One In Five Doctors Intend To Leave Medicine Altogether. Let’s Talk About Why.

Healthcare is facing enormous hurdles. Dr. Goldman, host of CBC’s radio series White Coat, Black Art, recently looked at doctor burnout. According to the Canadian Medical Association, more than half of Canada’s doctors may be suffering from burnout. And in the U.S., it’s even higher with nearly two-thirds of doctors feeling depressed, burned out, or both.

Meanwhile, a 2017 study suggests nearly one in five U.S. physicians intend to reduce clinical work hours in the next year. Roughly one in 50 doctors intend to leave medicine altogether in the next two years to pursue a different career. The study’s authors concluded that if physicians follow through on these intentions, it could profoundly worsen the projected shortage of physicians south of the border.

To compound matters, hospitals are also facing financial challenges.

According to data compiled by Bloomberg, U.S. healthcare bankruptcy filings more than tripled in 2017. Canada spent close to $242 billion nationally on health care in 2017, representing 11.5 percent of gross domestic product. Yet Canada’s public healthcare system relies heavily on fundraisers, private donations and even parking fees to make up for funding shortfalls.

How can employee engagement flourish in an environment where most chief business executives lead healthcare organizations on the brink of a crisis? Why should employee engagement be on the radar of these leaders when there’s so much else to contend with?

For starters, healthcare is one of the most complex work environments.  Physicians and nurses, researchers, scientists, administrative and support staff together form a unique community. Their insights speak volumes.

An American Charter calls on hospitals to support health professionals who try to get healthier by providing healthy meals and facilities and time for exercise. It says health professionals need to ask for mental health services. But it adds that hospitals need to provide confidential access to those services as well as time off to seek help as needed. The charter also says that hospitals and the people who run the health-care system need to streamline bureaucracy, reduce unnecessary paperwork and help doctors offload some of the jobs they do, to others. Employee engagement 101.

Unfortunately, healthcare tends to have lower employee engagement than most other organizations.

  • The number of distinct audiences that are coexisting and working to support each other have different dynamics and very different needs.
  • The sense of affiliation with the organization tends to be different amongst doctors verses admin, support staff and executives.
    • It’s a well-known fact that doctors tend to distance themselves from mundane administrative matters; their participation rates in employee engagement surveys are notoriously low.
  • There’s tension in policy direction and budget allocation. Different groups obviously have different priorities. They want to see policy and budget allocation done in different ways. In some organizations you could go as far as calling it rancor and disenfranchisement; doctors don’t feel they have enough influence on policy directions, decisions and budgets, while admin and executive feel they have too much.

Considerations for an effective employee engagement survey program

Galvanizing the minds and voices behind your healthcare organization through employee engagement surveys and actionable data is your most influential means to drive a stronger homogeneous vision and achieve higher client/patient outcomes and satisfaction rates.

The first thing TalentMap recommends before you even get a survey off the ground is to be inclusive in your approach. At the risk of slowing things down – and it will – you need to include doctors, researchers, nurses, support staff, admin, and union representation right at the get-go. Convene an employee engagement committee that’s going to steer the process. This working group will be involved in the instrument design, and most importantly the dissemination and acceptance of results, the interpretation of results and the cascading of the results.

Allay concerns. Boards of directors, management committees, executive committees, executive leadership, department heads and union reps are often nervous before you start any survey like this. Before you even get into the logistics, address worries.

Establish credentials. Choose your survey partner wisely. Whoever is leading your initiative must:

  • be credible
  • establish bona fide credentials on all fronts including methodology and survey instruments
  • live up to a very high standard of integrity, what the survey research business calls “validity and reliability”

Consider your different audiences. Doctors believe they need to be asked a set of questions relevant to them, questions fundamentally different from everybody else. This pressure to customize questions has time and cost implications.

Allow time in the upfront process to come to a common understanding about the terms of approach. If requests for customization are likely, turn to the engagement steering committee and its different representatives. Discuss how to keep the process manageable. What matters most isn’t whether to customize or not, it’s about having consensus among the different parties as to the right approach.

Deal with logistics. Address the complexity of the human resources information system (HRIS) – your database of all medical and support staff. Many organizations find they have to build their HRIS. Others opt to take methodological steps to give people access – usually through an open link URL which means setting up a website where people connect using a personal password, fill out the survey, and answer questions around length of service, age, and department.

Communicate.Communication is crucial to the whole process. Understand that your audience communicates in different ways. Use email, internet, digital or paper to reach different people in different places at different times.

Share results ASAP. The way to improve engagement is to act quickly. But there are some reporting issues specific to healthcare. Being researchers by nature; being investigative by trade, there’s a drive to over analyze – which leads to analysis paralysis. As interesting and intellectually stimulating as conducting that analysis is, nothing gets done.

TalentMap counsels healthcare organizations to communicate results quickly and widely to a large audience through town halls and staff meetings. Show what the key results are. What the issues are. What the themes are that really drive engagement organization wide.  Exploration and discussions can be held separately. Those who want to conduct further analysis can be provided the avenues to do so thereafter.

Healthcare is a distinct kettle of fish. Understand and accept different employee audiences have different senses of affiliation to your organization. Understand and mediate divergent points of view. Involve different audiences. Work on common issues together. Work on becoming more and more engaged.

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