Sometimes it’s the little things: Prevalence and prevention of burnout
Both seasoned and newer practice owners share their insights for preventing burnout through practice management.
Image credit: AdobeStock/Sergei/AI
A little goodwill can go a long way on a short-staffed day in the office. Jamie Kuzniar, OD, FAAO, FSLS, said that these are days at her practice, Elevate Eye Care and Eyewear in Rochester Hills, Michigan, when she finds it particularly important to go the extra mile and bring in surprise treats for her staff of 3. On a particularly busy day at her practice in early April, a trip to Starbucks contributed to a better outlook on the day.
“It just changes the morale of the day when someone walks in and gives you a coffee,” she said.
For many other optometric practice owners around the country, a focus on maintaining a positive work environment can keep the prevalent threat of burnout at bay. According to a StatPearls article on provider burnout in health care, organizational initiatives that can lessen the frequency of burnout among staff members include effective leadership, providing flexibility, recognizing work and using a compensation model, ensuring workplace goal alignment, and investing in staff well-being.1 Additionally, signs of burnout can be recognized by an increase in medical errors, poor patient satisfaction, lack of provider engagement, poor retention rate, and early retirement.
Prevalence
Burnout is defined as “a job-related stress syndrome resulting in emotional exhaustion, depersonalization, and reduced personal accomplishment.”1 Within the past decade, national studies suggest that over 50% of health care providers experience symptoms related to burnout. Some of the major factors that play into burnout include unsustainable productivity goals, lack of leadership support, difficulty maintaining work-life balance, increased screen time, and an increased focus on productivity, among others.1 Inevitably, high-stress work environments increase the risk of burnout in physicians across health care.1
Additionally, the COVID-19 pandemic amplified the intensity of chronic overstress in the health care field in the form of frustration, exhaustion, isolation, feeling undervalued, loss of sleep, anxiety, increased risk for substance use, and suicidal ideation.2 In a survey conducted from June 2020 to September 2020, 93% of more than 1100 health workers reported stress, 86% reported anxiety, 76% reported exhaustion and burnout, and 41% reported loneliness.2 Following the pandemic, the US Department of Health and Human Services projected that between 45,000 and 90,000 providers will have poor working conditions and high levels of stress by 2025.1
Additionally, health care provider burnout maintains a global prevalence. An Australian study surveying the mental health and well-being of Australian optometrists found that of the 505 participants, almost 31% reported moderate to severe psychological distress, with similar findings for depression and anxiety, and burnout reported at 56%, cynicism at 57%, and professional efficacy at 23%. Optometrists 30 years or younger were 3.5 times more likely to report moderate to severe psychological distress compared with optometrists older than 30 years. Common work-related issues included retail pressures, workload, and career dissatisfaction.3
Combating burnout with longevity
Amid the threats of burnout, seasoned and established private practices have found their own ways to keep staff happy and healthy. For Susan Resnick, OD, FAAO (Dipl), FSLS, and Glenda Secor, OD, having a competent staff that gets along makes all the difference. Resnick said that this provides an opportunity for management to remain more hands-off, with staff meetings happening only once a quarter, at most. “We’re not heavy-handed with respect to management,” she said. “We have all these systems in place that are kind of self-running.”
Resnick, who runs the 2 offices of Farkas, Kassalow, Resnick, and Associates in New York, has a handful of staff who have been with her practice for over 20 years. For Secor, whose private practice is in Huntington Beach, California, 2 of her 5 employees have worked for her for over 35 years. “That has made it easier for me to function with fewer people because I have very competent long-term staff,” Secor said.
Resnick said that providing a positive work environment contributes to job security and a sense of comfort among her staff. However, challenges remain, particularly with staff members who are used to completing administrative work or patient care the same way for a long time. “The beauty of having everything the same is that you don’t have to manage, and nobody has to get used to something different. The negative is that when you want to make a change, it’s a little bit more difficult,” Resnick said. The most recent tension was when Resnick’s practice bought out a second practice, which involved tedious integration of patient records.
Across the board, longevity is mainly a result of good pay, good benefits, cohesive personalities, and work flexibility, at least for Resnick and Secor. Resnick said that all members of management have a say in whether applicants get hired or new hires stay. For Secor, being people-oriented is a must to maintain this symbiosis. “In a private practice environment, you have to like people. If you don’t like people, it’s the wrong job,” she said.
