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The Need for Physician Burnout and Resilience Assessment

There is a myth that physicians who endured medical residency can endure anything. There is a similar myth that healthcare administrators can overlook anything. Consider these facts:

the need for physician burnout and resilience assessment

  1. Burnout is higher among physicians than for any other professionals.
  2. Burnout is higher for women than for men; varies by specialty; and varies by career phase.
  3. Burnout can be defined as the degree of emotional exhaustion, de-personalization, and self-efficacy at work. As one MD told me, “I just don’t have the energy to get up and do what I know I am supposed to do…”
  4. Clinicians often tell me that they wish for a helping hand “on their shoulder.” In my consulting experience, we all can provide care for the care-givers.

Since the days of Hippocrates, physicians and nurses have been taught to ask others, “How are you feeling?” Some physicians and nurses will state, in confidential moments, that they are feeling depressed, overwhelmed, unexcited about providing care to others, unable to pay their lingering $150,000 residency debts or to save $250,000 for their children to attend a great college. Part of the conflict is that physicians have always been taught to “heal thyself.” As if healing is an easy process.

My question today is “Who takes care of the care-givers?”

You may be reading this article because you are concerned about a physician, or yourself, or your practice group.

Consider these findings from a 2013 survey: 40% of physicians admit regular self- medication (drugs of choice range from alcohol to amphetamines). 15% of physicians have admitted to feelings of suicidal ideation in the last 24 months. Virtually 100% of physicians and healthcare leaders have experienced burnout at some point in their careers.  Some of my clients tell me that they appreciate the AA or Narcotics Anonymous meetings in their hospitals. But they may choose to attend AA somewhere else.

     So what are you going to do?

Thankfully, resiliency can be taught and developed. Resiliency can be defined as “the capacity to adapt successfully in the presence of risk and adversity.” Examples of developing resiliency abound, from the U.S. military to the British National healthcare system. Note that burnout and resiliency are directly related and inversely related. Just like any coin with two sides.

     We have developed evidence-based protocols and worked with thousands of health care leaders.  Call for details.

Take a moment to write down where you think you are on a scale of 1 (low) to 10 (high) on burnout.  Then do the same on resiliency.

1. A self- diagnostic question is “How do you know if you are avoiding burnout behaviors?

2. An organizational- diagnostic question is to ask your team if they have noticed you being less compassionate, hopeful and caring lately?

Or if you are daring, ask your team if they have noticed you being more abrupt, judgmental, or impatient lately?

Amid our current culture of healthcare reform and continued changes in care, there is no more important investment than providing care to our care-givers.  You are not alone.

Next steps:
1. Share this article with someone you care about.

2. Take the self-assessment described above 3. Schedule a complimentary session for someone who may be at risk of burnout

3.  Call Doug Gray, PCC, at 615.905.1892 today.

Doug Gray is the CEO and Founder of Action Learning Associates, Inc. a company that helps healthcare leaders develop resilience. Since 1997 the company has helped hundreds of individuals and organizations develop the strengths, competencies and weaknesses. They then provide confidential customized consulting. For detailed assessments, digital downloads, or to schedule your confidential, complimentary initial consultation, visit www.action-learning.com or call 704-995-6647 today.

Action Learning Associates, Inc. is a PAHCOM Corporate Member Since 2015

References:

Dyrbye, L. N., Varkey, P., Boone, S. L., Satele, D. V., Sloan, J. A., & Shanafelt, T. D. (2013). Physician satisfaction and burnout at different career stages. Mayo Clinic Proceedings, (88)12, 1358-67.

Scudder, L. & Shanafelt, T.D. (2015). Two sides of the physician coin: Burnout and well- being. Medscape.

Skiing above treeline and strategic leadership lessons

skiing above treeline

When 5” of powder blessed Breckenridge, CO, yesterday, I took this stunning video and wrote these thoughts. Here are three short perspectives on skiing above treeline, and strategic leadership.

 

  1. Flow is designed. Flow can be defined as that timeless psychological state when challenge and skill are in balance. Most people cannot imagine skiing double-black diamond runs down 1,500’. Most people should never try extreme skiing. Skiing above treeline, like any hobby, is an opportunity to experience ekstasis, that state of being literally outside of time and space.   Flow occurs when we take one turn at a time. We live in the moment. We proceed to a new place. Yes, you can design flow into your life. There are seven contributing variables for designing flow. Contact me for details or read this book or this book.

