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From Jeff Klunk, LG Health psychologist

For the past two years, I have provided coaching and feedback to stressed, burned-out physicians and non-physicians at Lancaster General Health.
During that time, and in my 30 years of previous experience with executive and performance coaching in workplaces, I have seen over and over again that stress and burnout increase when people perceive that what is demanded of them is greater than the control they have over their circumstances.
Here at LG Health, I frequently encounter two themes. One is the very prevalent thought in people’s minds that they just can’t handle one more thing to do. The other is that the list of new things to do keeps growing.
Here are some scenarios I often hear from physicians:

  • “I am expected to not overprescribe certain medications that patients tend to demand, but I am also held accountable when those same patients give me low satisfaction scores.”

  •  “I am expected to document thoroughly and read what others have documented, but there is no time built into my schedule, and I am not supposed to fall behind.”

  • “I am expected to implement governmental mandates and insurance company protocols even though our patients resist them -- and still somehow keep patients happy.”

  • “Complex patients that I don’t know are put into my schedule for brief visits, when they really require much more time and attention.”

  • “Prescriptions and orders for procedures I put in often come back to me due to any one of a myriad of breakdowns from insurance companies, pharmacies or staff.”

  • “My inbox is overwhelming and never-ending -- and then I am sometimes also responsible for covering someone else’s inbox!”

  • “Coding is increasingly detailed, complex and confusing.”

  • “Some of my patients have excessive or irrational expectations.”

All of these expectations require a provider to make complex decisions quickly, often with limited information. This contributes to a “tyranny of the urgent” feeling, which induces a stress reaction.
As stress intensifies, a cycle develops in which increasing tension leads to a sense of reduced personal power, which in turn leads to greater susceptibility to stress reactions. As we naturally focus more on the problematic issues over which we have limited immediate control, we feel increasingly pessimistic. 
There are no easy or simple answers. However, I have one idea that should provide some hope. 
LG Health has renewed its commitment to continuous improvement, and regular huddles are a key component. You might be thinking, “Yikes, one more thing to do!” And it’s true that improperly run huddles can become just one more time-waster that contributes to stress and burnout. 
But when properly managed, huddles can address the complex issues mentioned above, as well as others. Successful huddles actually can save time and reduce stress by addressing problematic, recurring issues on a big-picture level.
Instead of viewing huddles as one more time-waster, try to make them work for you. Come well-prepared, with an awareness of time-wasters and inefficiencies, so the group can discuss how to solve a problem or streamline a process. By raising the issues that waste your time, you can encourage conversation about what can be done systematically to address them.
When properly implemented, huddles and continuous improvement can give front-line providers more control over their circumstances and reduce the time-wasters, along with stress and burnout.
Jeff Klunk is a PA Licensed Psychologist with over 30 years of experience in Organizational Psychology, Coaching and Career Development. He has also provided integrated behavioral health services within LGHP in collaboration with LGHP physicians for the past two years.    
Jeff will write about stress and burnout in future issues of Progress Notes. Readers may contact him with any questions or comments.

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