My colleague, Paul DeChant, MD, MBA, and I both appreciate the value of good personal health habits and practices. You know the drill: eat a healthy diet rich in fruit and vegetables (a la the so-called Mediterranean diet); exercise; get adequate sleep; drink plenty of fluids. In that same vein, we appreciate that yoga, strength training, mindfulness, stress management, guided imagery, time management and the like can further contribute to a sense of personal agency and well-being. But as faithful readers of OWS blogs know, we part company with those healthcare organizations and their leaders who conflate personal resilience with organizational wellbeing and/or who believe that they can cure the rising tide of burnout among their front-line staff by adding still more personal health and well-being benefits.
It’s a classic faulty syllogism. If healthy behaviors are good, and if employees are suffering health and mental health issues, then doesn’t it follow that ratcheting up an organization’s array of wellbeing benefits will result in less stressed, more resilient staff?
No. In fact, hell no! Burnout is an occupational phenomenon: an individual response to significant, persistent, systemic problems in the workplace. It does not result from a lack of personal resilience. Unfortunately, this erroneous conflation (give ‘em more personal well-being services and burnout will go away) continues to be the principal response of most healthcare organizations.
Burnout & Organizational Change in the Healthcare Workplace
Now comes an important study of 46,000 workers across 233 organizations in Britain published earlier this year in the Industrial Relations Journal. The researcher, William Fleming, concludes: “(t)he results in this article pose a challenge to the popularity and legitimacy of individual-level mental well-being interventions like mindfulness, resilience and stress management, relaxation, and well-being apps. I find little evidence in support of any benefits from these interventions with even some small indication of harm that could confirm fears of critics.”
“I concur with reviewers of the field that organizational interventions, such as changes to scheduling, management practices, staff resources, performance review or job design appears more beneficial for improving well-being. …(M)ore emphasis must be placed on the greater benefits of organizational rather than individual change, as well as on the importance of high-quality intervention implementation.”
I offer this not to discourage the good and necessary work of chief wellness officers and others active is the clinician well-being movement. Rather, use this information — perhaps teaming up with your CFO — to focus instead on making changes in administrative policies, workplace efficiency, and leadership priorities and practices, to find the best return on an organization’s investment.
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