Medical staff and hospital leaders are well aware that physician burnout can potentially put patients at risk for adverse events. What they might not be aware of is that organizational culture and the way physician wellness activities are designed may be contributing to physician burnout.
The Joint Commission shone light on the importance of physician health when it created standard MS.11.01.01, which requires medical staffs to implement a process to identify and manage individual health issues for licensed independent practitioners that is separate from disciplinary processes. The Joint Commission does not require hospitals to have wellness committees, but many Joint Commission-accredited organizations created them in response to the standard. Some non-Joint Commission-accredited hospitals followed suit, because having a physician wellness committee is considered a best practice.
"The problem is that the committees were formed and thought they had to deal with all types of physician behavioral problems and possible impairment issues. They really got themselves over their heads because they started interviewing doctors and interviewing the nurses that made the complaints and then they didn't know what to do with the information," says Luis Sanchez, MD, director of Physician Health Services, Inc., a Massachusetts Medical Society corporation in Waltham.
Physician wellness committees should focus on physician advocacy, not corrective action, says says Jonathan H. Burroughs, MD, MBA, FACPE, CMSL, senior consultant at The Greeley Company, a division of HCPro, Inc. in Marblehead, MA.
"The purpose of the committee is to evaluate, advocate, and recommend to the [medical executive committee]. It should make no decisions regarding credentials or privileges and take no corrective action whatsoever," Burroughs says.
Physicians suffering from burnout or substance abuse issues may hesitate to come forward if they think that the committee will take a potential peer review action against them. The purpose of a physician wellness committee is to create a welcoming, safe environment for physicians to seek help.
To help create that safe, welcoming environment, committee activities should be kept confidential. For example, if the committee creates a physician support group, attendees' names should not be disclosed to any other individual or committee. Physicians may not attend the support group if they think that their attendance would potentially be used against them during credentials, peer review, or medical executive committee deliberations regarding their privileges.
For some hospitals, culture often gets in the way of achieving a proactive focus on wellness, rather than a reactive focus on discipline. Wellness activities should focus on shifting the organization's culture in a way that allows physicians to tend to their personal needs as they develop their careers, rather than letting their careers trump all else.