Minimizing Medical Burnout: Dr Tracy Asamoah On How Hospitals and Medical Practices Are Helping To Reduce Physician and Healthcare Worker Burnout
An Interview With Dan Rodrigues
… Clear communication. Listening is the starting point for all the interventions organizations can make. One factor leading me to stay at my previous job for so long was regular communication with my direct supervisor. He had an open-door policy and would take the time to listen to my concerns. His willingness to listen and validate my concerns gave me some hope that systemic issues could be addressed.
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 Dr. Tracy Asamoah.
Dr. Asamoah is a Career and Leadership Coach, Child and Adolescent Psychiatrist and writer in Austin, TX.
She helps women physicians and other high-achieving professionals navigate career transitions and develop into resonant leaders. In addition to partnering with clients in her private practice, Dr. Asamoah coaches and teaches with the American Medical Women’s Association, Physician Coaching Alliance and StrongLead, a business development consulting firm.
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?
I was an intensely curious kid and a bookworm. I spent many Saturday afternoons on our living room couch exploring our Encyclopedia Britannica collection. We had the entire, old-school, hardcover set. My favorite pages were a series of transparencies displaying the different organ systems of the human body. The pages eventually shredded from years of studying those images.
Before I decided to become a doctor, I actually wanted to be a veterinarian. After realizing that I would probably have reptiles as patients, not just cute dogs and cats, my interest shifted to the medicine.
What or who inspired you to pursue your career? We’d love to hear the story.
My parents were my earliest cheerleaders. Being raised in the South during the peak of the Civil Rights Movement, they understood the power of education and were committed to supporting their daughter who expressed an early interest in medicine.
My mom was a social worker and exposed me to issues around social justice early on. Some time in my tweens, she bought the book, I Dream a World. It’s a pictorial history filled with the images and stories of Black American female icons. In those pages, I learned about Clara McBride Hale who opened Hale House in Harlem in 1973. Hale House cared for babies born addicted to drugs. Her story sparked my desire to care and advocate for people who had the least access to resources in our communities.
I was blessed to grow up surrounded by family and friends who were as motivated to see the first physician in the family as I was. Their encouragement and support left no doubt in my mind that I could find success in whatever I endeavored to do.
What are some of the most interesting or exciting projects you are working on now? How do you think that might help people?
I’m part of community of physician coaches who, early in the pandemic, were actively exploring ways to support our peers on the frontlines. I couldn’t shake concern about how healthcare providers would navigate the aftermath of the acute crisis. I imagined that eventually, the “Healthcare Heroes” signs would disappear, and a vacuum of concern would emerge in place of support. I compared it to what we often see after a natural disaster. Eventually collective attention moves elsewhere and the victims, often still in significant distress, are left to cope on their own.
Through the American Medical Women’s Association, I’ve been able to partner with my peers and to create FLOURISH. FLOURISH is a virtual coaching program for women physicians to explore the impacts of the pandemic and cultivate a path towards wellbeing and thriving. Our program will offer group and individual coaching opportunities, wellness activities, and related content. Most importantly, it will be a virtual community of women physicians supporting each other towards wellness.
Our program is so timely considering Surgeon General Dr. Vivek Murthy’s recent report on burnout in healthcare workers. We want to create a “soft landing” for women physicians who have been uniquely impacted by the pandemic. We hope to support these women in a holistic approach in moving towards personal and professional thriving.
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?
Creativity Creative expression has been foundational to who I am personally and professionally. At various times since I was a kid, I’ve contemplated being an artist or a writer. Actively tapping into my creativity means that I can approach challenges with curiosity and openness. It opens possibility for outcomes that I would not otherwise have considered. It gives me permission to step out of the norm and respond to things in unexpected ways.
Creativity recently emerged as a central part of my recent career when I became a medical writer for an online health-related platform. Maybe most importantly, creativity helps me tap into a deep sense of joy in whatever I’m doing.
Perseverance My dad, a dedicated amateur marathoner for most of his adult life, was my earliest model of perseverance. He started running when he turned 30 years old and decided to quit smoking and get healthy. Once he made that decision, there was no other option in his mind but to make it happen.
“Set a goal and work towards it one step at a time” became imprinted in my mind. I’m wired like my dad when it comes to envisioning who I want to be and taking action. I often only see one option, me putting in the time and work as long as I’m emotionally, mentally, and physically able to do so. It’s not about the outcome, but the belief that I have the resources to achieve what I set my mind to.
