What if you could take concrete steps towards  reducing physician burnout,

enhancing your team’s culture, and being effective in today’s  globalized world?

Communication misunderstandings cause a variety of problems, including, but not limited to, increased burnout rates, an inability to network and work effectively in a globalized world, detrimental department culture,  and malpractice suits.1

“Enlightened CEOs understand the enormous importance to the bottom line of creating a context for work and the workplace that accommodates the human needs of every Employee.” -Randall L. Tobias, Chairman Emeritus, Eli Lilly and Company and former Vice Chairman, AT&T

Improving cross-cultural and interpersonal communication: Enhances physician engagement and well-

being. Cultivates positive team dynamics and

efficiency Develops cross-cultural navigation skills for the

globalized world and a diverse workplace.

Work-related burnout is a prevalent problem among physicians—and it’s getting worse, according to an article published by Shanafelt et. al. (2015) in Mayo Clinic Proceedings. The

study surveyed 6,880 people, in order to discover the relationship between the work life balance experienced by physicians compared to the general population. 2

At the time of their first study in 2011, Shanafelt et. al. (2012), 45% of US physicians were burned out.2,3

When following up in their study, Shanafelt et. al. (2015) discovered that 54.4% of all physicians had at least one sign of burnout.3

The top 8 specialties experiencing burnout were:

Emergency Medicine Urology

Physical medicine and rehabilitation Family Medicine

RadiologyOrthopaedic surgery

General internal medicine and Neurology.4

All physicians were assessed using the Maslach Burnout Inventory. This scale evaluates emotional exhaustion, depersonalization and feelings of lacking self-efficacy and personal accomplishment.4

Burnout can result in dire consequences including:

Job dissatisfaction Failed relationships Substance abuse Suicide6

Examples of behavioural problems and medical errors associated with burnout include malpractice suits, medical errors, low patient satisfaction and care for patients, and increased medical errors. 7

Del Canale et.al. ( 2012) found that physicians are burned out and apathetic, their patients take longer to recover and are less likely to follow physician’s recommended treatments. 8

Why does burnout happen?

The problem lies in the culture of medicine and its superman/survivalist/save the world mentality. Physicians have been acculturated to this worldview, and have been taught to value high performance, self-denial, and perseverance under high levels of pressure and stress, often at great cost to themselves. 9

#1 Cause of malpractice suits = miscommunications between patients and physicians and/or members of the medical team. 1

Patients who filed malpractice lawsuits felt: Disserted Misled Devalued Misunderstood personally, racially and culturally Disrespected Mistrust towards physicians 1

The American Association of Orthopaedic Surgeons (AAOS) (2003) urged medical professionals to focus on open, honest,

trust building dialogue that promotes healing.10

Physicians need to keep in mind that today's health care consumers have a lot more medical knowledge than in previous generations, and they often analyze the care they receive on the basis of their interactions with caregivers. 1, 10

Huntington and Kuhn (2003) discovered, the thing that sets apart the “adequate or average physician from the truly great

physician is how well the physician practices the “art” of medical care, conveying those highly valued human skills of compassion and caring concern that patients seem to

need so much.”1

Physician Well-Being

In 2015: 41.2% of Medical

School Graduates were non-white.

1.9% of the graduates were non-US Citizens/Non-Permanent Residents

0.5% had unknown races13

66% of physicians were men and 32.4% were women.14,15

The US Census of 2010 found that:

1.6% of people in the USA identified as Gay or Lesbian

0.7% identified as Bisexual

1.1% identified as something else or

refused to answer.14,15

As of the Census of 2010:16% of all people employed in healthcare in the USA,

27% of physicians and surgeons and 22% of

healthcare support workers were also foreign born. 14,15

75% of healthcare workers, and 91% of physicians reported fluency in English. 14,

15

Due to cultural and societal factors, many of the

minorities and internationals working in healthcare feel more pressure to succeed

than their white peers, and often live by the

perfectionistic standards mentioned earlier.11, 12

So… What is the solution?

Communication

Allison Weaver, MS. Ed. Owner and Founder

“I believe no program for global diversity or inclusion (GD&I) can be successful for either the organizations or individuals involved if it is based on the visible aspects of diversity alone. Obviously, these visible factors must be addressed as they are, in fact, where discrimination often begins. But our approach to diversity and/or inclusion cannot, and must not, stay there.

Programs will fail if they are only about fixing ‘the look’ of an organization by filling carefully constructed quotas to represent each type of defined diversity, while never giving thought as to how the unseen layers affect how this diverse group will or won’t function together successfully.

….If we do not find a way to dialog about our true beliefs and values in the deeper layer of culture, people who may see the world a bit differently from how their organization or company tells them they must think or be are either forced to lie and sign the statements in order to get or keep their jobs, or they are simply excluded. The insights and perspectives they might have added to what is going on in our globalizing world and solutions for how to respect very opposite views and still work together are lost.

