Navigating Post-COVID Healthcare: Burnout Prevention and Management

Speaker 1: 0:15

Welcome to Beyond the Stealthoscope Bottle Conversations with SHP. I’m your host, Jason Crosby. Today I sat down with Allison Griffin, a practice administrator at Urological Associates of Savannah. I specially practice with 14 providers and over 100 employees. She comes to us with over 35 years of experience in health care and has been in her role at Urological Associates since 2015. Today, we had a great conversation around provider and employee burnout, including how to avoid and manage the stress that our new post-COVID world has brought us. Are you ready for this vital conversation? Hi everyone, this is Jason Crosby and we’ve got with us Allison Griffin for today’s episode. Allison, thank you for joining us. How are you?

Speaker 2: 0:57

Doing fine. Thanks for having me, Jason.

Speaker 1: 1:00

Fantastic. Well, as everybody has heard through our intro here, allison’s got a vast amount of experience and other different areas of health care, so we’ve got lots of good stuff to ask her today and in light of, as we subject the matter, weathering the exhausting road less traveled, as she’s called. So, allison, you’ve had a great amount of experience in health care more than half your life. You’ve pretty much been there, done that, seen it all. What has changed, would you say, with regards to health care management?

Speaker 2: 1:32

Well, I think the question we’ve all been asking is you know, how did we get to where we are today? And we can blame it on a plethora of things, from COVID to the economy, to politics, but I think what we all realize is that somewhere we took a left turn down, the road never traveled, and it’s been a hard and bumpy one.

Speaker 1: 1:52

That it has, that it has. So what are some of the things or changes you have been encountering?

Speaker 2: 1:58

Well, work’s just getting tougher than it’s ever been. You know we had COVID, our disaster preparedness plans. All of us have them, but none of them factored in a multi-year pandemic with such lingering effects. And through it all, we’ve had to maintain staff and our patient volumes, maintain supplies, equipment, inventories, and all while remaining profitable. So most of us even had to apply for the provider relief funding that was made available, which was a new adventure that was made possible through the government, but that was a daunting new process. And then we had to report on the use of those funds. So much has changed. That was new for us.

Speaker 1: 2:38

That’s right, not exactly something that there was a book or a manual or a policy off the shelf we could pick off, as we all encountered COVID, lots of stressors. So, as those changes came about, what are some of the results or some of the things you’ve been seeing since those things occurred?

Speaker 2: 2:56

Jason, I think for sure. Society has just, overall, become more aggressive and demanding Providers, patients, staff and visitors. So some of us have had additional crises to manage on top of that, everything from hurricanes to floods, large equipment failure, closure of offices due to staffing inadequacies. I could go on and on. But the pace of business has just accelerated Following COVID. There were families that made adjustments, with remote schooling that occurred, and then some just decided to remain home and not return to the workforce. So that too has had impact, and those that are working are starting to demand higher wages, and as they realize that that increasing value is of relevance, then they’re driving up employer costs tremendously.

Speaker 1: 3:44

I’ve heard it described before that it’s a lot for folks in your, your role and management role to take in all that once and so the description of sort of like drink through a fire hose or the role now being more of a firefighter. How would you make that analogy between your role now as a firefighter?

Speaker 2: 4:05

Well, I think, as leaders, we are problem solvers that are accustomed to working at a fast pace just to keep up with the demand. But the stamina required to be the firefighter battling constant blazes is new to us, and so drinking from that fire hydrant has become, well, our new norm.

Speaker 1: 4:24

As you mentioned, drink through the fire. What’s been some of the adverse impacts from, from all of that that you’ve had to take on?

Speaker 2: 4:31

Well for sure, it’s been taking a toll on our minds, our bodies and spirits and speaking of spirits, some of us have even been indulging in more of those too, but many of us are just fizzling and slowly fading without realizing it. I think health issues are quietly creeping in. You know, many have had high blood pressure, raised cholesterol levels, lower immune systems due to fatigue and continual stress. Our bodies are just sending us signals that we can’t keep this pace.

Speaker 1: 5:00

That makes it more daunting here and you describe it out loud like that. You know we’ve all read it, we’ve heard about some of us experience it, but that’s quite a lot, and so with all of that that you’ve had to take on an experience. What are some of the new realizations in your role as an administrator?

