{"id":29,"date":"2017-12-04T19:46:27","date_gmt":"2017-12-04T19:46:27","guid":{"rendered":"https:\/\/nam.edu\/clinicianwellbeing\/?page_id=29"},"modified":"2019-05-24T17:42:47","modified_gmt":"2019-05-24T17:42:47","slug":"organizational-factors","status":"publish","type":"page","link":"https:\/\/nam.edu\/clinicianwellbeing\/causes\/organizational-factors\/","title":{"rendered":"Organizational Factors"},"content":{"rendered":"

Burnout is driven largely by external factors outside the control of an individual clinician. These include the culture and policies of the organizations that employ clinicians, as well as the number of health care responsibilities assigned to individuals. Many of these factors are determined by leadership.<\/p>\n

Leadership and Culture<\/h3>\n

As the U.S. health care industry evolves, clinicians are increasingly employed by large organizations like hospitals and health maintenance organizations \u2013 introducing a bureaucratic load that can impact clinicians\u2019 sense of autonomy, control, and satisfaction. Amid this transition, it is more important than ever that organizational leaders partner with clinicians to shape culture, multi-component strategies, and policies that support their well-being.<\/p>\n

Although burnout is widely recognized as a significant problem that impacts the quality of health care, including number of medical errors<\/a>, and clinicians\u2019 well-being, organizations must recognize it as a system issue, rather than placing the onus on clinicians to build personal resilience. Individual strategies to reduce burnout<\/a>, such as stress management workshops and mindfulness trainings can result in well-meaning but inadequate solutions focused solely on the individual clinician. These activities do not address the upstream drivers that contribute to burnout, and may allow harmful system trends to continue. Furthermore, simply raising concern about burnout and its prevention without dedicated investment and follow-up by organizational leadership may alienate clinicians and contribute further to cynicism and reduction of work effort.<\/p>\n

Evidence shows that the vision, mission, and values of an organization shape its culture<\/a> and affect clinicians\u2019 satisfaction, sense of belonging, and clarity of purpose. Specifically, an emphasis on productivity as a core value is associated with decreased professional satisfaction, whereas an emphasis on quality of care and work-life integration increases satisfaction and reduces stress. Leaders should be aware of the many factors that influence organizational culture and take steps to realign policies<\/a> with values as needed.<\/p>\n

The effectiveness of direct supervisors may also negatively or positively influence burnout. In one study, positive leadership skills in supervisors<\/a> were associated with increased physician satisfaction and decreased burnout risk. Organizations that lack skilled supervisors, therefore, may be missing a crucial protective factor. The problem can be perpetuated when organizations fail to establish leadership standards, hold leaders accountable, and remove those who are ineffective.<\/p>\n

Diversity and Inclusion<\/h3>\n

Despite widespread efforts to increase diversity, racial and ethnic minorities are still significantly underrepresented in health care professions. For example, African Americans make up about 13 percent of the U.S. population but only 7.5 percent of students entering medical school, a disparity that may have its roots in early education<\/a>. According to the Association of American Medical Colleges, pervasive unconscious bias results in physicians from underrepresented groups being paid less, receiving fewer opportunities for advancement, and feeling marginalized within their teams. Organizations may send unintentional signals that reinforce this marginalization<\/a> through \u201clack of diversity among top leadership positions; institutional grant and funding awardees; success stories featured in school magazines; names of centers, departments, and buildings; and even the portraits adorning the walls.\u201d Health care professionals from underrepresented groups are often asked to serve on diversity taskforces, a request that, while well-intentioned, further pigeonholes these individuals and adds to their workload.<\/p>\n

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Women physicians may also experience exclusion and marginalization<\/a> at work due to the perception that women are not well-suited for certain specialties or the assumption that women prioritize family life over career advancement. As a result, female physicians may feel unable to acknowledge their stress<\/a> for fear of confirming biases. Women also endure sexual harassment<\/a>, hold fewer leadership positions<\/a>, are paid less<\/a>, are less likely to be promoted<\/a> from entry-level to senior-level administrative positions, and receive less recognition<\/a> than male colleagues.<\/p>\n

Finally, although more research is needed to understand the experiences of LGBTQ clinicians, one study shows that a significant percentage of LGBTQ physicians report being harassed and ostracized<\/a> by colleagues or have witnessed disrespectful or discriminatory treatment of LGBTQ patients. In addition, some organizations do not offer partner benefits<\/a> for LGBTQ employees, making them feel unwelcome or unable to accept a position that might otherwise advance their career.<\/p>\n

Overall, discrimination and exclusion in the workplace may contribute to the erosion of important factors that protect against burnout \u2013 including effective teamwork, supportive professional relationships, fairness and opportunity, and a culture that values work-life integration.<\/p>\n","protected":false},"excerpt":{"rendered":"

Burnout is driven largely by external factors outside the control of an individual clinician. These include the culture and policies of the organizations that employ clinicians, as well as the number of health care responsibilities assigned to individuals. Many of these factors are determined by leadership. Leadership and Culture As the U.S. health care industry […]<\/p>\n","protected":false},"author":35,"featured_media":0,"parent":11,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"page-topic.php","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-29","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/pages\/29","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/users\/35"}],"replies":[{"embeddable":true,"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/comments?post=29"}],"version-history":[{"count":0,"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/pages\/29\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/pages\/11"}],"wp:attachment":[{"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/media?parent=29"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}