Today, primary care providers (PCPs), behavioral health professionals (BHPs), and other collaborative professionals are battling diverse demands posed by the ongoing COVID-19 pandemic, the harrowing state of mental health in America, and conflicting institutional priorities. In collaboration with the Collaborative Family Healthcare Association, evolvedMD recently hosted a critical discussion around improving workplace well-being for those on the frontlines. Featuring Erik Osland, Co-Founder and Managing Partner, and Dr. Ruth Nutting, Director of Clinical Programs, moderated by Sentari Minor, Head of Strategy, read below for key takeaways and insights from these dynamic leaders.
To frame this conversation, it is important to understand that there is actually a clinical definition of burnout as explained by Dr. Ruth Nutting: one or more symptoms of emotional exhaustion, depersonalization, and/or a decreased sense of personal accomplishment.
While we’ve known that burnout has been an issue in the workplace for several decades, at this time, burnout rates are hugely problematic, especially for frontline healthcare workers as illustrated by the following research shared by Dr. Nutting:
According to Dr. Nutting, there are numerous personal and organizational factors that contribute to the problem: perfectionism, being overly self-critical, and poor emotional regulation, as well as as clerical burden (“second shift” work) and unrealistic expectations for productivity among staff. Not to mention that 60% of healthcare professionals are experiencing some level of anxiety and/or depression—approximately three times higher than U.S. adults.
On the business side, Erik Osland acknowledged that it’s not only providers who are struggling, but whole teams—administrative support, medical assistants, etc.—that are negatively impacted due to staffing shortages and an influx of patients. Out in the field working with evolvedMD’s customers, Osland noted that the increased shortage in medical assistants is putting a major burden on primary care providers with a domino effect down the line.
Takeaway: Our medical system is broken. Even worse, the healthcare providers charged with taking care of us are struggling with burnout and adverse mental health symptoms themselves. Everyone counts, and we need to build a system reflecting that.
Fortunately, according to Dr. Nutting, there has been greater acceptance of mental health services within the healthcare workforce, with a 27% increase in physicians accessing mental health services between 2020-2021. Dr. Nutting noted that healthcare has embraced and recognized the need for mental health services, to which she credits behavioral health integration. Over time, this shift has ushered in the availability of employee assistance programs for mental health as well as developing communities of practice around well-being.
As a follow up, Erik Osland mentioned that accountability—both on the organization side and the employee side—is critical to supporting this paradigm shift. As a leader at evolvedMD, Osland shared a personal story in which he spoke with a clinician during the recruiting process who admired evolvedMD’s culture around self-care, work-life balance, and personal and professional support, but felt he had been given the same spiel from every company he interviewed with. The candidate asked, “What makes evolvedMD different?” Osland responded that it’s a shared obligation: leaders must provide the space and the opportunity, and the workforce must follow through on their end to take care of themselves.
Takeaway: The paradigm shift in healthcare is a shared obligation between leaders and employees. Starting at the top, leaders must provide the space and time for employees to take care of themselves, but employees must also take ownership for their well-being.
Osland shared practical approaches to incentivize self-care on teams including:
From day one, Osland and evolvedMD’s leadership team understood that if their employees aren’t practicing self-care then their ability to provide excellent service to patients suffers. Emphasizing and incentivizing self-care has helped evolvedMD deliver better whole-person care and position us as a Best Place to Work by the Phoenix Business Journal.
Takeaway: Creating balance, helping employees understand the importance of self care, and creating accountability by incentivizing self-care will not only prevent burnout and curb attrition but also improve the quality of services for patients.
Dr. Nutting shared that mental health and well-being interventions are not enough if we aren’t deliberately decreasing the demands we’re putting on healthcare workers. By focusing on employee mental health, healthcare institutions will enjoy benefits such as better clinical outcomes, lower costs due to lower litigation rates and attrition rates, and increased patient satisfaction. Ultimately, Dr. Nutting would like organizations to recognize the humanity of our workforce to help realize these benefits. She also highlighted the need for healthcare professions to remember the “why” of what they’re doing. By remaining focused on demonstrating compassion to their patients and feeling a sense of accomplishment, healthcare professionals will further fortify their overall well-being and prevent burnout.
By extension, rather than being a patient-first organization, Osland challenged organizations to be more people-focused. He believes that by focusing on and supporting your staff as people, by humanizing them and their needs, then the overall product and patient care will improve.
Takeaway: By prioritizing your staff, recognizing their humanity, and enabling them to focus on their happiness and well-being, healthcare will ultimately improve.
Osland noted the importance of organizations being committed to supporting their staff. For example, at evolvedMD, Osland talked about assigning clinical supervisors to manage our frontline clinicians’ day-to-day activities as well as their caseloads. These clinical supervisors not only help our clinicians strike a work-life balance by limiting caseloads but also take the time to thoughtfully invest in their personal and professional lives. As Osland put it, taking the time to learn more about your people and care for them will make a world of difference. Dr. Nutting echoed his sentiments, noting that compassion should start with leadership, and by doing so it will trickle down to others—including patients.
As for potential barriers to realizing this shift in healthcare, both Osland and Dr. Nutting expressed concern with the current fee-for-service payment structure as it doesn’t allow the flexibility needed for clinical delivery. Further, Osland believes leadership not prioritizing their people will be a hindrance to change. Dr. Nutting believes educational institutional settings such as medical schools and residencies not prioritizing balance, compassion, or humanity will be a hindrance as well.
Takeaway: Compassion starts with leadership. They must make time and effort to care about their people.
Dr. Nutting
Erik Osland
Dr. Nutting shared that taking time for your personal mental health is a necessity and not a luxury. Osland shared his belief that healthcare organizations are not doing enough and called for action for listeners to press their leadership teams to refocus and reprioritize on their people. When asked how employees should approach their leadership teams to share concerns regarding prioritizing mental health in the workplace, Osland suggested building a business case without the emotional component. Dr. Nutting suggested when presenting your business case to leadership, ask them to take part in the initiative and help set an example so that others will follow.
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