5 Ways Cleveland Clinic Boosts Physicians' Health

The health system's multipronged initiative promotes doctors' well-being.

Cleveland Clinic is expanding efforts to address physician burnout that the health system began a decade ago with a coaching and mentoring program.

Cleveland Clinic has not only launched new physician health initiatives but also adopted a new philosophy.

"We made a strategic decision when we started our efforts a couple years ago to focus on well-being rather than burnout. We prefer to focus on getting well and staying well," says Susan Rehm, MD, executive director of physician health at Cleveland Clinic.

Last year, internal engagement survey data shows modest but statistically significant improvement in several key measures for physician satisfaction at Cleveland Clinic. The data is represented on a scale of 0 to 5:

• +.04 for engagement
• +.03 for continuous improvement
• +.04 for well-being
• +.04 for trust
• +.04 for communication

Financial impact?

Gauging the financial impact of the well-being programs is imprecise because it is difficult to assess turnover, says Rehm. Tracking physicians who leave the health system due to burnout is a work in progress, she says.

However, turnover prevention goes a long way financially, she says. "The literature suggests that turnover of a physician costs the organization somewhere between $250,000 and $500,000. It wouldn’t take too many retained doctors to completely pay for the programs."

Cleveland Clinic's well-being programs have been staffed internally, so costs have been low.

"Because we used existing resources, the amount of new money that went into these programs was relatively small," Rehm said. "The biggest investment is training up clinicians to participate in these activities. If you take a surgeon out of the operating room for a day, that's potentially a big-ticket item that impacts us in areas like patient access."

Five of Cleveland Clinic's most prominent physician health programs are a blend of old and new initiatives:

1. Wellbeing Day

In January 2017, the 11-hospital health system established Wellbeing Day, granting time off for healthy activities. "We specify that it should be a day spent doing something that contributes to one's personal well-being," Rehm says.

Wellbeing Day is both a concrete and a symbolic effort, she says. "Wellbeing Day was a good start to demonstrate how Cleveland Clinic endorses well-being for the physician staff."

2. Coaching improvement

Nine years ago, Cleveland Clinic started a basic coaching and mentoring program, which featured a daylong orientation for staff members who wanted to be coached or to be a coach.

The program has grown over the years, including the addition of advanced peer coaches three years ago.

"An advanced peer coach receives four days of advanced training. They can help peers [with] career issues who need more intensive help than the average person looking for career development advice. We have trained more than 100 people in advanced peer coaching," Rehm says.

An internal questionnaire found that both coaches and the people they coach benefit. "We found that both were much more satisfied with their work and their lives," she says.

3. Engagement consulting

In 2017, the health system's professional staff affairs office took on a consulting role linked to a series of town halls that featured staff suggestions for operational changes. The engagement consulting features marshaling of resources and program development.

Engagement consultants also help managers with well-being­­–related staffing. "A couple of our departments and institutes have designated either engagement officers or well-being officers within their group to oversee well-being programs," Rehm says.

4. EMR ease

Since 2016, Cleveland Clinic has launched several initiatives to make the health system's electronic medical record more user-friendly, such as:

• Developing two apps that allow viewing and interaction with the EMR on handheld devices
• Freeing physicians of sole responsibility for routine tasks such as prescription refills

Cleveland Clinic's IT staff has been a crucial element of EMR enhancement initiatives, Rehm says.

"With every change that comes through, there are consultants from our information technology division who … help us with how we interact with the medical record, so we're not wasting a lot of time doing things that could be done more efficiently," she says.

5. Promoting empathy

For several years, all new hires at Cleveland Clinic have been required to take R.E.D.E. communication training. Empathy is a key ingredient in the Relationship: Establishment, Development, and Engagement training.

"The R.E.D.E. approach is an example of relationship-based communication. It can involve the use of empathy to bring out a patient's experience with their illness, their expectations, and how they wish to proceed," Rehm says.

R.E.D.E. has shown positive results with physicians, she says. "After going through the R.E.D.E. training, physicians reported feeling more empathy and less burnout."