In an era of constrained resources, how do you make the business case for innovations to reduce physician burnout? How do you pay for them?
“Anything that reduces health professional burnout is going to be better for our bottom line,” says Christine Sinsky, noting that recruiting and replacing a primary care physician costs about $400,000. The University of Utah, for example, developed a collaborative care model that helped reduce the staff cost-per-work RVU generated. “That makes sense to me when you’re more strategically distributing the tasks according to skill level so that you can make the business case for many of these innovations in the fee-for-service world and in the longer-term accountable care world,” Sinsky says.
“We’ve had an increased focus on safety and patient satisfaction [and] quality of care,” adds Tait Shanafelt, “and as evidence of the impact of provider satisfaction and burnout on those outcomes has grown more robust, I think the business case is clear.”
But there’s a second part to that question, says Shanafelt: the incorrect assumption that rectifying physician burnout is expensive and requires a massive investment to make improvements. Shanafelt describes how at Mayo Clinic in 2013, when 20 work units focused on reducing burnout, the only incremental resource they needed was the team that helped them engage in dialogue, identify solutions, and put them into effect. “Many of the redesign activities just require asking and empowering the local team to make changes and redeploy the current staff they have to perform different tasks,” explains Shanafelt.
For other provider satisfaction activities at Mayo Clinic, such as physician engagement groups, the cost per year is minimal. “We often refer to [these groups] as ‘budget dust’ because it’s less than 0.10% of the compensation that we pay to the physicians,” Shanafelt says. “So if it helps keep them in the practice and high functioning, it’s almost immeasurable in the scheme of their compensation.”
From the NEJM Catalyst event Leadership: Translating Challenge to Success at Mayo Clinic, June 2, 2016.