 

     2. Leaders are creators. Leaders build products or services. Doubt me? Then read any biography. Only those extraordinary leaders with an obsessive focus make the history books. Average leaders do not warrant attention in the history books or the biographies. How about you? By definition, leaders create value for their followers. And all significant leaders create great teams. If you were to say “yes” to that idea, or create something new, or delight a client, today, then you would see for yourself. One example of a significant leadership event in Nashville, TN is here.

 

     3.  Technology follows goals. Many years ago I climbed this mountain using backcountry ski mountaineering gear. It took all day. My goal was to experience grandeur. The adventure was exhausting but wonderful. Two years ago new lift lines made it possible to ascend to the same elevation without sweating. The technology followed my goals. Ironically, those ski trails are now called “Wonderland”, “Bliss” and “Euphoria.”   Get the point? There is plenty of grandeur to be found when we ski above treeline.

 

March is a great season for strategic thinking.

 

March is the season of heavy snowfalls, springtime flowers, new birth, opportunity, and clear intentions.

 

You may never ski above treeline. But you can certainly make smarter decisions about your professional and personal goals.

 

Some coaching questions include: (1) How can you design flow in your life or business? (2) What can you create today? (3) What goals will inspire grandeur?

 

Then let me know your answers. May you excel!

 

Doug Gray, PCC, CEO/Founder of Action learning Associates, Inc, www.action-learning.com today at 615.905.1892

Book Review of Triggers, by Marshall Goldsmith (Crown Business Books, 2015)

(Disclosure: I am a fan of Marshall Goldsmith because he is an enthusiastic role model for countless executive coaches. When I shook his hand at an event hosted by the Center for Creative Leadership, I told him so. And when I was given four copies of this book to distribute to our largest CoachSource clients, I told them something favorable. Marshall Goldsmith has celebratory cachet as a thinker and a champion.)

 

I wanted to love this book, but it fell short.

 

Triggers can be defined as “any stimulus that defines our behavior.” That broad definition enables Goldsmith to go beyond Skinnerian behaviorism, or beyond antecedent-behavior-consequence, or Duhigg’s cue-routine-reward model.   The “Circle of Engagement” model includes five steps: trigger-impulse-awareness-choice-behavior. The primary focus of the book is to “help others achieve lasting positive change.”

 

Structures help us define individual behavioral change. Goldsmith defines three structures: the AIWATT question, the “Six Engaging Questions” and the “Wheel of Change.

 

  1. The AIWATT question can increase engagement. Ask yourself, “Am I willing, at this time, to make the investment required, to make a positive difference on this topic?” Am I willing at this time… is the short version.

 

  1. The six “Engaging Questions” can be useful early in a coaching engagement, and when measuring behavioral trends. The questions are: 1. Did I do my best to set clear goals? 2. Did I do my best to make progress toward my goals? 3. Did I do my best to find meaning? 4. Did I do my best to build positive relationships? 6. Did I do my best to be fully engaged?

 

  1. The Wheel of Change can be described using two axis or four spokes on a wheel. One axis is the Positive to Negative axis, which “tracks the elements that either help us or hold us back.” The second axis is the Change or Keep axis, which “tracks the elements that we determine to change or keep in the future.” This descriptive model encourages clients to explore what they may need to create, eliminate, accept or preserve in order to achieve their desired behavior change.

 

The remaining content includes anecdotes from Goldsmith’s broad client base. His charming, self-effacing style often made me smile. The inclusion of the Buddhist anecdote reminding us that anger is always directed at “an empty boat” is a perfect reminder to stay focused on our internal locus of control in the moment. The resounding feeling I had is that the book made me feel good, consider using some of these structures, and then wonder “Now what?”

 

There are no citations of published works in this book. However, an emerging body of academic research does exist. Positive psychology provides the theoretical construct that the profession of executive coaching sorely needs. There is abundant research in well-being. Seminal leaders include Richard Boyatzis’ Intentional Change Model and studies using neurobiology, Mihaly Csikszentmihalyi’s Flow and optimal experience research, and Martin Seligman’s work in PERMA (positive emotion, engagement, relationships, meaning and purpose, and accomplishment.)   These are evidence-based thought leaders, with broad following, who are not referenced by Marshall Goldsmith. That fact makes me wonder, why not?

