There’s lots of talk about physician burnout. There’s even more talk about how we get rid of it. Everyone has a solution. But the problem with the conversation is that burnout is a sign, not a disease. Burnout is the downstream result of a number of complex upstream problems. But it’s rarely the problem. Focusing on fixing burnout is like trying to eliminate fever during a COVID outbreak. Physician burnout needs attention. But not as much as the things causing it. If you like this post, check out our Burnout Archives. Image via Burnout is a sign appeared first on 33 Charts ..read more

Optimization has become a defining feature of modern healthcare. We optimize, review, tweak, and measure our systems and ourselves against a super-optimized standard. Better, faster, safer, more productive, efficient and effective. We’re always looking for improvement. And for good reason. 21st century healthcare has worked to prioritize safety and quality improvement, and the results have been remarkable. Small changes in equipment sterilization or preoperative timeout processes, for example, can have a dramatic impact on patient safety. But not all corners of the hospital should be subject ..read more

The angry email is a timeless problem among young leaders and managers. Something gets us upset and we impulsively take to the keyboard to try to fix it. What comes out is typically edgy and direct. Usually there’s frustration buried between the lines. I’ve had the chance to work with several young physician leaders over the past couple of years. I’ve been able to follow up on a few of these emails and have noticed some patterns. Angry email and the fantasy of change The angry email is usually rooted in frustration over inefficiencies or some nagging problem that hasn’t been fixed. Ultimately ..read more

I love this concept of the people margin. It comes from Automattic engineer Mike Shelton in 2018. Data can be precise, specific, absolute and is meant to represent the actions and behaviors of people and things. Yet, people themselves can be imprecise, abstract, non-linear, and unpredictable. I call this the people margin – data’s margin of error when applied to everyday life. Context matters. We intuitively modify our behaviors based on numerous inputs. These modifications often can’t be explained with data alone. Only when we apply context to our product based on actual people’s s ..read more

In his book, Leaders Eat Last — Why Some Teams Pull Together and Others Don’t, Simon Sinek discusses the importance of a safe work environment for innovation, productivity and survival. He calls this leader-driven space the Circle of Safety. It is easy to know when we are in the Circle of Safety because we can feel it. We feel valued by our colleagues and we feel care for by our superiors. We become absolutely confident that the leaders of the organization and all those with whom we work are there for us and will do what they can to help us succeed. We become members of the group. We feel lik ..read more

Goodhart’s law suggests that when a measure becomes a target, it ceases to be a good measure. When I first read this I couldn’t help but think of healthcare and the quest for the perfect patient satisfaction score. The problem is that as soon as we steer physician behavior and teach to the test, patient satisfaction scores stop being a valid measure. Essentially, the metric becomes a proxy for ability. High patient satisfaction scores more likely mean that we’re good at getting high patient satisfaction scores. What’s worse is that when we obsess about the measure we wind up with a hospital f ..read more

This past weekend the storied medical meeting DotMD sold out in two days. How did this happen and what does DotMD deliver that no other meeting does? Experiences. People are desperate for experiences. And the future of meetings is about the creation of human experiences. Sound, sensory, and emotion. These define DotMD. Like minds. Beyond the power of the programming and a remarkable culture, DotMD draws the most fascinating people in healthcare. DotMD attracts the people who prioritize human experience, story and feeling. Scarcity. While we live in a world that prioritizes scale, some t ..read more

This sounds like a crazy question. But it really isn’t. What does a doctor do? What’s my job with my patients. What is a doctor’s role? Some of what I do is transactional. Simple stuff with clear end-points. Some of it involves critical conversations and deeper kinds of thinking, planning, and translating. Breaking my job down into different roles I got to thinking about what I do on a daily basis. In my work I … Find. I look for and find things. This is the discovery of problems during physical exam and endoscopy. Usually these are things the patient didn’t know about when they came to see ..read more

Medicine is facing a crisis of information. Beyond the increase of biomedical information are rising demands for physician response to portal messaging (MyChart messages) and review of wearable generated data.  More recently health professionals have seen a rise in MyChart messages coming in through the Epic patient portal. According to Epic, the number of patient messages spiked 151 percent nationally from the period covering the first 11 weeks of 2020 through the end of the year.  This change has been driven by health systems actively promoting portal use. COVID has clearly driven ..read more

Since the pandemic healthcare has undergone a remarkable transformation. Before COVID dropped in as our latest wicked problem, technology was upending everything we do. I’ve been thinking a lot about the burnout, confusion, uncertainty, and exhaustion that we’re facing. I’ve been thinking about the conditions that define healthcare. When we talk about these challenges that we’re facing there’s a tendency to blame isolated issues — we believe that our problems can be solved with targeted changes. The belief that perfecting the electronic health record would fix burnout in physicians is a great ..read more