CAVEAT EMPTOR: Mayo Clinic CEO says fire your doctor if you suspect physician burnout - during PBS interview
By Dike Drummond MD, CEO TheHappyMD.com
Dr. John Noseworthy MD, CEO of the Mayo Clinic, said patients should actually fire their doctor if they suspect physician burnout during a recent TV interview on WTTW in Chicago.
This is a first on two levels
This is the first time I have ever heard a major American healthcare executive asked this obvious question ... AND ... the first time I have ever heard a CEO answer it.
Not only that, Dr. Noseworthy is a physician and the boss of the massive and well respected Mayo Clinic no less. (full disclosure; I graduated from Mayo Medical School in 1984)
Here's the bind
Mayo measured its internal physician burnout rate two years ago as part of a study on physician leadership and its effects on burnout — and it is 40%. Here is the article link.
Grab the full PDF article and you will see that 3896 Mayo Clinic doctors were surveyed and 40% admitted to at least one symptom of physician burnout. This is similar to recent studies of burnout prevalence in American doctors.
Hmmm ... Is Dr. Noseworthy saying this ??? ... that patients should be able to diagnose burnout in their personal physician and then figure out a way to dismiss their doctor ... an act that could result in up to 40% of the Mayo Clinic physician workforce being sidelined on any given office day?
This is a can of worms indeed!
The full interview exchange is in the video at the base of this blog post. Here is my transcript of a portion of the conversation:
Starting at 8:10 in the video file:
Carol Marin: "What are patients supposed to do when they feel they have a physician who is not empathetic or is in some way burned out or cynical? What does a patient do?"
Dr. Noseworthy: "Change physicians. It is too risky to be cared for by someone who is impaired. It is difficult to say that but it is true. You can say, "Doctor ... you used to be a great doctor. You used to care about me. You seem different. I hope you are getting some help." But in the meantime, patients and their families have to look after themselves."
Carol Marin: "So, in other words, if you are going to fire your doctor, you would suggest that the patient have a conversation to say why I am firing you."
Dr. Noseworthy: "I think it might be helpful."
If you suspect your physician is burned out, Dr. Noseworthy recommends you ...
"Change physicians. It is too risky to be cared for by someone who is impaired."
Just what would that conversation look like?
"Excuse me Dr. Drummond", says my patient sitting in one of those backless gowns on the end of the exam room table. "I am concerned about your lack of empathy. My suspicion is that you are burned out. I hope you are getting some help and I have been told it is too risky to be treated by an impaired physician like you today.
May I please see another physician? I will wait here until you return with a suitable replacement."
What would the physician then do?
- Would the doctor step out of the room, grab a partner at the nurse's station and ask them to see this patient?
- If this was the fourth patient in a day when they have 22 scheduled, would they keep seeing the rest of the patients on their schedule, hoping the other ones don't notice ... or at least don't say anything?
- Does the patient then have a duty to bring it to the attention of the physician's supervisor and blow the whistle on this "impaired" physician?
What does Mayo do to prevent physician burnout?
Dr. Noseworthy is quite proud of the fact that his organization pays for one meal a month for the doctors to share with their ward/wing/service. Here are his words from the video:
Dr. Noseworthy: "The Mayo Clinic buys lunch or dinner for 1100 physicians once a month. It's a small investment. It is the collegiality that comes from that. And with that we have seen a downturn in our burnout by 7% when the national percentage has gone up by 14 - 18%."
I have some questions about this:
- Are the lunch/dinner meetings mandatory?
- Is someone tracking your attendance to make sure you participate?
- Is this "we pick up the check" initiative actually causing the majority of the doctors to actually sit down for a meal together in any given month?
- The study referenced above points out there are almost 4000 employed Mayo Clinic physicians. Why are they only buying lunch for 1100?
- Is paying for lunch once a month actually responsible for a claimed 21% difference in burnout rates between Mayo and the rest of the country ... Really??
Seems to me this lunch or dinner would be very easy for an overworked doctor to blow off ... since it is just one more expectation from leadership.
How much cash do they provide for this meal?
I have been told by a Mayo doc in one of our training audiences that the amount of the meal stipend is $25/month. That's a Subway sandwich and a bottle of nice beer. All of a sudden I am feeling valued for sure. (sarcasm intentional)
Last but not least ...
At one point in the interview, Ms. Marin asks Dr. Noseworthy point blank if he has ever been burned out. His reply?
"I have not had a bad day in 35 years"
I find that impossible to believe
It is impossible for a physician, especially one who has risen to the level of CEO in a group the size of Mayo, to have never had a bad day across a 35 year career.
You, dear reader, have had multiple bad days. So have I. So has every physician I have EVER met. We all have stories of heart breaking bad outcomes, some of which we have never even told to our significant other. Some of us have those traumatic bad outcome experiences stacked like cord wood in our memories.
And 90% of the physicians I talk to who migrated from patient care to leadership have a significant burnout story ... or two ... or three.
Leadership transparency is a piece of the way forward
Honesty and transparency from our leaders is an important first step in reversing the burnout epidemic. You set the standard for authentic communication on your teams. When a leader tells the story of their struggles as a physician it provides cover for all physicians to be more real with each other. It provides cover to both ask for and receive help in the tough times we will all have in any given month or year.
The time to tell the truth and share our stories of struggle is now.
When the doctor in charge admits they are human it creates an opening for everyone to tell the truth of the challenge to maintain empathy -- and even our physical health -- day after day over a 40 year career.
LEADERS: Tell your burnout story and watch the difference it makes
I stand in front of every room I train and tell my burnout story and my story of a traumatic bad outcome. My act of disclosure is never easy. It allows others to be more honest with their colleagues in the audience, talking about the stress of practice and their own burnout, perhaps for the very first time.
If a leader like Dr. Noseworthy continues to claim he has never had a bad day in his career over 3+ decades ... he is shutting down the opportunity for his people to be human and get the help they need.
I invite all of us to be more real about the stress of being a physician. Notice your workaholic, superhero, Lone Ranger, perfectionist programming and admit you are human too. It will give your colleagues and staff the ability and permission to be more real.
This is an important starting point for healthcare leaders to begin rolling back the physician burnout epidemic.
Click Here to see the full video on the WTTW website
PLEASE LEAVE A COMMENT:
What do you think a patient should do if they think their doctor is burned out? What would YOU do if you thought your personal physician was burned out?
Dike Drummond MD is CEO and Founder of TheHappyMD.com. He is author of the groundbreaking book Stop Physician Burnout - what to do when working harder isn’t working - with over 25,000 copies in print. He has trained over 10,000 physicians - for over 60 corporate clients - to prevent burnout with the Burnout Proof LIVE workshop.