Healthcare executives look to bring the joy back to medicine

DALLAS—As health systems survey candidates for executive roles, experience, academic achievements and other measures of scholarship typically top the priority list.

Leadership qualities, “coachability” and emotional intelligence are often overlooked, particularly at academic institutions. That represents a fundamental flaw in the hiring process and the medical education system, which hardwires doctors to be self-interested and autonomous, said Dr. Peter Pisters, president of the University of Texas MD Anderson Cancer Center.

“Our search committees have been anchored in a series of biases that include an overemphasis on scholarship and an underemphasis on leadership capabilities, especially emotional intelligence,” Pisters told the audience during Modern Healthcare’s Workplace of the Future conference last month. “That has created real challenges.”

MD Anderson has brought in psychologists specializing in emotional intelligence and incorporated that metric into the selection process. It mandates implicit bias training to ensure objectivity. Like many systems, the academic medical center has also pushed for more diverse leaders and has cast a wider net to attract more applicants.

This was a massive departure for MD Anderson, Pisters said, describing the past process as a group gathering in a room, typically white males, making the best decisions they could for the organization.

“Everyone has a blind spot—things everyone else knows about you that you don’t know about yourself,” he said. “Our job is to shrink it.” The challenge is creating a culture that facilitates feedback, and then holding leaders accountable to adapt accordingly, Pisters added.

Healthcare executives shared a variety of strategies aimed at reinvigorating the workforce. Billing requirements, regulatory checklists, order entry and other administrative tasks have stripped purpose from healthcare employees.

Technology is too often viewed as the answer to workforce problems, rather than an enabler, leading to higher levels of burnout.

Healthcare recruiters and executives hope new succession-planning processes, streamlined reporting structures, mission-driven investments and a team-based approach to healthcare will create a more fulfilling work environment.

“We’ve got to reestablish the joy of medicine,” said Dr. David Williams, CEO of UnityPoint Clinic and UnityPoint at Home, the ambulatory division of UnityPoint Health. “If we can get people to focus on why they got into the business in the first place, it is well worth it.”

Healthcare employers are at an inflection point. Healthcare has twice the number of job openings every month compared with the number of hires, said Barry Asin, president of Staffing Industry Analysts, owned by Modern Healthcare parent Crain Communications. Staffing costs are surging as health systems are trying to lower costs.

The healthcare temporary staffing industry has grown into a $17 billion industry, made up of more than 1,000 firms that are trying to fill the void of a nationwide nurse shortage, among other workforce needs.

This has given more power to the employee and caused employers to rethink and improve their corporate cultures, benefit programs and infrastructure.

“We are in a moment of crisis in finding the help we need,” Asin said.

Ascension, for one, is reworking its linear reporting structure, said Trevor Walker, vice president of human resources organizational development and learning. It’s testing out a model where interdisciplinary teams report to one leader, rather than their respective department heads.

To boost recruitment, Froedtert Health is reworking its tuition reimbursement program, said Holly Reilly, vice president of human resources operations. For growing needs like IT, four-year degrees aren’t necessary. But certifications don’t fit into Froedtert’s tuition reimbursement program, she said.

Providence St. Joseph Health is investing in revenue streams related to organizations that build low-income housing, provide food and help meet other basic needs.

Ideally, those ventures can bolster its clinical care as well as rekindle its mission, said Darci Hall, chief learning officer at the Renton, Wash.-based system. “Healthy communities start with a safe place to live and food to eat,” she said.

But a more proactive, outcomes-oriented healthcare delivery system brings new data and responsibilities. Employers have to toe the delicate line between developing existing employees and hiring additional help.

Healthcare organizations are always looking for the next piece of technology that can facilitate this transition. But sometimes it can hurt more than help, said Heather Brace, senior vice president and chief people officer at Intermountain Healthcare.

“Sometimes technology can be really distracting more than it can be helpful,” she said. “So we are finding ways to be better about discerning and learning which technologies are best to bring into our organization so they are not duplicative or creating more work.”

Brigham Health has hired administrative support, community resource specialists, data-mining experts and additional help on the clinical side to facilitate more proactive care. It has also identified current workers who live in the community, know the cultural landscape and can help link individuals with local resources, said Dr. Jessica Dudley, chief medical officer at Brigham and Women’s Physician Organization and vice president of care redesign at Brigham Health.

This new care paradigm requires, at times, ceding control. Providers also must get more comfortable in building teams outside of their respective organizations, said Dr. Adam Myers, chief of population health at Cleveland Clinic and director of Cleveland Clinic Community Care.

“We are not afraid to work hard in medicine, but we want our work to be meaningful, we want the tools and resources to accomplish the tasks that are asked of us, and we want to have appropriate accountability. Those are the three things that lead to professional improvement,” he said. “We have meaningful work in healthcare, but the problem is we dilute that down with many nonmeaningful tasks. To the extent we can offload some of those to teams, the better.”

At St. Jude Children’s Research Hospital, about 20% of patients will not overcome their cancer diagnoses. This creates a daunting challenge to keep clinicians and employees’ spirits up, said Dr. James Downing, St. Jude’s CEO.

Memphis, Tenn.-based St. Jude improved its employee recognition as well as its mentorship program. The organization asked its employees what brings them joy in their work. Staff wrote their answers on blocks of wood that were used to a build a sculpture featured on campus.

“It is a place where 1 in 5 patients will die from their disease, but it is a place of hope, a place of joy,” Downing said.