causes

4) ConditioningDenies our humanityBlocks us from noticing burnout And from helping each other

Einstein's “Insanity”

Burnout Causes

The PRACTICE

Your JOB

LIFECONDITIONING

STRESS

Burnout’s Highest & Best Use

Three Steps to build a more …

Ideal Practice1. Ideal Practice Description2. Venn of Happiness3. Master Plan


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Ideal Practice DescriptionStep 1) If you had a magic wand …

What is YOURIdeal Practice Description ?

[ write it down ]

VENN of Happiness

What is your Current Overlap?[ In Percent % ]

IDEAL Practice

THISPractice

Step 2)

Your Master PlanStep 3)Ask this question …

“To align This Practice more

with my Ideal Practice

… what would I change?”This list is your MASTER PLAN

[ write it down ]

Your Ideal Practice

Pick one item on your MASTER PLAN and TAKE ACTION

- Use your team- Celebrate all progress- Review your Ideal Practice

Description & Master Plan at least quarterly


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Wherever you STRUGGLE with a “problem” that won’t go away …

It’s probably NOTa PROBLEM

Problem vs. DilemmaProblems have solutionsProblem + Solution =Patient Example: A pointing abscess

Burnout is not a ProblemIt is a DILEMMA

Problem vs. Dilemma

No Problem!

You can’t solve a dilemmaMake it go awayBecause it is not a problem

Patient Example: Obese Diabetic

A Dilemma is a PerpetualBalancing Act

Problem vs. DilemmaAddressing a DILEMMA

1) Call out the Dilemma2) Develop a STRATEGY3) And an SYSTEM to monitor your

effectiveness4) Tweak and adjust as needed

Problem vs. Dilemma


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Common Dilemmas- Burnout- Work – Life Balance- Best care at lowest cost- Compensation formula- Call Schedule- EMR

Dilemmas

EMR STRATEGYHater -> Power UserMinimal Data SetUse the software

- Templates, Quick Keys- 30% free typing threshold

Team documentationScribe

EMR

EMR Monitoring System- Time between last patient and

leaving work- Chart backlog - Work done at home

EMR Burnout Prevention Strategy

The DILEMMA of BURNOUTWhat are the components

of YOUR Strategy ?


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2 Work Life Balance Tools

1) The Schedule HACK

FOCUS:Work-Life Balance

The Schedule HACK

Taming the Gorilla

The Schedule HACK

In Work Life Balance, the Strongest Structure WINS

What calendar do you have on you right now?

The Schedule HACK

Create a Life Calendar UsingTwo Things You Already Have1) The Paper Calendar on YourRefrigerator

2) Your Cell Phone


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The Schedule HACK

Use the Schedule HACK Weekly

Always Carry Your LIFE Calendar

Practice saying “NO” with elegance and grace

The Schedule HACK

Align Your Use of Time With Your Complete Circle of Priorities

[= Happiness & Fulfillment]

The Schedule HACK

What to HACK?- Your Life – NOT Work- Date nights- Your two Bucket Lists- “Scheduled spontaneity”

The Schedule HACK20 minutes once a weekPaper calendar / cell phoneALWAYS carry your Life

CalendarPractice saying, “NO”Create BalanceTake your life back


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2) Boundary Ritual Boundary Ritual

What is YOUR Boundary Ritual ?(write it down)

First Steps – For a ColleagueWho are you concerned about?- Reach Out- Take your Doctor or Leader Hat Off- Expect Intense Denial- Be Persistent

Come From Your HeartYour Outreach

Could Save Their Life

A Culture Demonstration

Question OneQuestion Two

Question Three


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What Did You Learn ?

Please Stand UpFind a Partner

What Did You Learn ?

What do you feel is the most importantthing you learned today ?

What new action will you take as a result ?

When ?

2 Minutes Each

Next Steps

What to do when working harder isn’t working

The Field Manual to building a More Ideal Practice

Over 100 additional tools for your burnout prevention strategy inside


burnout proof - western carolina medical society (wcms) · 5 burnout symptoms maslach burnout...

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