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Healing the healer in healthcare

Posted Jul 05 2013 9:25am

by Thomas Dahlborg

"I'm a family doc in Eugene, Ore., where we've lost three physicians in 18 months to suicide. I was suicidal once. Assembly-line medicine was killing me. Too many patients and not enough time sets us up for failure."

There are many studies highlighting the harm our broken healthcare system is doing to patients--e.g., hospital errors occurring in one-third of all hospital admissions; medical mistakes contributing to up to 187,135 deaths and 6.1 million injuries; an estimated annual cost of measurable preventable medical errors of $17.1 billion (based on 2008 dollars).

But what about the harm caregivers face?

Many studies have highlighted the fact that physicians have a significantly elevated suicide rate in comparison to other professionals. In her article "What I've learned from saving physicians from suicide," Pamela Wible, M.D., highlights that not only are doctors overworked, exhausted and depressed, but few are seeking help.

As noted in the past (and exemplifying many similar conversations), a physician friend of mine from a well-known, local health care system confided in me that he was so tired and burned out that he was thinking of leaving the practice of medicine. As a primary care physician, he was feeling his role had moved further away from that of a healer and more toward a "production worker."

Rather than focus his energy on best positioning his patients for optimal healing, he was pressured to triple book every 15 minutes to generate the required 30 relative value units (RVU) per day and thus "earn" his salary.

He said he had lost his soul for healing. Today he spends most of his time on non-patient-care activities, doing medical claims reviews for a large insurer instead.

This represents another lost opportunity. Another lost primary care physician who would rather care for patients but not at the cost of his soul or his patient's safety.

Another friend of mine, at the time a resident physician, shared similar sentiments. Her residency program emphasized the need for speed (productivity) when it came to completing patient assessments, rather than ensuring patient safety and optimal outcomes. She was tired, considered leaving the practice of medicine, and knew the broken healthcare system was not healthy for her or for her patients.

Back in 2008-2009, the Daniel Hanley Center for Health Leadership brought together healthcare leaders to improve primary care physician recruitment and retention in rural areas, and yet what we learned transcends beyond recruitment and retention to the soul of true healing.

We learned physicians are concerned with finding organizations that truly care about them. We learned physicians define the "caring" that they seek from organizations to entail:

  • Finding an organization that is willing to create an optimal practice model that positions the physician to focus on healing (and not revenue generation) ... improving patient experience, safety and outcomes along with recruitment and retention of physicians.
  • Finding a practice that will develop support systems sensitive to the understanding of the physician's goals and needs ... helping to heal the healer prior to them leaving the primary care workforce (or worse).
  • Finding an organization with a commitment to collaboration and the creation and nurturing of a community of healers with a focus on learning, growing, sharing, supporting, and healing.

In my own experiences leading a medical practice I have borne witness to this. I have heard physicians and others share how being loved, honored, and sometimes challenged in a trusted community has deepened their ability as healthcare providers, increased their confidence, courage and trust, and connected them more strongly with a sense of meaning in their work.

To truly honor the calling to serve our patients we also must honor the calling of healing the healer. Only when caregivers are healthy (physically, mentally, emotionally, spiritually) will they (will we) be best-positioned to improve patient experience, outcomes, safety and truly heal.

Thomas H. Dahlborg, M.S.M., is chief financial officer and vice president of strategy for the National Initiative for Children's Healthcare Quality ( NICHQ ), where he focuses on improving child health and well-being.

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