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Institutionally Driven Initiatives May Help Prevent Burnout More Successfully

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Corporations have evolved in the millennial age by prioritizing employee well-being. Many have understood the value in offering onsite childcare, salons, dry cleaning services, grocery delivery partnerships, workout centers, virtual or real-time mental and physical health care, and healthy dining options. By reducing stress and creating efficiency between work and life, employers maximize their employees’ ability to be more effective professionally. 

Medicine is often viewed as less amenable to creating a wellness- centered environment for their providers. This may be due to limited financial resources when considering the cost of offering such services, especially if they are provided outside standard business hours. However, for institutions that care for patients daily, offering  comprehensive wellness for providers should not be an impossible task. 

A few weeks ago, I noticed a tweet from a medical student, soon to be resident, describing her residency orientation. Her residency program at Boston Medical Center offered interns a scheduled appointment with an assigned primary care provider during orientation week to establish care. This tweet felt revolutionary.  As a new resident, I wish this opportunity existed during my orientation.

I would like to emphasize that Boston Medical Center realized the value in doing more than a resident retreat, a mandatory bonding activity, or a pamphlet on 5-minute meditation breaks. This is the first time I discovered a healthcare institution offering a concrete program to foster long term resident wellness. Establishing a relationship with a primary care provider hopefully initiates a new priority on personal health and well-being during residency. 

In general, every orientation package includes a laundry list of electronic medical record tutorials, modules on patient care, and licensing documentation. In the epidemic of provider burnout, there is an urgency for creative solutions to provide clinicians with ways to maintain a healthy well-being. Perhaps, resident orientation is the ideal time and place to lay a foundation for burnout prevention among trainees. 

The traditional approach to burnout prevention has involved the same slideshow presentations or mandatory activities that add to the already demanding workload of trainees. Despite efforts to change this approach, the burgeoning wellness programming for trainees has not translated to reduced rates of burnout. 

We can discuss programs that could make training easier such as maternity/paternity leave, childcare services, primary health care access, mental counseling services, greater availability of nutritious meals, and strategies to maximize wellness outside the hospital, but these strategies have not been implemented nor fully supported by a majority of healthcare institutions. In this space, pairing residents with a primary care provider could be a novel effort to establish wellness and perhaps prevent burnout.  

Understandably, many of the solutions to burnout are restricted to residency training programs’ financial resources. Both the repercussions of burnout and burnout prevention are challenging to quantify. Despite the desire for proactive measures, the cost may not outweigh hypothetical consequences of burnout for our patients and providers. In this balance, innovative solutions can grow. Simple actions such as utilizing orientation to establish care for providers is visionary.  

The recommendations of many burnout prevention programs often places the responsibility on providers to shield themselves from the inevitable. Programs such as Boston Medical Center’s reduce this burden by creating institutionally driven initiatives, potentially translating higher success. Burnout prevention should be a greater priority to the healthcare system instead of a line in every trainee’s ever-growing to-do list.

Shree Agrawal is a urology resident at the Cleveland Clinic Glickman Urological and Kidney Institute. She completed her B.S. in biology degree and medical degree at Case Western Reserve University, as well as a clinical research fellowship in genitourinary reconstruction at Cleveland Clinic. She is passionate about research surrounding patient decision-making and currently blogs for Doximity and the Association of Women Surgeons. In her free time, she enjoys boxing, practicing yoga, and cooking. She is a 2018-2019 Doximity Author. Twitter: @ShreeAgrawal21

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