Speaker 2: 5:18

Well, I think that leading our practices means also prioritizing care for ourselves, our providers, our staff. I’d love for your listening audience just to grab a pen and paper and let’s just take a couple of moments to capture their answers to a few important questions.

Speaker 1: 5:37

Fantastic. Okay, let’s ask away. This would be some good self-reflection, on behalf of listeners, for sure. So what are some of those that you want that they should self-reflect on? That’s important to them.

Speaker 2: 5:51

Well, you know how many hours a week are you typically working. We realize that the definition of salary really means permission to work 24-7. So how many hours are you working? Zero to 40, 41 to 79, 80 plus? Second question has your enthusiasm drive an energy level for your role declined over the last three years? Yes, no. Have you experienced health issues over the past three years that you feel could be attributed to your work stress level? Yes, no. Have your positions been supportive of addressing burnout for you and your leadership team? So those are some of the questions, but I think we’re to be reminded of the importance of self-care and time off. Jason, it’s clear that no tombstone has ever read she worked her butt off or amazing overachiever, but rather they read faithful friend, loving mom, devoted partner. So we are to be the leader that demonstrates the importance of that work-life balance so that others follow. We need to schedule and prioritize our own health appointments, like dental health checkups, and then seek convenient online therapy as needed for yourself and encourage others to do the same. There’s so many tools out there, some of which are like BetterHelp, talkspace, brightside, mdlive and LiveHealth, so there are numerous tools available to us.

Speaker 1: 7:22

It certainly feels like we’ve all read her talk about self-care over the number of years, but it’s really heightened, of course, of late. That’s some really good information From all of these new stressors that we have in our culture now in particular work culture. What have you found that helps combat some of those stressors that can be so destructive for your staff?

Speaker 2: 7:46

Yeah, I think overall, Jason, we just need to silence the noise. We need to use our morning time to start the day off wisely, organize our thoughts and plans for the day, catch up on your reading them, limit social media, resist comparison, because that is such a time waster and it’s a non-productive area that many of us could do without. We need to unsubscribe to emails that distract and eat up the minutes of our day. For myself, I take a midday time out. It’s called halftime. I leave the office for lunch every day. I feel the sun, I breathe in the fresh air. I refrain from answering emails or texts during that hour and just reflect on the halfway point of the day to gauge success. Then I amend my to-do list for the second half of the day. So it’s somewhat of a silencing the noise opportunity.

Speaker 1: 8:37

During the off-time. That’s some really good input during the work day that we also definitely take advantage of. How would you shift that over when it’s quote-unquote, using air quotes on a podcast during your off-time?

Speaker 2: 8:49

Sure, sure. Well, nights and weekends are really important to establish boundaries, not just a work-life balance, but for your own health and wellness of everyone. You can set the tone of expectancy for yourself and your providers and your staff. You can refrain from engaging in after-hours contact unless it’s a true emergency. They can call or email the next day when business resumes. But really preserve your quiet time. If you must work on your weekends to keep pace with the demands, then do it early, so that nothing steals the joy of the day or impacts your precious time with your friends and your family. Our work is what we do, but it should never become who we are. So it’s important to have your restful sleep, a consistent pattern for winding down and settling in, and that applies for weekends too. Also, take a walk, engage in other exercise, develop a consistent routine, take time for your family connection, eat together and interact, and conversation free from your cell phone. Share only the positive highlights of the day, because no one really wants to hear all that, what you went through or recounted all, and then engage in other enjoyable activities that keep your mind and body strong, and it can be a range of things like meditation, prayer, yoga, communion with others, connecting with nature, maybe a hobby or music that you enjoy, something that calms and makes you happy golfing, swimming, fishing we have an abundance here that we can enjoy with our lifestyles.

Speaker 1: 10:25

Before we switch over to the provider side. I know you’ve got a couple of other little check-in questions for folks, as they have their pen and paper, that need a couple of questions. They asked themselves what would those be?

Speaker 2: 10:39

Well, do you truly check out when you’re on vacation and refrain from checking emails, answering your calls? How have you set your personal work boundaries to take care of yourself, post-pandemic? Have you restricted your work hours? Have you forced yourself to take at least a couple of PTO days off per month? And are you learning to set and communicate more reasonable time frames for project completions, those deadlines?

