Healthcare provider burnout is something we talk about a lot in this blog. But that doesn't mean that we're not prone as anyone else to believing the lies, myths, and misinformation realted to the extreme stress and fatigue that providers face. 

Sometimes we just need to understand what is happening in our lives in order to change it. So, in our quest to support happy providers and healthy patients...

A roundup of 5 lies about healthcare provider burnout we've come across:

1. Doctors are most impacted by provider burnout.
   Actually, nurses, aides, and other key players in medicine face burnout in equal or higher numbers as doctors. This profile shows a vivid picture of one nurse's stressful day -- and we find it helpful to know that regardless of our role on the team, we're all facing the same stress. 
2. Feeling burned out means you don't like your job.
   As RN Theresa Brown points out in this Huffington Post article, that's far from the truth, "You can feel like you love a lot of things about your job but you can still be getting burned out about the job."
3. Burnout comes from caregiving at work. As baby boomer parents reach the age when they need caregiving, there are increasing numbers of healthcare providers whose caregiving starts again as soon as they get home. These double-duty providers need to take special care to prevent caregiver -- and healthcare provider -- burnout. 
4. Giving and caring is what burns us out. 
   Counterintuitively, it may be the barriers that keep us from giving that really cause a sense of frustration and helplessness. Recently, an experienced physician in Boston spent 2 hours on the phone trying to get a patient's insurance approval, finally giving up and handing her the $30 to buy pills. The doctor was sanctioned and an uproar ensued. When "random acts of kindess" are cause for disciplinary action, burnout is inevitable. 
5. Doctors don't worry or make mistakes.
   We actually think it's this expectation of physician infallibility that contributes to burnout. This interesting TED Talk "playlist" presents talk after talk about what keeps doctors up at night -- a perspective that might help us all stay a little saner. 

Something happened in the last couple of decades of practicing medicine. On one hand, it's become increasingly difficult to care for our patients: we see 5 patients in the time we used to see 1; it's impossible to navigate insurance companies' rules; and hospital regulations seem to tie our feet and ask us to jump.

At the same time, medical administrators use "patient satisfaction" as the metric of success, and so regulate provider actions in service of that metric: sit down when you're speaking with patients; talk about feelings; talk about facts; thank the patient for choosing our hospital. Oh, and see more patients.

Somehow these formulaic demands feel both overwhelming and insufficient. We agree that patient satisfaction is fundamentally important. But we disagree that the route to patient satisfaction -- when up to half of physicians show signs of burnout -- is more rules, more sticks, and more carrots.

We'd like to propose something revolutionary: that patient satisfaction starts with provider satisfaction. Our experience is proof, the studies back it up, and our patients seem to echo the sentiment. So, in service of that… 

5 reasons that patient satisfaction starts with happy, satisfied providers:  

1. Compassion fatigue can disable us. Compassion fatigue (sometimes called Secondary Traumatic Stress) is a documented condition, common in caregivers and healthcare providers. When compassion fatigue occurs, disconnection, negativity, and even inefficacy in regular work is the result. A lack of support, pervasive stress and pressure, and isolation are all causes -- the exact things that inspired us to start ClickCare -- and are things that persist in so much of healthcare. 
2. Happy providers communicate better. We all know that providers that communicate well have happier patients. But you might be surprised to find out that if we're happier, we'll communicate better. In fact, a study from the University of Arizona showed that happy people have deeper, more substantive conversations, something that patients seem to crave. 
3. Burned-out providers become unable to do even the basics. One recent study shows that providers with burnout are detached, have a low sense of empathy, and even lie and cheat.  So while sometimes we think of self-care or avoiding burnout as a selfish thing, it's very clear that getting what we need as providers is the most altruistic thing we can do. 
4. Will power and good decision-making plummet when exhausted. There is a really fascinating set of research that shows that will power and good decision-making are linked. And the more decisions we are required to make (or the more will power we use), the more that "muscle" becomes exhausted. Once exhausted, our will power and decision-making become very poor -- until we recharge, rest the muscle, and are ready to use it again. As every healthcare provider knows, a day in the office is an endless series of complex decisions. And when we're not given the space or support to rest from that complexity, the evidence shows that we'll perform poorly.
5. Finally, providers actually need the same things patients need. So often, providers and patients are pitted against each other in a "zero sum" model of medicine: it is assumed that if the provider is getting what she needs then the patient won't, and vice versa. In fact, however, as elaborated in this New York Times article, providers need many of the same things that lead to patient satisfaction. Both patients and providers need more time in the exam room, better communication, simpler regulations, less rush, and more authentic interaction with each other. So it's actually a win-win.