Hiring process and training success
For a newer practice like Kuzniar’s, which has been operating for about a year and a half, following quality training and hiring practices helps keep burnout at bay and contributes toward a goal of longevity. She said that in her hunt for quality staff on hiring websites like Indeed, an enticing factor for new hires to apply has been transparency about her practice being closed on Saturdays. “I had a lot of really good, experienced people who just want to get back to private practice patient care,” she said.
Early into developing a hiring method for her practice, Kuzniar said that experience does not always translate into skills she needs in her office. “You can have an optician who has been an optician for 15 years and still doesn’t know how to use the lensometer,” she said. “That happened to me because you just assume you’ll know how to do all these basic things because you’ve been in the industry so long, but different offices require their opticians to have different levels of skills.” Because of this, Kuzniar added a short quiz to her interviewing process to assess to skill level and training required for a given new hire. “It’s been eye-opening,” she added.
For Kuzniar, Resnick, and Secor, cross-training is also a crucial aspect to managing workload among all staff members. For Kuzniar, it’s been important for her to know how to do all the jobs in her office so she can assist with training and in the event of a call-off. “If they’re up front and all the phones are ringing, I answer the phone. If a patient walks in who needs a dispense and there’s a bunch of people in the optical, I do the dispense,” she said. “I’m not afraid to go out there and help staff. I think the biggest thing is that we all need to help each other. We can’t just say, ‘Well, you know, I’m a doctor, I’m not answering my own phones.’”
Work environment
Appreciating staff members comes in many different forms, from bonuses to holiday parties. Kuzniar has also taken a more personalized approach by having her staff take a 5 Languages of Appreciation in the Workplace quiz, modeled after the 5 Love Languages. She said while monetary raises and bonuses still play a part in her appreciation of her staff, she has also found that words of affirmation play a vital role in making her staff feel respected. “It also goes the opposite way,” Kuzniar said. “If their love language is words of affirmation, and you are really hard on them with negative criticism, it affects them more.”
Additionally, shortening the work week also helps keep burnout at bay. Resnick said her staff works a 4-day work week by committing to longer hours on the days they are in the office. This also allows more time for her staff to complete administrative work. “What it does is it gives them some added times before and after patients come to do all the other stuff that they were trying to get done while patients were here,” Resnick said.
In terms of day-to-day staffing, Resnick said her practice commits to what they call “the diner effect.” “So when the diner is empty, it looks like all the waitstaff is waiting around doing nothing, and then when its crowded, there’s not enough [staff],” she said. “Well, it’s the same thing. We always want to have extra staff.”
Secor also said that keeping up to date with new technology also plays a role in maintaining loyalty and trust with staff. “Unfortunately it gets obsolete way too quickly, but that truly does differentiate your practice from other less progressive practices…and that builds loyalty. It’s the loyalty that’s invaluable, and it’s loyalty with staff and it’s loyalty with patients,” she said.
Ultimately, if staff members are experiencing frustrations, Resnick said that it is important to keep a listening ear and allow them to get their concerns off their chest. However, for each problem they voice, the staff member is also encouraged to provide a solution. Secor also said transparency in communication is necessary to help those who may be experiencing symptoms of burnout. “[Burnout] is the real deal,” she said. “You cannot ignore it—you have to address it.”
References:
Singh R, Volner K, Marlowe D. Provider Burnout. In: StatPearls [Internet]. StatPearls Publishing; January 2024. Accessed April 18, 2024. https://www.ncbi.nlm.nih.gov/books/NBK538330/
Addressing Health Worker Burnout: The US Surgeon General’s Advisory on Building a Thriving Health Workforce. US Department of Health and Human Services. May 9, 2022. Accessed April 18, 2024. https://www.hhs.gov/sites/default/files/health-worker-wellbeing-advisory.pdf
Bentley SA, Black A, Khawaja N, Fylan F, Griffiths AM, Wood JM. The mental health and wellbeing survey of Australian optometrists. Ophthalmic Physiol Opt. 2021;41(4):798-807. doi:10.1111/opo.12823