Speaker 1: 11:04

Yeah, it’s funny. You talk about email especially when you’re on vacation. I think that applies to so many. I had myself was just on vacation the last few days and it’s so tempting because now there’s just a button on your phone you can press to simply open up your email app. Right, and there’s a. And then there’s the debate of should we schedule when emails go out versus well, should you actually open an email in the first place? In the constant debate simply around checking an email, it’s amazing I’m so glad you mentioned that, because it’s so amazing how much of a stressor that is Simply having that little app set on your phone that’s so easy to hit. But if you open that little button, the stress that can come from that, yeah, that’s a great point. Okay, let’s shift over, because I know obviously you’ve worked with physicians for a number of years. You’re CEO of a really large group, so let’s switch over to the provider. So, when it comes to provider care, what are the some of the things you would recommend?

Speaker 2: 12:03

Well, it’s important that we are certain not just to manage the practice, but also our providers. We need to address their changing needs and their desires so we remain on course with what is important to them and that they deem as priorities. We need to frequently update them and so that they are made aware of what we’re involved in and accomplishing as their leader. It’s no surprise to listeners here that most physicians are so very busy with their own loaded place that they have no idea what’s on ours. So that’s that important check-in time. We need to give consistent applause and congratulations and add a voice for their hard work. Everyone wants to feel valued and appreciated, and our providers are no exception there. I’ve even noticed that when we’ve had employee events in-house just things that we’ve done to boost morale it tends to flow over and affects the mood and temperaments of our providers just as much. So often, as leaders, we can truly set that tone and create our own ideal, healthy, cheerful environment. We also need to monitor and regular communicate with providers about their job satisfaction and needs, ideas for solving problems that are facing the practice. I’d be willing to try new approaches to address problems or needs and confront provider behavior issues head on because it’s difficult but it is necessary. You know there are three key points involving providers that are probably worth taking a note of. Number one is providers must support you and create that workplace that does not tolerate staff, patient or visitor disrupting operations of care. That’s very important. So that’s that can be provider support essential. Number two would be ensure your providers take off their own time for rest and restoration. No martyrs allowed, no martyr mentalities. And three, don’t allow burnout to become the reason that they retire early or leave your practice. There was an interesting article in July’s MGMA connection magazine this year and it basically said that you need to address burnout as a means of slowing physician retirements. Implement a robust physician retention plan that speaks to the issues causing burnout and strives to make physicians happier in their jobs, provide options to physicians who are thinking about retirement and propose alternatives. So there are many other things that we need to consider.

Speaker 1: 14:35

Wow, those are all very valuable points. So tell us some of the tactics you’ve seen work or not work when you’ve seen tensions rise with providers, in particular, as those Tension or stressors lead to bad behavior.

Speaker 2: 14:50

Well, most of us have a code of conduct policy. Every now and then it’s ideal to Bring that out and dust off of it, maybe even require a yearly signature on that puppy, so it’s date stamped. Remind them that federal law requires workplace protections for all workers, and that applies to position owners too. All workers are to have an environment free from discrimination, hostility, harassment, retaliation, and Providers are always so careful, you know, to protect that DEA from misuse or over prescribing narcotics. But encourage them to give equal respect and pause for workplace protections, as they too can result in bad press, a reportable offense to the Georgia Medical Board, costly cases to defend, an even suspension of their license. So it is equally as important.

Speaker 1: 15:41

No kid. Wow. Well, let’s. Let’s check in again. We’ve been talking about providers last few minutes. I think we need to folks. They got their pen and paper. What’s something important they should ask themselves.

Speaker 2: 15:52

Well, how often do you experience hostile behaviors, either from your staff, your providers, patients or visitors? Several times a week, several times a month, several times a year or hardly ever?

Speaker 1: 16:05

Let’s, let’s hope it’s. It’s one of the last bullets there and not the first sure. Right gosh, but that’s. I think those are important questions to ask. It’s part of reflecting and just to get where your state of mind may be, especially in Rolls similar to Allison’s, so as as we ask these poll questions, probably a good moment to the check in and Self reflect. So, allison, I’ve heard you say Crazy. Is now the new or is now the customary? What exactly brought you that conclusion? What do you mean by that?

