Minimizing Medical Burnout: Amel Hammad Of Riveron On How Hospitals and Medical Practices Are Helping To Reduce Physician and Healthcare Worker Burnout
An Interview With Dan Rodrigues
Hospitals and practices need to do a better job of managing demand and scheduling for their non-emergency services. They need to focus on scheduling for the right capacity, with the resources that can support that capacity without leading to burnout.
The pandemic was hard on all of us. But statistics have shown that the pressures of the pandemic may have hit physicians and healthcare workers the hardest. While employment is starting to return to pre-pandemic levels generally, the healthcare sector is lagging behind, with a significant percentage of healthcare workers not returning to work. This is one of the factors that is causing a shortage of doctors. Some experts say that the US may soon be short almost 124,000 physicians. (See here for example)
What are hospitals and medical practices doing to help ease the extreme mental strain of doctors and healthcare workers? What are hospitals and medical practices doing to help solve the scourge of physician and healthcare worker burnout?
To address these questions, we are talking to hospital administrators, medical clinic executives, medical school experts, and experienced physicians who can share stories and insights from their experience about “How Hospitals and Medical Practices Are Helping To Reduce Physician and Healthcare Worker Burnout”. As a part of this series, I had the pleasure of interviewing Amel Hammad.
As a managing director at Riveron, Amel Hammad is based in Chicago and leads the firm’s healthcare industry practice focusing on financial, operational, and strategic solutions for healthy and troubled companies. Amel’s healthcare industry experience includes restructuring and turnaround, interim management, enterprise assessment, strategy implementation, revenue cycle management, payor negotiations, capital raises, and mergers and acquisition advisory for healthcare systems, single hospital engagements, physician and dental practices, and post-acute and senior living organizations.
Thank you so much for joining us in this interview series! I know that you are a very busy person. Before we dive into the main focus of our interview, our readers would love to “get to know you” a bit better. Can you tell us a bit about your childhood backstory? What or who inspired you to pursue your career?
I’m the daughter of immigrants from Egypt and grew up in Philadelphia. My parents instilled in me at a very young age the importance of working hard and they taught me to take advantage of every opportunity to help people. My parents always wanted me to be a doctor. When I went to high school, however, I discovered that I wasn’t very good at chemistry. I did win a lot of awards in math and I enjoyed business events. With that, I decided to focus on finance and business in college. But my dad worried that if I didn’t become a doctor, I wouldn’t be successful. I think I spent a lot of time proving him wrong!
Today I lead the healthcare practice for Riveron, a national business advisory firm with clients across multiple industries. I focus on developing financial, operational and strategic solutions for healthy and troubled healthcare companies. So I actually did build a career in healthcare and to take every opportunity to help people, just not in the way my parents envisioned.
What are some of the most interesting or exciting projects you are working on now? How do you think that might help people?
Many of the interesting projects I’m working on right now deal with the downstream effects of the pandemic. COVID-19 made people realize that the world is very small and that what’s happening on the other side of the planet can be extremely significant to our day-to-day lives. I’ve seen how the pandemic impacted the entire industry, across the continuum of care as well as the downstream industries that support patient care. To be more specific, the impact of supply chain issues and resource constraints that have contributed to rising inflation — and with interest rates continuing to rise — these are factors that contribute to complexities of current projects. But helping healthcare organizations address their challenges in productive and effective ways is one of the satisfying parts of my role.
Another topic, mental health, is rising to the forefront as well. I am volunteering my time to help a not-for-profit group set up by mental health practitioners, and the group supports creating better access to mental health services. The focus is to expand the ability of psychologists to prescribe psychotropic medication. While there are many methods for addressing mental health issues, medication is necessary for treating some individuals, Currently, there is limited access to obtain medication through a qualified provider, which sometimes presents a barrier to proper care.
You are a successful leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?
Three qualities that have been instrumental in my career as a leader are curiosity, resilience and being an active listener. Being curious — trying to understand and get as much information as possible — helps me as a business consultant quickly assess a company, its people and the situations they’re facing so that I can provide the appropriate guidance.
Being resilient helps me to meet my own challenges, of course, but it also allows me to serve as a trusted advisor to the distressed organizations I work with. Even when I’m working with operational turnarounds, bankruptcies or liquidation events, I have a deep understanding that difficulties can be overcome and that people and organizations can bounce back in the face of adversity.
Finally, I know that active listening has been a really important skill set over the course of my career. It allows me to understand what people are good at and what they need in order to be successful and then figure out how to marry those two together. This has been a strength not only in the strategic advising I do for our clients, but also in working with the people in our own organization.
How do you define “Physician and Healthcare Worker Burnout”? Does it just mean poor job satisfaction? Can you explain?
