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President’s Letter
Is Resilience Training the Answer?
By Scott L. Furney, MD
T here is a lot of talk about physician and ACP burnout EMR training is available, we need to be first in line. Most
these days, and for good reason. In a previous letter, I important, we need to acknowledge that the income treadmill
reviewed the unacceptably high prevalence of burnout is a self-defeating cycle when run at an unsustainable pace.
in our clinicians and I also reviewed, in brief, some Eliminating testing for patients who do not need it will provide
insurers the understanding that when we do order an MRI, we
of the drivers of that burnout. Clerical work in electronic health really need it for the patient in front of us — and without the
hour of bargaining that follows most orders. Lastly, spending
records, shortened time with patients, administrative burdens and more time with each patient may reduce our incomes, but we
will enjoy our years in practice and will be less likely to drive
many more distractions from bedside care all contribute. ourselves into early retirement.
Resilience training for physicians has been proposed as an So, back to resilience training; I am not saying it is a bad idea.
For some, it may be very helpful in the journey to a balanced
antidote for the plague of burnout. I would argue that this is life. I am concerned, however, that it appears to be the main
focus of improvement efforts in stemming the tide of burnout.
misguided when used as a primary strategy. The drivers are Without addressing the host of other stressors in the workplace,
the impact and durability of that effort will be limited. As a
The providers who much more related to excess profession, we need to do more than go to another after-hours
train so rigorously stress than “weak” providers. event and commiserate.
The analogy of insufficiency
fractures versus stress fractures In humble service,
for their career might provide some guidance. Save the Date!
For osteoporotic bones,
David G. Welton, MD Society Fall Luncheon
are more like elite medications to improve bone
resilience is standard of care. Wednesday, Sept. 18, 2013 • 11:30 a.m.
athletes than the For stress fractures, we reduce Charlotte Country Club
the stress to allow the bones to
frail elderly. Their Speaker: JOHN E. BARKLEY, MD
bones are not weak. heal and work on the mechanics
Stress is the that caused the fractures. I Mecklenburg County Medical Society and their guest(s).
think we are dealing with
stress fractures when it comes Membership Social
to physician burnout. Consider
Thursday, Oct. 25 n 6:30-8:30 p.m.
primary problem. the resilience one must have to
successfully complete medical The Olde Mecklenburg Brewery
school and residency. The 4150 Yancey Road, Charlotte
providers who train so rigorously for their career are more like To RSVP, email Sandi Buchanan at sbuchanan@meckmed.org.
elite athletes than the frail elderly. Their bones are not weak. Stress
is the primary problem.
There also is a component of “blaming the victim” when we
tell providers they have to improve their resilience in order to be
satisfied in their practice. This is especially ironic when sessions
aimed to improve resilience and reduce burnout occur on evenings
and weekends! Asking providers to spend their Saturday learning
how to obtain better life balance adds insult to injury.
If the analogy makes sense, then we must focus on the root
causes and reduce stress in order to prevent future fractures. When
I speak to providers in full-time practice, they are fairly uniform
in their requests:
• Reduce or delegate non-clinical tasks to others
• Improve the usability of EMR’s
• Improve patient contact time — both in duration and quality
• Reduce or eliminate pre-authorizations for providers shown to
provide high-value care
In many of these domains, we need to embrace our role in
making them possible. If we are too controlling or do not invest
in training our staff, we retain many non-clinical tasks. Where
6 | September 2018 • Mecklenburg Medicine