 

According to the International Coaching Federation, there are now some 50,000 professional coaches in a $7 billion industry with little consistency. (Disclosure: I have been certified at the ICF-PCC level since 2006.) The Conference Board 2014 survey, from 142 companies, defines external executive coaches compensation ranging from $600-200/ hour depending upon the size of the company, developmental needs of the leader, and seniority. The average investment for 6 months and 40-45 hours is $25,000. The 2014 ICF survey states that the average salary is $214/hour. The market realities and financial value of executive coaching are significant.

 

My experience of countless “coaches” is that the profession sorely needs a) a scientific evidence-based backbone and b) a theoretical backbone.   Without such theory, science, and applications, the profession of executive coaching is at risk.

 

In hindsight, I realize that I wanted Marshall Goldsmith to provide some leadership or insight into these aspects of executive coaching. Marshall Goldsmith’s book Triggers does not address any of these academic, social and market realities. Hence it fell short of what I had expected. I can imagine him chuckling and retorting, “OK, so what are you going to do that would make you happier?”

 

Perhaps that is the subject for a different blog.

 

Call me if you’d like to discuss this book?

5 Hot Tips for Succession Planning

This article was published in the March, 2014 issue of Professional Safety magazine, at their request.

Here is the pdf for you to share with others: SuccessionPlanning PS 3.2014

Here is the article:

At a recent ASSE meeting I asked, “What is your leadership succession plan?”

After a blank stare from several members I heard:
“We don’t have one. What is it, exactly?”
“You’re looking at it. I’m all we’ve got.”

Safety professionals are not alone. Let me explain what succession planning is, and provide the 5 steps you need to develop a succession planning process.

Definition
Succession Planning can be defined as a process for identifying and developing key leaders within your company. The primary purpose is to increase engagement and retention by providing a career ladder. Some people talk about “bench strength” as if it is a number- how many people do we need to replace the “first string” or senior team in the “hit by a truck and all down scenario?” (Sorry for such a morbid view for safety leaders.) Another purpose of succession planning is to create a talent development culture that affirms individual strengths and develops competencies that drive results. For instance, if you need more safety leaders with business development expertise to review proposals, then you would consider including the safety leaders on sales calls. Over time you would promote the best safety leaders who also generate new business.

Trends
By 2020 some 25% of the workforce will be baby boomers, over age 65, called the “silver tsunami.” These boomers may not be able to afford to retire. Sadly, the average retiree in the U.S. has a median household net worth of less than $190,000. And men will live to 86 years of age. Your senior leaders may be forced to continue working. Your younger safety leaders may become so discouraged that they take other positions in related fields in order to make more money or develop their careers. Look closer to home for trend patterns: There is a dearth of ASSE members in that 25-50 age cohort. Some job sites look more like country clubs- dominated by silver-haired veterans and young workers. Too many companies lack mentoring or coaching programs. My conclusion: there is a tremendous need for simple, effective succession planning processes.

How to create a succession planning process?
Imagine a wheel with 5 spokes, or a calendar item that tickles you every 5th month, or assigning these 5 steps to 5 different people. These are the 5 steps in an ongoing succession planning process:
1. Identify key roles (such as managers and above) that may require replacement in the next 3 years. List each role and each person.
2. For each role, list the job competencies and personalities that are a) required and 2) recommended. Keep it simple. Lean on your HR colleagues. Solicit updates from those in the role. We know that the best workers compensation people, for instance, have a high attention to detail. If uncertain, or if you desire confidential expertise, hire an external vendor like us.
3. Assess your current people based on their a) status now (e.g.: ready now, development needs defined, development needs to be defined) and b) potential (e.g.: skills, ability, longevity, health, etc.) Then list concerns for each person such as job performance, health risks, medical needs, family concerns, job potential, or ability to travel. Create a database or flow chart.
4. Identify a pool of potential talent. Great people are everywhere. “Talent scarcity” is a myth perpetuated by managers who choose not to invest in their people. Your primary talent pool is internal; your secondary talent pool is external. Please hire internally. Internal promotions lead to higher levels of retention and engagement at lower cost. External hires typically cost more and drive conflict (which can be a necessary motivator at any company.)
5. Use progressions of experiences to actively develop key people so that they can be “ready now” for advancement. Succession planning is not a checklist or software package. It is a series of meaningful experiences. For instance, action learning teams of cross functional managers may be selected to develop a breakthrough product. High potential managers may be tasked with a business development opportunity or leadership training experience. Senior leaders can be partnered with 3-4 “hi pos” for quarterly mentoring sessions. Note that none of these experiences is expensive. For expertise contact any external vendor with experience in succession planning and leadership development experiences. Avoid wasting money on events.

