On Friday, March 25, Thom Mayer, M.D., presented a lecture titled, “It begins with you! Why health care leadership leading matters” based on his book “Battling healthcare burnout: Learning to love the job you have, while creating the job you love.” Mayer said his goal for the lecture is to equip health care workers with tools to better themselves and their workplaces.
Mayer is the medical director for the National Football League players association, executive vice president at LogixHealth, and senior lecturing fellow at Duke University. In his lecture on Friday, he discussed how to handle burnout personally, and in team settings, to create a better culture in health care.
To begin his lecture, Mayer started by saying that his goal was to give “levers you can use personally and professionally as health care workers.” These levers start with three goals: think about how leading begins with you and about leading in a radically different way, act on those thoughts within a week, and innovate you and your team to evolve the system.
Mayer said that innovation comes from “trusting those around you to fail so that you can build a stronger healthcare system.”
Addressing burnout and change
Mayer suggests that addressing burnout for teams begins with this thought–deep joy, deep needs. In other words, focus on where deep joy intercedes the world's deep needs, he said. As health care workers, Mayer implied that the joy within us is important to combat burnout and change.
As a reminder, Mayer talks about how health care workers have worked through crisis, and have led others through crisis. However, for health care workers to continue to run, there are three fundamental insights to consider.
First, every member of a health care team is a leader. (We lead ourselves and often others) Second, every health care worker is a performance athlete. (We all have to take care of ourselves). Third point, the work beings with us. (We have to take care of ourselves before others.) Self-care is essential.
Mayer asked current leadership to evaluate the current focus of their leadership training programs. Is it metrics, or is it personal development programs?
To help health care workers avoid burnout, it is important to realize the early signs of rustout. Rustout, according to Mayer, is “the path before we get to burn out.” Some signs of rustout are a tense neck, upset stomach, or a small headache. Rustout and burnout occur when passion is lost. Mayer suggests writing a letter to the person we were when we started medical or nursing school to rekindle the passion we first felt. A health care worker’s rustout/burnout can lead to patient burnout as well.
Mayer also wants to remind health care workers that admitting rustout/burnout is not a failure. “The way we’re currently working isn’t working,” said Mayer. “Definitions have to drive solutions.” By decreasing stressors, adaptive capacity increases. When job stressors are bigger than adaptive capacity, burnout occurs. Symptoms of burnout are emotional exhaustion, cynicism, and loss of meaning at work.
How to manage burnout and stress
Mayer said, “You should feel just as happy coming to work as you do leave work.”
How we start the process of rekindling our passion is to understand the battle between personal and organizational resilience. The cycle starts with a culture of passion and fulfillment, that then moves into hardworking flow + fulfillment, or as Mayer stated, “stop stupid, start smart.” Finally, the cycle moves into reigniting passion and personal resilience and continues.
To help find what needs to change in the system, Mayer gave six Malsach domains of burnout: loss of values, mismatch job stressor/adaptive capacity, loss of control, lack of fairness, loss of community, and lack of rewards and recognition.
If the results are not what we want, we need to make changes. Health care is an ever-evolving field as well. Change is inevitable, but positive change can be chosen over negative change.
How to make change
In the same vein, Mayer stated that “if someone isn’t with you when the plane takes off, they won’t be with you when you land.” This is fuel to redesign the processes, the systems, and the culture to get a stronger healthcare system.
Change occurs once the paradox of teamwork is addressed. Actively working as a team instead of individuals grouped together shifts the culture of health care. Smart people don’t equal smart teams, smart teams only come about when true teamwork is the focus. Teamwork should be a detail.
Another way to change the current culture of health care is to say thank you. Mayer said, “say thank you fifty times a day, starting today.” Say thank you to patients, their families, if you’re a physician, to the burse, in front of your patient. An environment of gratitude and support goes a long way.
To further enact change and combat burnout, Mayer suggested the love, hate, tolerate too. Find what you love and maximize it, find what you hate and eliminate it, and finally, find what you tolerate and minimize it. By utilizing the tool, you will rekindle the passion you felt when you started your job as well as cultivate a better work environment.
The timing of change
According to Mayer, “the best time to enact change is now. You have to have the courage to be crazy enough to change yourselves, the system, and the culture.”
Focusing on the next play is how we keep going. The next play for health care workers is the next patient, the next family, the next team member.
For more information, check out Mayer’s book “Battling healthcare burnout: Learning to love the job you have, while creating the job you love,” or the recording of his Grand Rounds lecture.