Curiosity I’m a lifelong learner in every aspect of the word. I thirst to know and understand the world around me. I’m constantly seeking new learning opportunities or ways to understand things from a different perspective. My curiosity has driven me to explore unfamiliar professional pursuits such as trying to launch a start-up and writing. Curiosity has led me down many “rabbit holes” trying to answer the question, “What else?”
Ok, thank you for all of that. Let’s now shift to the main focus of our interview about minimizing medical burnout. Let’s begin with a basic definition of terms so that all of us are on the same page. How do you define “Physician and Healthcare Worker Burnout”? Does it just mean poor job satisfaction? Can you explain?
At its core, medical burnout is a mental, physical, and emotional state of distress caused by a healthcare professional’s experience in their professional role. The symptoms of burnout have been well defined and reflect feelings of stress, inefficacy, devaluation, and hopelessness.
Although individuals experience burnout, burnout is a systemic issue. Heavy workload demands, technology-related inefficiencies, and loss of autonomy have left healthcare professionals feeling devalued and depleted. It’s only been in the last few years that burnout in healthcare has been widely acknowledged with active momentum towards addressing it.
Poor job satisfaction may certainly be one aspect of burnout, but that’s not the whole story. Someone can be dissatisfied with their job, but not experience significant psychological or physical effects of this sentiment. They might see options for turning things around or have discovered effective coping tools.
Burnout is pervasive and goes beyond what a person thinks about their workplace experience. Its impact can be paralyzing and the resources to manage it are often unavailable or unknown.
How would you define or describe the opposite of burnout?
I believe that flourishing lives on the opposite end of the spectrum from burnout. Emory University professor Corey Keyes developed a framework of flourishing that describes a state of mental health and mental wellness. In a state of flourishing, a person can grow and evolve and feels valued, supported, effective.
We can create workplace environments that help healthcare professionals flourish. That means creating environments that prioritize employee autonomy, validation, and wellbeing.
From your experience, perspective, or research, what are the main causes of Physician and Healthcare Worker Burnout?
My personal experience, my experience coaching physicians experiencing burnout and the research are all aligned. Burnout emerges in settings where healthcare systems do not listen to, validate, or attend to the needs and wellbeing of the people they employ.
Burnout emerges from within difficult workplace cultures. The individual details of the day-to-day work, such as inefficient EHR and limited resources to meet patient needs, are symbolic of greater systemic issues.
Even if you work in a healthy workplace environment, you’ll probably experience stress. You may even be dissatisfied with certain aspect of your work. However, you’re less likely to experience burnout if you feel supported, hopeful and see options for navigating challenges.
Have you seen burnout impact your own organization? Can you give a first-hand description of how burnout can impact the operations of an organization?
I’m flying solo now, but I’m certain that burnout was a big factor in the frequent turnover within organizations I’ve worked for in the past. Unfortunately, although many decisions made by administration directly impacted employees’ work experiences, these organizations did not routinely seek input from its healthcare professionals
When I worked in settings where turnover was an issue, morale was often low. I personally felt restricted from coming up with creative solutions to systemic challenges because those idea were often rejected.
Burnout harms an organization’s mission as well as its profitability. Burnout has been linked to more frequent medical mistakes. Increased medical mistakes are directly at odds with missions centered on patient care. Burnout can get expensive too. One of an organization’s biggest expenditures is its workforce. There are huge additional costs associated with employee absenteeism and turnover.
Does your practice currently offer any mental health resources for providers or clinical staff? We’d love to hear about it.
As I mentioned, I’m not currently affiliated with an organization. However, I think all organizations can offer basic information to access mental health resources if they do not have with ability to offer those resources internally.
Equally as important is creating a workplace culture that removes the stigma and shame around mental health issues. Organizations can promote policies that actively encourage and support its employees in seeking the care they need.
Preventative practices can also support mental wellness. Organizations can create workplace environments that reduce sources of stress. For example, designing employee centered policies that reduce unnecessary administrative tasks.
In an ideal setting, healthcare professionals should be able to seek mental health resources, either internally or externally, in safe and confidential settings without the fear of repercussion. Let’s face it, given the immense stress in our world today, more people than ever could benefit from access to mental health resources.