Review your metrics
You all know the value of “What gets measured leads to results” attributed to Peter Drucker. You need to know the corollary, “What gets rewarded gets repeated.” There are two parts to that maxim. If your reward compensation is not tied to succession planning, then you are wasting your time and resources. As a graphic example, one CSP recently told me about a company where they were tasked with setting up goals on an annual performance review sheet. But they did not need to ever attain those goals. If they completed the sheet they were rated “satisfactory.” They were measuring the wrong metrics. Good people left. They wasted time, money and careers.
A better metric for effective succession development is the % of vacancies that are actually filled with internal promotion vs. external hire. Your job as a leader is to encourage people to stay in your company. They must believe in your “leadership pipeline” or “career development ladder.” Pick your metaphor. In fact, at some publicly traded companies, if 45% of the promotions are external hires then it begs questions about the quality of the senior leadership team and the board. You should be developing people, not hiring externally.

The bottom line? You only have 3 options for succession planning:
1. develop succession planning internally
2. develop succession planning externally
3. ignore the inevitability with a “wait and see” approach

In reality, you only have 2 choices if you have 20+ employees. See options 1 or 2 above.

A coaching question to leave you with is: How are you identifying and developing your best people?

Bio: Doug Gray, PCC, is a leadership coach who helps safety leaders develop and retain their leaders. Reach him at 704.895.6479 or www.action-learning.com

Who is Doug Gray, PCC?

Doug Gray

Doug Gray, PCC, is a Leadership Consultant and Executive Coach.

 

Coaching and Consulting Experience

Since 1997, Doug has partnered with hundreds of executive leaders in the Healthcare, Energy, Manufacturing, IT, Construction and Financial industries.  He is quick to say that he has “just enough expertise to support leaders, without too much complicating industry-specific knowledge.”  His clients agree.  Doug typically uses customized assessments to assess organizational and individual strengths.  A popular speaker and facilitator, Doug loves to facilitate experiential leadership training programs and strategic planning retreats.  His recent speaking topics include “How to Apply Positive Psychology to your Business” and “How to Increase Employee Engagement.”

 

Doug knows how to manage and lead teams.   Doug brings a unique background as an educator, administrator, and non-profit director to his clients. That background enables him to help leaders who are passionate and need his direct, supportive expertise.   He is regarded as an expert facilitator using Action Learning methodology.  And he will bring strategic focus, humor, and proven expertise to maximize your consulting investment.

 

A representative list of leadership coaching engagements and clients include:

  • CFO and 20 leaders in finance and accounting, Fortune 500 energy construction company, who needed to embrace a redesign without losing productivity
  • team of EVPs tasked with redesigning the IT needs of their F100 healthcare company
  • MD struggling with burnout who needed confidential consulting (e.g. anonymity from his employer and insurer)
  • CEO in a technology company recently promoted to replace the founder
  • President and 18 members of executive leadership team, Fortune 500 energy construction company, who needed to demonstrate alignment within 6 months
  • SVP and site managers at a nuclear power construction site who needed to increase alignment with business partners and avoid negative media
  • SVP in functional but de-centralized group who needed to assimilate 20 leaders, using action learning methodology in direct meetings, coaching, and SharePoint to drive accountability
  • Small business owner of a franchise who needed to fire an employee after 11 years of good service
  • SVP, global bank, who needed to reorganize a division
  • VP, global bank, seeking career opportunities
  • newly hired VP who needed to develop radical transformation of a functional group that required external coaching and team building leadership training using a customized app
  • Newly promoted director who lacked interpersonal skills to manage 33 people
  • Founder of an IT company who was not able to develop new business

Business/Organizational Leadership Experience

Doug has been a successful business owner since 1997; he knows the challenges and “what works.”  He co-developed the Leadership Development Institute at the University of Maryland, College Park and taught there for 7 years, and he is a former adjunct faculty member at several colleges including NC State University.  He directed a non-profit agency in Washington, D.C. for 9 years and grew it 900% while managing 120 people.  As a former world-class athlete, Doug knows that the rigor of change requires regular support from experienced consultants, plus a dash of humor.