Poor job satisfaction is a symptom of burnout and only tells one part of the story. I think it is really important to define burnout in general before I explore how it applies within the realm of healthcare. Many experts define burnout as a state of emotional, physical and mental exhaustion driven by excessive, prolonged stress. The state occurs when individuals feel drained and unable to meet constant demands, and with the stress continuing, a person can lose willingness to engage in tasks or question what was initially appealing about an activity. This condition will reduce productivity and drains your energy, leaving you feeling increasingly hopeless, unmotivated or resentful. The impact of burnout can spill into every area of your life, including personal and professional aspects, and burnout can also cause long-term changes to a person’s body that can increase health risks and pave the way for negative outcomes.
As it relates specifically to physician and healthcare workers, burnout is a condition that occurs after these workers are asked to meet unrealistic productivity demands and pressures of the system. Some of these demands can be unforeseen, much like the COVID-19 pandemic, where the demand was not aligned with resources available, and burnout can easily occur in such cases.
How would you define or describe the opposite of burnout?
I would describe the opposite of burnout as being in balance. When individuals are able to manage their workloads and do things that energize them, they can reconnect with the reasons they actually pursued these careers to begin with. Ideally a person thriving in their healthcare career will be supported by their organization so that their workplace efforts align to the organization’s strategies, and effective healthcare strategies should focus on driving positive outcomes for patients in a manner that is balanced and sustainable over time. Burnout can be avoided knowing that maintaining balance — or correcting imbalances — healthcare organizations and healthcare professionals need to take a proactive approach, often informed by data and continually anchoring efforts to strategic priorities.
From your experience, perspective, or research, what are the main causes of physician and healthcare worker burnout?
Whether I’m working with healthy or distressed healthcare organizations, I see physicians and healthcare workers who are facing unsustainable productivity requirements. Physicians have to focus on volume in their practices in order to generate revenue for the organization. They need a constant churn to meet the productivity numbers that, in turn, dictate their compensation numbers. And all the people who support physicians have to endure that same churn.
There’s tremendous pressure to increase volume due to the increasing constraints on reimbursement. Healthcare providers are paid by Medicare, Medicaid and the commercial payers, which are the ones dictating the pricing for a visit. Those payers are continually pushing to limit reimbursement and that generates more pressure to increase patient volume in order to meet the same revenue numbers. The costs can’t be passed on to customers, because the “customers” making payments in healthcare are the government and commercial payers. The dynamic leads to increasing burnout for the physicians and staff who are working under these demands.
Can you describe how burnout impacts the operations of the organizations you work with?
Burnout causes individuals to reevaluate why they chose this field in the first place, and many end up looking for other careers. There have been shortages of healthcare workers since the start of my career 20 years ago but it’s getting much worse across all types of organizations. I also see how burnout impacts the culture of healthcare organizations, which is really important for retention in this industry. The more burnout there is in an organization, the harder it is to sustain a supportive culture. The result is even fewer staffing resources because people don’t want to work in organizations where the culture doesn’t support employees.
Do the organizations you work with offer mental health resources for providers or clinical staff?
Some organizations try to offer a baseline of mental health services, such as providing 10 visits with a mental health professional, but these benefits aren’t offered by every organization. I feel that everyone should have access to mental health resources, and if somebody is in burnout, they’re probably going to need to see a mental health provider more often than these baseline services that would allow for a visit once a month for 10 months. Organizations should look for ways to support their healthcare workers holistically, which is the same approach that has proven to be effective with patient care in general. This means organizations that don’t currently offer mental health support should start to do so, and all organizations should assess whether they have gaps that need to be addressed.
Do you think that streamlining operational efficiency with digital transformation and automated processes can help to ease the workload of providers and clinical staff and minimize medical burnout?
Of course there are areas where automating processes can help alleviate the burden on the clinical staff, and I always look for them when I’m helping organizations address their unique needs. For example, we can streamline electronic medical record (EMR) processes by auto-populating information. But you cannot automate the provider visit or the need to meet with patients, and those touchpoints are where burnout in the healthcare field originates. Telehealth can help by allowing people to conduct a visit from anywhere, but it has its limits. Let’s say you’re trying to improve medication adherence. You can automate the process up to a point with auto-calls and prompts and options. But the human being on the other end of the line might be sick, probably has questions and may well be experiencing mental health issues. So despite ways to streamline and automate the process, in the end, there’s an element of human interaction that remains necessary. This means that although automation could be part of a solution, some drivers of burnout must be addressed in other ways.
Can you share five things that hospitals and medical practices can do to reduce physician and healthcare worker burnout?
- First and foremost, these organizations have to re-evaluate productivity measures to allow physicians and healthcare workers more time to do their work. If not, there’s going to be more burnout and this will exacerbate the resource constraint problem — which will in turn, cause more burnout. It’s a vicious cycle. To help support realistic productivity, organizations also need to mandate time off. We live in a society where we’re incentivized to put in a lot of time on the job but more hours become less productive when people experience burnout. Hospitals and medical practices have to mandate minimum amounts of time off and leaders have to lead by example.
- Hospitals and practices need to do a better job of managing demand and scheduling for their non-emergency services. They need to focus on scheduling for the right capacity, with the resources that can support that capacity without leading to burnout.
