The Executive Suite: Limit physician burnout risk by analyzing company culture, contract criteria

Physician burnout has become a national epidemic. Although it was a concern before COVID-19, burnout has increased over the past year with many physicians feeling more stressed and overworked than ever.

For those looking for a new job, the following are some key considerations that might limit potential for burnout.

Find out everything you can about the culture of the employer you may go to work for.

Even if the financial offer from the employer is substantial and the location is perfect, there are sometimes more important factors to consider!
What do physicians who work there say about the work culture?
What is the physician turnover rate?
Does the employer support physician flexibility and quality of life, and what policies do they have that reflect this approach?
How does the employer support their physicians with the administrative burdens of medicine?
Are there scribes or nurse practitioners that help with charting?
How can a physician express concerns and does the employer listen and respond?

Although no employer is perfect, my clients can often get a sense about how the medical staff is treated by asking these types of questions and hearing what other employees (as well as the employer) has to say!

Physicians should not be afraid to ask questions about the employer’s view on physician lifestyle and concerns about burnout during the interview and contract negotiation process. An employer with an indifferent/uncaring response could be evidence of a bad fit for a physician who is prioritizing lifestyle issues. More often than not, the way an employer handles themselves during contract negotiations provides important insight on how they treat physicians on a daily basis or when important issues arise.

Quality of life for a physician often comes down to location, schedule, duties, and call.

When negotiating a contract, these are key items to focus upon.
Does a physician have a say in the schedule or call?
Is there administrative time to complete medical records?
Does the physician have to work an unreasonable minimum of patient contact hours, which can contribute to burnout and fatigue?
What say does a physician have concerning his/her locations and duties?

Physicians like to know where he/she will be working and should understand if expected to travel between multiple locations, which can be stressful and impact overall productivity. Physicians expecting to work in a certain role (e.g., outpatient) should be clear if he/she does not want to end up doing inpatient work unless there is an agreement to do so. Another common issue is physicians unexpectedly being scheduled to work evenings, weekends, and nights (depending on specialty), despite having discussed a specific schedule during the interview process. All of these work issues can result in personal stress and unhappiness.

Unfortunately, many employers object to adding any promises on these topics to the written contract or even agreeing that the parties will work out these issues by mutual agreement. This means that physicians must either have faith when entering into a contract that the employer will honor their word or walk away from the job opportunity.

The biggest dilemma for many physicians is balancing their financial goals with lifestyle ambitions and concerns about burnout.

Often the trade-off for a significant financial package are the terms that affect job satisfaction. When physicians take on roles with aggressive productivity formulas or large base salaries with minimum production goals, there must be an understanding that there may be less flexibility on other points that directly impact financial performance. Typically, more patient contact hours, call, and travel to where patient demand is greatest can be a requirement for the high-producing physician. These types of roles often include longer hours, more weekend and after-hour expectations and less personal time away from work.

When it comes to avoiding burnout, a physician must understand his/her own personal goals and seek a contract that will meet those needs. Sometimes, however, unexpected events may occur, or the physician may find the new job is still not a good fit despite appearing to meet the physician’s objectives. I believe the best contract is the one a physician can walk away from easily if he/she is unhappy. Physicians should always understand and be able to live with the exit strategy in the contract that is signed. Does it lock the physician in for a period of time? What are the consequences when the physician leaves (i.e. tail, non-compete, repayment of a bonus)? A physician must make sure he/she knows the answers to these questions before signing any contract!

There are many factors that cause physician burnout, and most cannot be controlled by any physician. Those looking for a job with a more minimized chance of burnout can start by evaluating the employer they choose to work for and the contract they sign.