Leadership Climate Affects Burnout — And We Can Do Better

By Leon E. Moores, MD, DSc, FACS

Leadership matters. We have all experienced the difference in the work environment when the leadership climate is positive, there is a high degree of psychological safety, and the leader motivates the team to achieve.

Unfortunately, in medicine today we think of a “physician leader” as a division chief, department chairman, or hospital chief medical officer. Because of that definitional bias, we ignore the fact that in virtually every care environment – clinics, ERs, ICUs – physicians are influencing behavior to achieve the desired result: better patient care. In other words, they are leading.

This is not to say that physicians are always “the boss” or that others on the team are not also influencing behavior to achieve desired results. However, there is little argument that physician attitudes, communication skills, and ability to lead impact the environment of care in a significant way. If we recognize that all physicians are leading and can learn how to do it better, we have an opportunity to improve healthcare team member satisfaction and reduce burnout.

Contrasting pictures of leadership’s impact

Let me ask you to do a thought experiment for about two minutes. Think about the most rewarding professional environment you have ever experienced. Think about the interactions and impact that you had with the leader of that group, and with unofficial leaders within the group. Picture some of those interactions and think about how it made you feel about coming to work. Did you feel resilience, or burnout? Close your eyes for a minute and picture that environment.

Now think about your most negative, stressful professional experience. Put yourself back in that environment and remember the impact the team leader had on you and others. Did you feel or did you witness other team members feeling like they couldn’t bring up relevant information? Did you feel resilience, or burnout? Close your eyes for a minute.

Hopefully that wasn’t too painful, and perhaps I should have reversed the order. However, if you’re like me, the disparity in emotions upon reflecting on those environments makes it clear that leader behaviors affect team member resilience.

After 35 years in healthcare, I know that my teammates are incredibly resilient. Many factors push physicians, nurses, technicians, and administrators down the burnout slide – from ever-increasing regulation and financial pressures, to cumbersome electronic medical records, to the everyday pressure of taking care of our fellow human beings in times of great need, wanting them all to do well and knowing not all of them will. We keep coming back to work because we are dedicated, we care about those people and we know that we can move that patient outcome needle a little more positively through our efforts every day.

Herein lies the opportunity. We currently place emphasis on physician leadership development when doctors are 10 or 15 years into their careers and assume administrative roles. But because we don’t recognize that all physicians across our healthcare systems are leading – impacting healthcare teams – we miss the chance to improve the everyday experience of our team members. We do not teach our medical students and residents fundamental leadership competencies, and importantly we do not even explicitly inform them that they will be leading. 

This defines the current gap, and an amazing opportunity. Even if we can’t devote curricular resources to leadership theory and practice, just informing physicians that they are influencing the care environment, and patient outcomes, through their minute-to-minute leadership interactions may cause them to reflect upon those interactions with the intent to improve.

Think back to the thought experiment earlier and imagine that every doctor in America was closer to the first vision. The impact on the care environment and team member satisfaction could very well result in increased resilience, decreased burnout, and better patient outcomes. Because we are starting at basically ground zero, we can move

that needle with relatively little effort.

About Leon E. Moores, MD, DSc, FACS

Dr. Leon Moores (https://allphysicianslead.com/), author of All Physicians Lead: Redefining Physician Leadership for Better Patient Outcomes, is a West 

Point graduate who was commissioned an infantry officer in the 82nd Airborne Division. Moores earned his MD from the Uniformed Services University (USU) School of Medicine and his Doctor of Science in healthcare leadership from the University of Alabama, Birmingham. He has served as chief of surgery at Walter Reed Army Medical Center, deputy commander (SVP) in National Naval Medical Center Bethesda, commander (CEO) in Fort Meade Medical System, and CEO of Pediatric Specialists of Virginia. A practicing professor of pediatric neurosurgery, he most recently served as the CEO and president of the largest medical group in northern Virginia. A sought-after speaker and consultant in physician leadership, Moores has been designated “Top Doctor” by Washingtonian and Virginia magazines, and has been awarded citations from the governors of Maryland and Virginia.

Doctor with crossed arms.
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