 

Education and Training

Doug’s graduate research at Dartmouth College included development of an assessment to determine risk tolerance and risk aversion.  That theme of mitigating risk in business and leadership has prevailed in his continued learning from clients and colleagues in the safety, consulting, executive assessment, and leadership development industries.  He is certified in the Hogan suite, DISC, several 360’s, several EI assessments, and 5 coaching certification programs.  Since 2000, Doug has been a Professional Certified Coach (PCC) with the International Coaching Federation.  A perpetual learner, he is a doctoral candidate at the Chicago School of Professional Psychology in Organizational Leadership.  His research interests include the effect of positive psychology on business leaders, managers, and executive coaches.

 

Publications and Appearances

Doug loves to share his expertise as a speaker, facilitator and a writer.  As a keynote speaker, he has addressed annual meetings, executive retreats, and nonprofit leaders.  As a facilitator, he has partnered with clients to design experientially memorable leadership training solutions that range from boot camps to strategic off-sites to contests using customized mobile apps.  As an author, he has frequently been published in journals ranging from the American Society of Safety Engineer’s Professional Safety to Financial Advisor to webinars and hundreds of guest blogs.

 

He is a published author of articles on leadership development, physician burnout, healthcare, analytics, safety and productivity.  Doug has published two books:  Passionate Action; 5 Steps to Creating Extraordinary Success in Life and Work (2007), and Adventure Coaching; A Guidebook for Action-Based Success in Life and Work (2006) that can be purchased here and here.

 

Consulting Value Proposition

“Developing smarter leaders.  Faster.”

Doug will not waste any of your time or resources.  He expects you to achieve great results.  And he always guarantees exceptional value.

Call him now at 704.995.6647  or contact us here or schedule your initial consultation here.

 

For biographies on other Action Learning Associates, Inc leadership consultants and executive coaches, contact us here or review the list of our partners here.  We also provide scaled solutions for any-sized organization, anywhere in the world.

The Action + Learning + Service = Success Formula

I have recently developed this 3-part formula for success.  Let me know what you think.

Draw an equilateral triangle.  Label each corner “Action”, “Learning”, and “Service.”  Place a dot in the center.

1.  Actions define successful businesses.  Founders and anyone cited in a history book have one trait in common:  an obsessive focus on action.  Score yourself 1 (low) to 10 (high) on the question “How action oriented am I?”  If you are unsure, focus on actual results, rather than intentions.

2.  Learning leads to failure, and failures lead to success.  I track “Learnings” in digital folders and update them regularly.  I regularly attend conferences and take on projects so that I can fail, faster.  Yesterday I had lunch with a consultant who repeated the same points I heard him make 12 months ago.  He is not learning much.  I cut the lunch short and moved on.  Score yourself 1 (low) to 10 (high) on the question, “How much am I learning?”  Learning is a messy process.  If you are not tracking your learning, you are probably repeating ineffective old patterns.

3.  Service is a measure of your relationship with others.  Humans are social animals.  We yearn for relationships.  We exist to serve others- clients, loved ones, communities, goals…  The most impact-ful businesses track user engagement.  The best nonprofits, like Rotary, reward service above self.  Score yourself 1 (low) to 10 (high) on the question, “How well am I serving others?”  If you are unsure, ask your clients or loved ones.  Or solicit more clients.

Now place your scores on the triangle you created.  Use the dot to represent 1 (low) and let the corners represent 10 (high.)

What do you notice when you study your self-assessment triangle?

Where do you need to invest energy and resources?

Who can help you develop ?

You may know that action learning is a methodology, using cross functional teams of 4-8 people to solve a key problem. They are tasked with breakthrough, and with a short deadline such as 6 months. They require executive sponsorship and some resources. But the action learning process is a small investment with proven ROI.

In Europe and Australia, the Action Learning methodology is thriving. In the U.S. there is less adoption. One reason for that lagging adoption may be the fact that the business environment does not encourage accountability between cross functional teams. Yet.

We provide individual and team accountability.

How are you planning to share this Action + Learning + Service = Success Formula with others?

Please call me with your stories!

Here is a sample image to get you started:   ALServiceFormula