A look back at the past, can help us with the Now. Right now, the "Future of Healthcare" is a big conversation. The Supreme Court is about to hand down a decision on healthcare, but the train has left the station. Years before the internet, at the birth of computing, there was considerable controversy about the control of computing. Large companies were designing large computers for large jobs. Steve Wozniak and his colleagues changed all of that. Now we have small, powerful and even smaller, computers for everyone, everywhere. Control of the internet was next. Like telephone, radio, and TV before it, large companies and government tried unsuccessfully to control and centralize development. The discussion about healthcare is very similar. Dave Chase, our colleague in the NY Times report, discusses this in TechCrunch, entitled "Supreme Court Decision On Obamacare Has Little Relevance To Healthcare Disrupters."

At the ATA 2012, some special Woz quotes were caught on iPhone VIDEO even though they were omitted from the ATA Highlights. You can hear again his wonderful encouragement for the entrepreneur, his talk about hard work and passion, his recommendation to do what one cares about and feels is important, not just do business.

Steve further said…”I love all the little devices that hook up to my iPhone. I’m a gadget guy. You know, I probably wouldn’t get a blood pressure thing at home and take readings and write them down. But heck, when I take a reading and it’s automatically on my iPhone, I can show it off, I love it.”

When Dr. Harris asked him specifically about telemedicine and mHealth, his shout out for iClickCare was a thrill because he mentioned iClickCare, and iClickCare alone, on the stage at the ATA 2012 in front of 5000 of our closest friends! He even volunteered a move to Alaska to reap some of these benefits of telemedicine. 

In total, Steve Wozniak is a generous and appreciative individual whose life has made, and is making, the world a better place.

ClickCare believes that, especially in light of the pending Supreme Court decision on healthcare, real change occurs through innovation and collaboration. What are your thoughts?

Accountable Care Organization, Care Coordination, Pay for Performance, Patient Centric Care, Coordination of Care, and so much more. It is all ready here. See the difference.

 A missed opportunity for homecare? A prevailing attitude? A broken system?

Which, or all?  Why did medical collaboration not happen?  We have our opinions, but, we want to know yours. We know what we would do differently. What would you do?

A near transcription of a true event this past weekend (names changed)...

Scene:  Saturday, 1:07 pm, Physician hears: "Beep, Beep, Beep"

      Physician reads beeper: "Melissa - Homecare at Home. Plz call ASAP. 555-555-5555. Dr. Pollard's patient. Wound pink."

      Physician calls: This is Dr. Specialist calling back.

      Nurse: Thanks for calling. Dr Pollards's patient had surgery and it looks pink around the wound.

      Physician: Pink?

      Nurse: Yes, pink.

      Physician: When was the surgery?

      Nurse: I am not sure, I was not here last week, but I think it was a week or two ago. Maybe 9 days.

      Physician: OK, where is it pink? Is there a temperature?

      Nurse: She didn't tell me the temperature, just said that the wound area was pink.

      Physician: How pink? Is it red? What part of the wound?

      Nurse: I don't know, I am the office nurse. This was called into me by the nurse in the field.

      Physician: Did it change? Is it worse? Is the nurse availaible? I can see the patient in the Emergency Room.

      Nurse: No, she has left for the day, and said she would see the patient in the morning. We just wanted to inform you. FYI.

      Physician: FYI?

      Nurse: Just wanted to inform you.

      Physician: FYI or CYA?

      Nurse: Unfortunately, we all have to do it.

Let us know your thoughts.