Cleveland Clinic Develops Three-Pronged Approach To Address Burnout

Okay, you can read the whole thing here but be careful because it just may make your head explode. The title of this blog was ripped off from an AAFP Smartbrief headline talking about the program. I laughed so hard when I saw it and then this image came to mind. I would like to offer the Cleveland Clinic this image as their official logo for the project. I think it’s perfect. And here is the slogan, in case they want to spread this to other hospitals: “Stick our three-pronged approach into your burned out doctors because they’re done!”

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Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  9 comments for “Cleveland Clinic Develops Three-Pronged Approach To Address Burnout

  1. Pat
    February 4, 2019 at 9:56 pm

    Advising me to be a “coachee “ on a kickball team only inspires fantasies of violence.

    And if these patronizing bastards surveyed my activities during my “Well Being Day,” I would have answered straight-faced, “getting drunk and watching porn…and yeah, cooking, if you count cannibalism.”

    What insulting garbage.

  2. James Tinsley
    February 4, 2019 at 2:33 pm

    Couldn’t have said it better. The VA told us to rub a golf ball under our feet. You could have heard a pin drop in the room.

  3. Steve O'
    February 4, 2019 at 10:03 am

    Psychology long ago split into the humanistic side and the dark side. Carl Rogers followed the ancient principles of philosophy, of teaching the individual to explore and actualize himself/herself to be the best and most excellent (s)he can be, under his/her own terms. Skinner and the dark side of psychology studied how to reduce and manipulate humans in the manner of herd animals. The goal is to induce the objects to feel happy, and oblivious to the conditions of their own external manipulation and the substitution of external values for their own. I quote Koestler’s brilliant observation about such manipulation here quite often.

    This cited work in NEJM is Skinnerian and Fascist Psychology par excellence. The passion, feelings and sense of fulfillment is exactly NONE of an employer’s business. It is not a variable to be managed. Coaching and managing individuals is merely the application of psychological methods to cause a response and change in behavior of the lab rats.

    Since the industry has to engage in official tours to “listen,” they discover:

    we learned that communication topped the list of factors (20%), followed by technology (17%), workplace culture (16%), stress (16%), and staffing (16%).

    These words are laid out neatly like turds on a tablecloth. They have no meaning whatsoever. They are merely labeled knobs which the experimenters can tweak to make the subjects respond appropriately.

    Communication is the process of conveying a message. The message offered by most providers in pleading with their controllers usually has an element of please leave me the fuck alone. The meaning of this message is ignored, but its form – that of communication – is scrutinized and deemed important, and the providers are lauded for their team efforts in communication. This is ludicrous.

    I would go on to say that the creation of healthy workplace culture is a self-forming process which is highly dependent on the individuals involved. Yet somehow, nationwide, the entire American workplace seems to resemble an eternal high school filled with unhappy, vindictive teachers and students. The Eternal Reformers and Leaders always need little more time and attention – and of course money – to reform the endless crisis. It is likely that the interventions by managers to manipulate the crisis of the American workplace culture that have made it a regimented horror resembling a low-security prison.

    In the military, the goal is to ignite the passion of the well and fit, to charge into battle and engage the enemy, and inspire a sense of valor and belonging in the soldiers who will face danger. When they become broken toys, though, they are cast aside with not a second glance. Nobody loves a one-armed soldier, or one with PTSD. They are a commodity to be used up. In medicine nowadays, the providers and nurses are also commodities to be used and discarded.

    This paper on engagement in NEJM is an internal brief to the basic training camp instructors at the various training camps, how to psychologically control and command humans to obey a central will. Such inexcusable Fascist thinking is a desecration of humanity under all terms in all conditions; it is especially a senseless and futile endeavor to blunt the individuality and creativity of those very people whose skill and understanding are needed save lives. It is a sad commentary on how to get meat into battle in warfare, and a shocking futility in medicine.

    I understand there was a very high incidence of mental collapse and loss of function by those enlisted persons selected to work for the Nazi’s in the Vernichtungslager, the extermination camps of the SS during World War II. They had a sense of anomie, helplessness, and a sense of futility and loss of universal purpose in life. The SS suicide rate was in fact quite high. How they could have benefited from Reigniting the Passion to Practice! But sadly, they did not have any occupational psychologists to insist upon more “me” time for them for, exercise, cooking, spend time with kids/significant other, health care visits, medical procedures, wedding planning, time in nature, wellness activities, such as yoga or massage, spiritual retreat, church mission work. And, after all, there was a war going on.
    Perhaps this opinion of today’s American Medical Leadership sounds extreme, but such a worrisome and powerful entity must be explained critically, morally. What is the middle ground we should seek between cruelty and decency, between nurture and abuse? Why do we believe one exists?

    • Pat
      February 4, 2019 at 9:55 pm

      Very insightful Steve, as always, sincere compliments to your scholarship and analysis.

  4. Gerard Mazza
    February 4, 2019 at 8:25 am

    It is having to deal with the bureaucrats who write articles such as this and then force us to implement this garbage into our practices that is causing the burnout. Practicing medicine is fun, practicing filling out the endless stream of useless forms that have covered up our office, complying with a myriad of alphabet soup of government agencies, dealing with maintenance of certification, required CME for all sorts of social issues, etc., is not fun. I am sure that we will soon have to have documentation showing our compliance with some newly created anti-burnout regulations as those who govern and rule us will surely determine that having another form or piece of paper will “fix” the burnout issue.

    • James Tinsley
      February 4, 2019 at 2:47 pm

      Well said.

  5. Randy
    February 4, 2019 at 8:21 am

    I read through most of it. They created an office of Practice Innovation and Professional Fulfillment which held meetings and helped to create mentors. They had the amazing idea to have MA’s help with refill requests and prior auths. They created a day off to do wellness stuff and what do you know, people liked having a day off! They did a listening tour. They created Institute Champions – it’s not clear what they do.

    Here’s one sentence that reflects what is going on here: “The peer-based coach-and-coachee dyad works toward strengthening professional, patient, and personal relationships as well as improving engagement, resilience, satisfaction, retention, and academic output. “. It’s the usual useless buzzwords. if I see a peer-based coach-and-coachee dyad and Institute Champion heading towards me I’m running in the other direction.

    Ultimately this is just putting lipstick on a pig. instead of getting at the sources of burnout they work to get docs to feel better about it.

  6. PW
    February 4, 2019 at 7:25 am

    I started reading it, couldn’t take it… aaaarrrgghhhh!!!!

    • James Tinsley
      February 4, 2019 at 2:51 pm

      It relieved my stress. I practically fell asleep several times. I rarely see so much say so little. The VA is probably banging their door down to buy that program. It would fit right in.

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