Minimizing Medical Burnout: Aaron Patzer Of Vital On How Hospitals and Medical Practices Are Helping To Reduce Physician and Healthcare Worker Burnout
An Interview With Dan Rodrigues
Make sure the software you’re using is user-friendly, easy to understand, and beautiful.
The pandemic was hard on all of us. But statistics have shown that the pressures of the pandemic may have hit physicians and healthcare workers the hardest. While employment is starting to return to pre-pandemic levels generally, the healthcare sector is lagging behind with a significant percentage of healthcare workers not returning to work. This is one of the factors that is causing a shortage of doctors. Some experts say that the US may soon be short almost 124,000 physicians. (See here for example)
What are hospitals and medical practices doing to help ease the extreme mental strain of doctors and healthcare workers? What are hospitals and medical practices doing to help solve the scourge of physician and healthcare worker burnout?
To address these questions, we are talking to hospital administrators, medical clinic executives, medical school experts, and experienced physicians who can share stories and insights from their experience about “How Hospitals and Medical Practices Are Helping To Reduce Physician and Healthcare Worker Burnout”. As a part of this series, I had the pleasure of interviewing Aaron Patzer.
Aaron Patzer, is the co-founder and CEO of Vital, a modern software to increase productivity and improve patient health in hospital emergency rooms. Aaron is well known for his success with Mint.com (sold for $170 million to Intuit), and for his ability to use technology to make complex things simple. After selling Mint, Patzer went on to found Fountain.com, a video-conferencing app that connects you to a doctor, lawyer, veterinarian or electrician in 60 seconds to help you solve any problem. The company sold to Porch.com in 2015.
Thank you so much for joining us in this interview series! I know that you are a very busy person. Before we dive into the main focus of our interview, our readers would love to “get to know you” a bit better. Can you tell us a bit about your childhood backstory?
I’ve had an interest in tech since I was a kid. I started playing around with computers when I was six years old, ran a BBS when I was 10, and started my first web development business when I was 16, in 1996.
(I designed about 10 of these with lego and construx, and made my parents photograph them in order to “sell my designs”. Still love product design. Still write Jira tickets or play with Figma designs every day. Still a creative 6 year old at heart.)
What or who inspired you to pursue your career? We’d love to hear the story.
Early in my career, I moved to Silicon Valley to join a startup during the dotcom boom. I was 19 and it was my first time really setting up a new apartment. I was also naive on how paychecks worked (every two weeks) as I had really only worked for myself until then. I was surprised to see I overdrafted my account for the first (and only) time. This mistake was a key part of the genesis for Mint.com as a more automatic way to manage personal finances.
I ended up growing Mint to around 3 million users when it was sold to Intuit in late 2009 for $170M. It’s 15 years after founding, and Mint is still going strong with something like 20M+ users last time I checked.
I stuck around Intuit until 2013, founded another business called Fountain for on-demand video expertise, where I saw a ton of medical questions being asked to the nurses we had contracted. Having sold that in 2015, I moved full bore into health. It helps that it runs in the family. The first place I started was helping my sister — a tenured professor doing transplant research — to come up with a machine learning algorithm around kidney transplants. My brother-in-law saw what we were working on, and wondered if it might help him in the emergency room.
Turns out, we could. Within a few months, we proved we could accurately predict admission into the hospital very early during a stay by processing the free-text nurses were writing about patients. That led Dr.Justin Schragerand I to the founding of Vital.
And here we are.
What are some of the most interesting or exciting projects you are working on now? How do you think that might help people?
As we extend our product further and deeper into the hospital, the power of our algorithms and automation continues to expand. With CareAdvisor, our inpatient hospital solution, we are working on predictive models that flag sepsis and other risks that endanger patients. That kind of impact is why I love this job.
You are a successful leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?
First, I am obsessed with customer-centered software design. It’s what worked at Mint and Intuit, and it’s sorely needed in healthcare where ease-of-use for the patient is often an afterthought.
Second, I’m not afraid of hard problems. Mint had to connect to 12,000 banks, brokerages, and financial instruments. Vital needs to connect to 5,000 US hospitals. The data is messy, siloed, heterogenous. Honestly, it’s a pain. And that’s an opportunity. I think it scares most people, investors, and startups away. Because it will take years, or perhaps decades to solve. I’m not the fastest or the smartest. But I think I’m really determined.
Third, I am an inventor. I don’t shy away from an empty piece of paper. I like bringing entirely new things into the world. During one of my past endeavors called Swift, I tried to tackle a very big problem in transportation. While the technology worked, it was a product that wouldn’t scale. Although this may have been an idea that others would have thought was crazy, I still wanted to try it and I needed to prove whether it would be successful to myself. It didn’t work that time but I learned a lot.
Ok, thank you for all of that. Let’s now shift to the main focus of our interview about minimizing medical burnout. Let’s begin with a basic definition of terms so that all of us are on the same page. How do you define “Physician and Healthcare Worker Burnout”? Does it just mean poor job satisfaction? Can you explain?
As with any employee, a role that is high intensity, has many demands, and is continuously high stress can lead to physical, emotional and sometimes even spiritual exhaustion. This is burnout. Over the past three years in particular, with the demands and stress of the pandemic, growing patient volumes and acuity, and the growing shortage of staff, we saw an unprecedented level of burnout among physicians and healthcare workers. This absolutely leads to growing job dissatisfaction and now is contributing to the shortage of healthcare professionals.