- Organizations also need to provide a better range of non-compensation incentives to support individuals’ work-life balance. Whether it’s education, additional training, mental health services or health and wellness benefits like gym memberships, hospitals and practices need to see their physicians and staff as human beings with a range of needs.
- In addition, leaders need to do a better job of empathizing with physicians and healthcare workers. Top executives in hospitals and medical practices too often seem removed from the people who are dealing with the day-to-day issues. Leaders need to do more to demonstrate the value they place on the team as a whole.
- This leads to my final point, which is addressing attrition caused by burnout. My current team has tackled this issue by helping organizations identify employees at high-risk for burnout-driven attrition and provide high-level recommendations to reduce this turnover. For example, we partnered with a company’s data team to access, analyze and acquire in-scope datasets for targeted roles. We analyzed recent employee exit interviews and population data to assess baseline attrition levels to understand common reasons for leaving, then we built a predictive model that identified key variables and conditions related to current attrition and provided related recommendations and guidance. In this case, our team was able to accurately predict 83% of employee attrition and helped the company develop and design HR-led intervention strategies aimed at retaining employees in the target population. This approach shows that organizations can use data to address burnout and take action to improve healthcare worker retention.
What can concerned friends, colleagues, and life partners do to help someone they care about reverse burnout?
As someone who has experienced burnout, I feel that people need to give themselves grace when they are in this situation. In a society that rewards hard work, sometimes in the pursuit of success we fall victim of never saying no and over doing it. In these situations, it helps to acknowledge that it’s OK not to be OK, and it takes courage to admit that you are at a point where you need to reevaluate and reset. To reverse burnout, people really need to talk to someone who will empathize and provide ideas for setting healthy boundaries. I encourage people to reach out to a friend or colleague for an honest conversation when they feel they’ve reached their limits. Seeking professional help can also be very helpful when people feel stuck. A professional can help provide guidance to not only address the current diagnosis but a toolkit to help prevent the on-set of burnout in the future. One tool I use regularly to avoid burnout is to reflect on efforts, achievements and accomplishments. When you are approaching burnout, there is a negative spiral of thoughts of feeling not good enough and the tool of reflection can have a positive, grounding effect.
What are a few of the most common mistakes you have seen people make when they try to reverse burnout in themselves or others? What can they do to avoid those mistakes?
I can answer this question from personal experience! One of the things I did to reverse burnout was run away from it. I thought that completely changing what I did would fix the problem. What I learned, though, is that you have to not run. Instead you have to take the time to evaluate what’s causing the burnout and how you can start eliminating those pitfalls. And then, whether you stay in the same role or do something different, you have developed tools during this time of reevaluation to prevent burnout from happening again.
It has been said that our mistakes are our greatest teachers. Can you share the funniest or most interesting mistake that occurred to you in the course of your career? What lesson or take away did you learn from that?
My biggest mistake was running away from burnout. I left business consulting in 2014 for a 9-to-5 job because I forgot why I loved this job. After taking different jobs and going back to school, I realized that I had become burnt out because I didn’t know how to set boundaries. I developed new tools to ensure that burnout doesn’t happen again and was then able to return to the work I truly love, which is centered on helping struggling companies return to health.
Can you share your favorite “Life Lesson Quote”? Why does that resonate with you so much?
I like to say that you can’t expect fish to thrive on land. What this means for me is that there are things that we’re really good at and situations that we really thrive in. If we try to do things that don’t suit us, we’re going to be continually disappointed with the outcome. So focus on what you do well and continue to enhance and expand those areas of your life.
Because of your role, you are a person of significant influence. If you could inspire a movement that would bring the most amount of good for the greatest number of people, what would it be? You never know what your idea can trigger.
I’m passionate about helping healthcare organizations improving mental health outcomes and elevating mental health because it’s a key component of wellbeing alongside physical health. In my view, improving access to mental and behavioral healthcare will enrich all areas of our society. There are many facets to this topic that need to be addressed — everything from reducing stigmas around obtaining mental health care, to improving access for underserved populations, and beyond. As with other forms of healthcare, it’s possible to roll out these initiatives in a way that is profitable for the healthcare organization and effective for patients. As an advisory professional, these complex challenges are part of my everyday work, and I welcome the opportunity to help the healthcare community envision and realize new possibilities.
How can our readers further follow your work online?
You can connect with me on LinkedIn or check out our latest business and industry insights on the Riveron website.
This was truly meaningful! Thank you so much for your time and for sharing your expertise!
About The Interviewer: Dan Rodrigues is the founder and CEO of Kareo, a Tebra company, a leading provider of cloud-based clinical and practice management software solutions for independent healthcare practices and billing companies. Rodrigues is known for his visionary leadership in the healthcare technology industry. Rodrigues’ future-forward expertise has led companies such as Scour and Skematix. He is highly committed to providing patients with a seamless, digital experience in healthcare. Rodrigues’ business insights have been featured in publications including Forbes, Fierce Healthcare, and AP News.
Minimizing Medical Burnout: Amel Hammad Of Riveron On How Hospitals and Medical Practices Are… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.