In my work I have found that streamlining operational efficiency with digital transformation and automated processes helps to ease the workload of providers and clinical staff. Has that been your experience as well? Do you think that streamlining operational efficiency can be one of the tools to minimize medical burnout? We’d love to hear your perspective.
That’s a tough one since technology has played a significant role in burnout in medicine. Electronic health record and digital communication platforms often increase expectations placed on healthcare professionals as well as their workloads. Organizations need to audit their EHR and digital communication systems to understand how they might be contributing to burnout. Time on computers and other devices means time away from engaging with patients. This has a direct impact on clinical care and how healthcare professionals experience their jobs.
The key is, as you said, operational efficiency. Organizations can prioritize maximizing efficiency and minimizing unnecessary or intrusive interactions with these systems. I believe that technology has an important role in how we track patient care and communicate both within and across healthcare systems. There’s more work to be done to shift these systems from burdensome to beneficially integral.
Digital technology designed around simple documentation, records review and communication will allow healthcare professionals to focus their time and attention on patient care. Such platforms will also support overall wellbeing.
One straightforward intervention that I often recommend to my clients is designating specific time blocks to check email inboxes. I discourage repeated, frequent email checking and trying to clear digital inboxes. This frequent checking wastes time and energy. Trying to clear a digital inbox can be a task in futility. Inevitably, it refills as soon as it’s purged leading to feelings of frustration and helplessness.
Fantastic. Here is the main question of our discussion. Can you share 5 things that hospitals and medical practices can do to reduce physician and healthcare worker burnout?
1 . Clear communication Listening is the starting point for all the interventions organizations can make. One factor leading me to stay at my previous job for so long was regular communication with my direct supervisor. He had an open-door policy and would take the time to listen to my concerns. His willingness to listen and validate my concerns gave me some hope that systemic issues could be addressed.
2 . Encourage social support Humans are social beings. We’re mentally, emotionally, and physically healthier when we’re able to work in supportive communities of our peers.
When I was growing up, my mom was a director at a small, non-profit agency that had a supportive, close-knit workplace community. Even as a kid, I could see that she thrived during her years working there. The leadership created safe spaces where employees could share their experiences and work through difficulties.
In high school and during the summers, I worked there as an administrative assistant. I could feel the care and support the employees had for one another. As an adult exploring my own work opportunities, I’ve always held that work experience as a model of what I hoped to find.
3. Prioritize employee wellbeing One of the things my previous organization did right was to allow for a flexible work schedule. As a mom with young kids at home, I needed to work part-time. Since I was commuting 45 minutes to work, limiting the days that I was in clinic made a big difference.
There are a lot of ways that organizations can support employee wellbeing. Again, it starts with your organization listening to you and partnering with you in optimizing your work experience. When employees thrive, organizations benefit.
4. Encourage autonomy We go through a lot of training to work in healthcare. Medical education teaches you to think critically about medical issues and to evaluate the medical evidence to design interventions. Your autonomy gives you a sense of control and confidence in your work.
For several years, I was a staff psychiatrist with a federally qualified healthcare center. Many of the families I worked with needed help beyond the medical interventions I offered. I tried to convince my organization that the mental health team needed case managers to support our most under-resourced families. I even wrote a job description to help get the process started. My requests were disregarded, and I felt devalued and discouraged.
I fully understand that healthcare delivery functions on a business model, but there can be better synergy between healthcare organizations and their providers. Alignment empowers those delivering care to do so based on their best judgement and expertise.
5. Address resource limitations Access to healthcare resources can be limited. Everyone experienced this during the pandemic, but for some communities, this experience isn’t new. Healthcare professionals can become overwhelmed trying to meet the needs of communities with limited resources. This is even more challenging working for healthcare organizations that don’t actively address these needs.
During the pandemic, access to resources was limited for patients as well as us. Healthcare professionals can’t sustain trying to squeeze water out of a rock indefinitely.
Most of us working in healthcare want everyone to have fair access to resources. Many have gone to great lengths, pulling together whatever resources were available, to care for patients. While not every need can be addressed, healthcare organizations can partner with their healthcare professionals to identify and address resource limitations.
What can concerned friends, colleagues, and life partners do to help someone they care about reverse burnout?
People need community. We’re wired to live and thrive in supportive social groups. Supportive networks can be critical for people struggling with burnout. Family, friends, and colleagues can help by being present and available. Sometimes being that person who listens, without judgement, is enough to help someone think about their next step.
