In baseball, it's called hanging a curve.
In human relations, it's a gaffe, a faux pas, a groaner.
Typically, a single loose pitch--or lip--won't ruin a career, though its impact on a game or a relationship can be dramatic.
In our special report this month, reporter Linda Boone Hunt talks to some big leaguers in healthcare administration about burnout. Not surprisingly, these physician executives gave her an earful. Managed care, government cuts, shrinking margins, the press for profits: All were mentioned as stressors by physician leaders who had either left the playing field or were at least contemplating a move.
One point of stress they cited came from their own dugout: fellow physicians who accused physician leaders of joining the dark side. So, in part, burnout can be physician-inflicted, argues author Michael Woods, M.D., whose book on improving physician communication skills is reviewed on page 25.
"Physicians are just abysmal followers," says Woods. "Physicians for years have clamored for a voice in healthcare management, but when one of them steps up, they're viewed as a turncoat."
Woods argues the ill effects of competition are in part to blame. Physicians undergo what amounts to de-sensitivity programming beginning with the competition for grades at the undergraduate level, Woods says. It extends through medical school and the battles between peers for the top residencies--and, later, fellowships--and continues into their practices in the competition for patients. It helps create me-centered people who are poor at empathic communication.
Empathic listening, according to management guru Stephen Covey, whom Woods cites often, is the highest form of listening. Woods says empathic communication by physicians is a skill vital to relationship building, a key to personal and professional success.
Woods also suggests burnout is linked to the notion that extrinsic motivators--i.e., money, position, status--have gained primacy over intrinsic motivators, such as job satisfaction, personal happiness, benevolence and community.
Again, he argues, physicians have been sold "a bill of goods" in training that big bucks are their rightful due, so working harder, seeing more patients and being more efficient will lead to happiness.
"I think burnout is completely related to this concept of efficiency," he says. "I think efficiency is the wrong motivation because healthcare is all about relationships and trust. And in relationships, there is no substitute for time."