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As many of you know, Dr. Tony Castle formally retired from his Associate Physician Executive duties at the end of February. Thanks to all who stopped by to wish Tony the best in his new chapters. Tony was instrumental in his regulatory and Med Staff relations support. He served as my connection to WBH and the OB-GYN providers there. He remains a member of the State Board of Medicine and connected us to so many Pennsylvania Medical Society programs, including the efforts to reduce and provide alternatives to prescription narcotics. Tony, Carl Manelius and Mary Beth Schweigert worked hard to make Progress Notes an effective communication outlet for the physician and provider staff. Their articles highlighting new physicians and the interests of established staff contributed to an open rate of over 35 percent, well above national benchmarks. As physician editor, Tony’s leadership and understanding of relevant topics for his colleagues will be missed and very difficult to replace.
The February issue of PN featured an article on physician/provider burnout. While all agree that there are no easy answers, the problem is real and likely accelerated by the rapid changes in healthcare. As increasing efforts and resources are dedicated to the patient experience, it has become apparent that physician and provider engagement drives better results. The article on burnout was the most well-read in the issue by far. Members of the Med Staff have approached me about quantifying the concerns and establishing a work group to test some new ideas. 
There is a growing body of literature addressing burnout -- and not just limited to healthcare. A recent Harvard Business Review article spoke to “Work Life Balance” and pointed out that the two are not mutually exclusive. We have not been prepared to adapt to both the stress of our profession and the rapid changes in healthcare delivery. In fact many of the ideas proffered -- take a vacation, travel, read a book, join a committee, volunteer, connect with colleagues -- may work but also seem like more stuff to do, more bricks in the hod. Most agree that time off should be predictable and required.
Quint Studer, long a customer/patient experience advocate, has begun to study physician burnout and its impact on the healthcare team. I believe he correctly identifies key elements of a great physician workplace: quality, efficiency, input and appreciation -- a place where meaningful work translates into tangible results.  In another HBR article, Blake Mycoskie, founder of TOMS, Tomorrow’s Shoes buy one pair of shoes and send one pair to someone in need, recognized how his company’s growth and the operational demands interfered with the purpose and passion that had fueled its success. The “what and how” of a product-focused corporation overwhelmed “why” the corporation was started. It is in fact a balance.
I would not presume to know what will work. We plan on making physician burnout a regular feature in Progress Notes going forward and hope to make this interactive so we might start a community to care about one another. I solicit your thoughts and ideas. In addition, we will partner with The Advisory Board for a physician survey in May, which will ask about burnout in addition to quality and safety concerns. These are not meant to be additional bricks in the hod. That is another story, but I hope we can find something to lighten the load together.
Click here to contact the Progress Notes staff with your thoughts and ideas on burnout.


Lee M. Duke II, M.D.
Chief Physician Executive
Progress Notes' Editor-in-Chief

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