Speaker 2: 16:37

Managing people and their heightened emotions in the workplace. It’s become a constant challenge. I’m old enough to remember candid camera and Alan font and, quite frankly, he’d have a year’s worth of material Just following me for a week. I mean, it seems like every day we won up the previous with craziness. A person attempted to bathe and are fountain up out front during regular business hours. I had a man get his head stuck in a bench out front during off hours but I captured it on camera. Grown adults making unreasonable demands every day. Just, they expect healthcare to be like a fast food drive-through where they can have it their way. So, managing the unexpected you know we have deaths, illness, staffing Changes and challenges. You get hospital politics and issues.

Speaker 1: 17:23

It really is action-packed, never boring, ever changing that may be the single greatest thing I’ve heard described that that is not related to a child under four, maybe you know. But a head, that’s a new one. Okay, I’m glad I have to button while you were doing that, because that one that’s pretty good. So you mentioned before the patient provider agreement and you guys having that at your practice, at your logical associates, that you’ve implemented. Tell us more about that document and really what’s accomplished for your group.

Speaker 2: 18:00

Well, I can’t claim it to be the author of it, but we did amend it. It is part of our new patient packet and, basically, being privately owned, we put together a patient provider agreement and we have our new patients to sign it and Basically, it lets them be on alert if they’re unwilling to follow medical recommendation or treatment plans, unwilling to schedule recommended follow-up visits or undergo the tests that we recommend. If they use vulgar, demanding, threatening or abusive speech towards our staff, providers or even other visitors, a Demonstrate abusive medication equipment supplies, damage our property or grounds or display any type of threatening behavior, that we have the right to dismiss them from the practice. It certainly has been a document that I’ve had to pull out and counsel Patients on and visitors to let them know that you know we are privately owned and, quite frankly, their behavior Doesn’t have to be tolerated here. In most cases people will back down and understand, but it’s been a tool that has helped us to maintain peace and control.

Speaker 1: 19:03

Oh, fantastic. Well, that’s definitely something for some of our audience members to take the heart and hopefully implement on their side as well. So what other tools can you suggest for organizations that can hopefully strengthen their overall well-being?

Speaker 2: 19:17

Although I’ve not used this. The American Medical Association recently introduced what’s called the organizational biopsy and it apparently is an assessment tool and a set of services that were developed by the American Medical Association to support organization in holistically measuring and taking action to improve the health of their organizations. So it does everything. It crosses four domains the organizational culture, with leadership, teamwork and trust. The practice efficiencies, self-care and then the retention of workers. So that is available at the web address, practicetransformation at AMA-ASSNorg, and I guess you can make that available at the end of the podcast today for our listeners.

Speaker 1: 20:05

Certainly will Well be sure to vote. You should see that Our show notes will list up there for you. So I know we’ve kind of come to the end here. What are a couple of the closing questions. As folks again for another check-in, self-reflect, what are a couple of questions they should ask themselves?

Speaker 2: 20:20

Well, I think some of the tools that can help making sure you’re tapping into your providers and staff throughout the day, making yourself available to listen and appropriately respond to their needs. Demonstrate through your actions that you truly care about them. Have an open door policy so you remain approachable. Use your professional organization. Lyft serves to connect with each other and other colleagues, to gain new insights and toss around ideas, and then again, if you have an employee assistance program, familiarizing yourself with what it offers and educating your providers and staff on all of those available benefits.

Speaker 1: 20:53

Fantastic. Well, allison, this has been a great discussion. We get caught up in the day-to-day and the technicalities of our jobs day in and day out, and I’ll take a moment to sort of reflect on all the stressors we have, especially these last few years. So I know it’s been helpful for me, I’m sure it’s been helpful to our audience and we’ll be sure to include a lot of information in the show notes as well. But well, thank you for joining us today and really appreciate your time.

Speaker 2: 21:20

Thank you for having me.

Speaker 1: 21:21

You’ve been listening to Beyond the Stealth School Bottle Conversations with SHP. This has been our production of strategic health care partners.

Speaker 3: 21:29

Your hosts are Jason Crosby and me, Aaron C Higgins. This episode was produced and edited by Nile and Weave. Our social media content producer is Jeremy Miller.

Speaker 1: 21:41

The transcribers Heather McBite, and our executive producers are Mike Scribner and John Currie.

Speaker 3: 21:46

For more information about SHP, the services we offer, including the back library of episodes, episode transcripts, links to resources that we discussed, and much more, please visit our website at shpllc.com. Thank you for listening.