And if it is true that some beliefs and values are mutually exclusive, then, it seems to me, we must not be afraid to acknowledge that rather than claiming universal ‘inclusion.’ If we admit this reality, we can dare to dialog with others quite unlike ourselves because we can listen and learn fabulous things without being afraid we will have to become the ‘other’.” -Ruth van Reken, co-founder of Families in Global Transition 18

So… how do your coaching sessions work?

Coaching Content Areas Include:

Navigating Cross-Cultural Communication in the Workplace

Gender, Identity and Communication Non-Verbal Communication and the Art of Listening 

Emotion, Social Relationships and Interpersonal Communication in the Workplace

Work Burnout and Intimate Relationships  Problem solving: Interpersonal Conflicts, Power Plays

and Deception

End Goals….

Next Steps…

Bibliography :1. Huntington, B., & Kuhn, N. (2003). Communication gaffes: a root cause of malpractice claims. Proceedings (Baylor

University. Medical Center), 16(2), 157–161.2. Shanafelt, T., Hasan, O., Dyrbye, L.N., Sinsky, C, Daniel Satele,, D., Sloan, J, West, C.P. (2015). Changes in burnout and

satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population. Mayo Clinic Proceedings. 90(12):1600-1613.

3. Shanafelt, T. Boone, S., Litjen, T., Dyrbye, L., Sotile, W., Satele, D., West, C., Sloan, J., Oreskovich, M. (2012). Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population. Archives of Internal Medicine. 172(18):1377-1385.

4. Vasser, L. (2016). Specialties with the highest burnout rates. AMA Wire. Jan. 15. Retrieved from: http://www.ama-assn.org/ama/ama-wire/post/specialties-highest-burnout-rates.

5. Miller, C. (2016). What is the price of physician stress and burnout? Medical Economics. Jul. 13. Retrieved from: http://medicaleconomics.modernmedicine.com/medical-economics/news/what-price-physician-stress-and-burnout?page=0,1 .

6. Balch, C., Freischlag, J., Shanafelt, T. (2009). Stress and Burnout Among Surgeons- Understanding and Managing the Syndrome and Avoiding the Adverse Consequences. Archives of Surgery. 144(4):371-376.

7. Rakl, E.A., Mustafa, R., Bdair, F, Schünemann, H. (2007) The United States Physician Workforce and International Medical Graduates: Trends and Characteristics. Journal of General Internal Medicine. 22(2): 264-268.

8. Del Canale, S., DZ, L., Maio, V., Wang, X., Rossi, G., Hojat, M., Gonnella, JS. (2012) The Relationship Between Physician Empathy and Disease Complications: An Empirical Study of Primary Care Physicians and Their Diabetic Patients in Parma, Italy. Acad Med. 87(9): 1243-9.

9. Montgomery, A. The Inevitability of Physician Burnout: Implications for Interventions. (2014). Burnout Research. 1(2014)50-56.

10. American Academy of Orthopaedic Surgeons/American Association of Orthopaedic Surgeons . (2003) The Importance of Good Communication in the Patient- Physician Relationship [advisory statement, Document No. 1017] Rosemont, IL.

References:11. Oaklander, M., (2015). Life Support: Inside the Movement to Save the Mental Health of America’s Doctors. (2015) Time Magazine. Sept. 14. 44-50.12. Andrew, L.B.., Brenner, B.E. (2015). Physician Suicide. Medscape. July 9, 2015.13. Kaiser Family Foundation (2016). Distribution of Medical School Graduates by Race/Ethnicity. Retrieved from: http://kff.org/other/state-indicator/distribution-by-race-ethnicity/ .14. McCabe, K. (2012). Foreign-Born Health Care Workers in the United States. Migration Policy Institute. 15. US Census Bureau (2014). US and World Population Clock. Retrieved from: http://www.census.gov/popclock .16. Stanford University. (2016) WellMD. Retrieved from http://wellmd.stanford.edu/. 17. Keller and Carroll (1994) A new model for physician-patient communication. Patient Educ Couns. 1994 Jun;23(2):131-4018. Van Reken, R. (2016, March 3). X-Expats Open Talk Series: Casual Conversations with Ruth Van Reken: PART 3/3: Diversity and Inclusion Programs[Web log post]. Retrieved from: http://www.crossculturalkid.org/x-expats-open-talks-series-casual-conversations-with-ruth-van-reken-part-3/ . Other: All photos are in the public domain and labeled for reuse or taken by the author. Licensed under Creative Commons Open Source

Images Music Credit: Lee Rosevere “In a Moment” Licensed under Creative Commons: By Attribution 3.0