Concerned loved ones and colleagues can also help someone struggling with burnout identify their options and encourage them to take the next step.
It’s important to offer support without judgment or shaming. You can create safe spaces for someone to make decisions that are best for them, even if you disagree with them.
If you’re worried about someone’s health or safety, you can help them find professional care.
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?
Burnout is not a personal flaw or shortcoming. I think one of the biggest mistakes is believing that an individual struggling with burnout just needs to be more resilient or stronger. Burnout is a systemic issue. Like the Surgeon General’s recent report and other research has stated, reversing burnout out is a societal, organizational, and individual matter.
I’ve seen some people trying to just “push through it.” Unfortunately, ignoring your burnout might lead you to feeling worse or experiencing other issues like depression or anxiety.
Addressing your burnout starts with recognizing it. Once you identify it, then reach out to a supportive friend, peer, or professional who can support you in navigating steps towards recovery.
If you know someone experiencing burnout, make sure they know that you’re there for support. You can start by listening without judgment and supporting their journey towards wellbeing.
It’s worth noting that healthcare organizations are at various stages in their willingness and ability to make changes to help reduce burnout. Some healthcare professionals might have to initiate steps to prioritize their own wellbeing in the absence of significant external changes.
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?
I made a pretty significant mistake early in my career, the day I signed my first contract as an attending physician. I was so thankful to have been hired at the same institution where my husband was starting his residency program. Eager and naive, I signed my contract “as is” without any attempt to clarify or negotiate the terms.
Fresh out of training, I didn’t feel empowered to negotiate for what I needed. Now, I jokingly tell colleagues and trainees about a small clause at the end of the contract. The list of my roles and responsibilities ended with “and anything else that we need you to do.” Those might not have been the exact words, but the sentiment was there.
Fortunately, I had joined a supportive department. I wasn’t asked to do anything too inappropriate, but I found myself taking on some roles that I should probably have questioned and negotiated.
After that initial experience, not only have I scrutinized subsequent contracts, but if I’ve ever been uncertain about the terms or needed help with wording and crafting a counter, I’ve sought legal expertise.
As is the case with those experiencing burnout, if you don’t advocate for yourself, chances are no one else will. We’re better at knowing what we need than anyone else. Speaking up can be uncomfortable and at times risky, but in the end, is the best way to care for ourselves.
Can you share your favorite “Life Lesson Quote”? Why does that resonate with you so much?
Dr. Maya Angelou famously said, “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”
At the end of the day when taking care of patients, where I trained, my awards and how “productive” I’ve been all fade away. What people remember is that I helped them feel safe and cared for. Each patient was seen as a whole person, with respect and dignity.
A healthy healthcare system is one that allows healthcare professionals to function as whole, valued individuals delivering healthcare. I’ll see our healthcare system as being on the road to recovery when healthcare professionals feel empowered to embody Dr. Angelou’s words in their daily work.
Not that Dr. Angelou’s wisdom needs validation, but research shows that patients are less likely to sue their physicians when they have positive relationships and good communication.
Ok, we are nearly done. 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 that be? You never know what your idea can trigger.
Equity in healthcare. People’s lives depend on the equitable allocation of healthcare resources. Inequalities show up in how people understand and treat diverse populations of patients, how care is accessed and how resources are distributed. It also impacts how we study and understand diseases and treatments.
The negative impact of inequality in healthcare is far-reaching and at its worse, can lead to increased morbidity and mortality. Patients from under-resourced communities experience inequalities directly. They often mistrust healthcare systems and providers causing delays in seeking medical care.
Individuals interested in healthcare careers are also impacted by inequality. People from communities underrepresented in healthcare careers often have fewer opportunities and resources to pursuit these careers. Studies have shown the certain populations are more likely to be treated negatively by supervisors, coworkers, and patients which has a significant impact on professional experience and wellbeing.
I would love to see initiatives around implicit bias, medical mistrust, access to and provision of care, and access to healthcare careers on the leading edge of healthcare evolution.
How can our readers further follow your work online?
You can find me at:
https://www.tracyasamoahcoaching.com/
https://www.linkedin.com/in/tracy-asamoah-physician-life-coach/
This was truly meaningful! Thank you so much for your time and for sharing your expertise!
Minimizing Medical Burnout: Dr Tracy Asamoah Of Tracy Asamoah Coaching On How Hospitals and Medical was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.