Improving the Lives of Academic Medical Center Physicians Through Front-line Empowerment and Leadership Commitment: Stanford Children’s Health physician engagement cells
Physician burnout has reached burning platform levels. Burnout is strongly associated with patient safety, outcomes, and overall workplace quality. A 2013 Stanford Physician Wellness survey found that 26% of Stanford physicians are burned out. The same survey also measured professional fulfillment (happiness, self-worth, self-efficacy, and satisfaction at work) and found that at the same time, 76% of Stanford physicians are professionally fulfilled. We decided to deeply study the drivers of professional fulfillment, including appreciation and peer-support. In 2014, physician leaders and administrators at Stanford Children’s Health launched an initiative to learn more about the engagement and wellness of its physicians. Through a series of faculty retreats (separate retreats for physician leaders, mid-career faculty, and early-career faculty), additional surveys, and monthly focus groups, we amassed enough data to build an intervention with physicians on the front lines. Many of the pain points identified stem from tension between the School of Medicine and the Hospital (LPCH) as a root cause of dissatisfaction and frustration. Physicians are employed by Stanford University School of Medicine but deliver clinical care inside Lucile Packard Children’s Hospital, which is a different business entity. Likewise, all of their non-physician team members and colleagues are hospital employees. This matrixed structure results in the feeling of serving two masters, each with different goals and missions. We knew if we were to be successful then we must address the structural, professional development, political, etc. issues that come from working across two (or sometimes more) institutions within one enterprise. Therefore, we involved physician leaders and administrative managers from both the Stanford School of Medicine and Lucile Packard Children’s Hospital in this work. Physician Engagement “Cells” are made of early-mid career faculty members across five divisions at Lucile Packard Children’s Hospital, knowing that the pain points for general pediatricians are not the same as the pain points for pediatric otolaryngologists. Two administrative representatives (one from the School of Medicine and one from LPCH) met with the members of the cell over two lunches (paid for by the hospital). At the first lunch the cell discussed global stressors that prevent the faculty from being able to feel their best and do their best work. The second lunch focused on the local (division) issues that the members of the cell would then present to their Division Chief with recommendations. Data from the first lunch of each cell will be discussed at a larger meeting with the cells, Division Chiefs, VPMA from the Hospital, and Department Chairs of the School of Medicine. There is a commitment from the Department of Pediatrics in the School of Medicine and LPCH to work on the issues that will improve the lives of its physicians as told by their lived experience.