How would you define or describe the opposite of burnout?
The opposite of burnout would be high energy, a daily sense of accomplishment, like you’re actually contributing to the world. Meaning makes anything possible.
From your experience, perspective, or research, what are the main causes of Physician and Healthcare Worker Burnout?
There are a variety of factors at play here: high volumes of very sick or acute patients, and at times, the inability to save a patient despite heroic efforts. In many hospitals, patient volumes exceed the hospital’s capacity both in terms of space and staffing. Those periods of high volume stretch the demands on staff beyond what is normal or can be sustained.
In addition, we’re seeing a critical (and growing) staffing shortage. Too few people are entering the workforce, many are leaving the profession for a less stressful job, and some are retiring early. Nurses, physicians, and staff are trying to do it all with too few people; maintain high levels of care, communicate with the patient and their family, and adequately educate them about their care. Medscape released its 2022 Physician Burnout and Depression Report and the findings don’t paint a bright picture. Emergency Medicine physicians reported the highest increase in burnout year-over-year, jumping from 43% to a staggering 60%.
What can reasonably be inferred here? There are too few software systems supporting healthcare professionals in a way that reduces demands and stressors of work. Combine all these factors with increased patient expectations — you find yourself in a situation of high stress and burnout.
Have you seen burnout impact your own organization? Can you give a first hand description of how burnout can impact the operations of an organization?
The pandemic has added pressures and we’re very aware how this can impact an employee — even as a fully remote company. We’re all balancing work and life responsibilities, some are navigating illnesses and childcare closings, and we have all dealt with fewer opportunities to socialize. All of these can quickly compound and lead to burnout.
We offer a flexible work environment, parental support and mental health support. Employee benefits extend beyond the obvious. We have a #wordle and #cooking channel. We celebrate birthdays with cakes sent to team members (according to dietary restrictions!). We have video calls to meet new team members and have a #watercooler channel to talk about non-work topics. These things are important. We try to balance stressors with professional growth opportunities and ample leave time, at least 4 weeks, even for new employees. We encourage our team members to take the time they need and work when it best suits them. I try to lead by example, having worked remotely from Europe, Hawaii, and places that suit my lifestyle.
Does your practice currently offer any mental health resources for providers or clinical staff? We’d love to hear about it.
We offer mental health reimbursement for all our employees and use a check-in tool called 15Five that starts with a pulse check on how the employee is feeling — providing managers the opportunity and means to start a needed conversation with an employee who may be approaching burnout.
In my work I have found that streamlining operational efficiency with digital transformation and automated processes helps to ease the workload of providers and clinical staff. Has that been your experience as well? Do you think that streamlining operational efficiency can be one of the tools to minimize medical burnout? We’d love to hear your perspective.
Nurses often have to take on responsibilities that aren’t necessarily within their job descriptions. Software that can effectively automate tasks and reduce workload for staff is not widely available, yet the opportunity is there. And sometimes technology actually adds MORE work and discomfort for healthcare professionals and their patients.
Done properly, AI can create an individualized care experience that gives patients more control of their care. AI-driven software can, and should, serve clinicians by supplementing daily tasks with decision support, predictive analysis, and a more informed approach to care planning and care management. Digital tools can give patients control of their care and get them engaged in their care while simultaneously taking the burden off staff by encouraging fewing questions. This creates a positive experience for both patients and staff, which reduces medical burnout.
Fantastic. Here is the main question of our discussion. Can you share 5 things that hospitals and medical practices can do to reduce physician and healthcare worker burnout?
- Provide technology-enabled tools that reduce tasks, lighten workload, and automates non-clinical processes and non-clinical communication.
At Vital, we do this in two ways: route non-urgent requests for things like food, water, ice packs, pillows, room cleaning, etc. to non-nursing staff at the push of a button. Nurses neither have to call and coordinate or fulfill these requests themselves.
We also use AI to create highly personalized discharge goals for each patient. These bite-sized actions allow patients to take greater responsibility for their own health. Instead of sitting back and letting nurses “nurse them back to health” patients are motivated to improve their own outcomes and leave the hospital sooner.
2. Manage patient expectations early, to prevent the stress of the unknown from being directed at staff.
Vital does this in the ER by letting patients see, step-by-step, exactly what is going to happen next. We provide AI-powered wait times to let people know how long it will be before they get a room or are seen by the doctor. Knowing makes all the difference in being able to bear a wait during a time of stress.
If the ER is particularly busy, we show volumes as analogous to traffic — not the fault of the providers for not moving fast enough — just the result of everyone showing up on a Tuesday evening. By gluing patients — who may be having one of the worst days of their lives — to regular communication on their phone, staff get fewer questions, and have less angry visitors.
3. Give credit where credit is due!
You can reinforce the value that individual staff members bring to everyday moments by sharing real-time patient recognition and appreciation. Vital uses patient feedback surveys to gather and report patient appreciation for staff as the care takes place.
4. Apply AI and NLP to provide an expanded level of clinical decision support.
AI works tirelessly as an assistant to care providers. The goal is not replacement, but augmentation. We let often tired providers know when something might have been missed. But we’re also very careful not to over-alert.
5. Make sure the software you’re using is user-friendly, easy to understand, and beautiful.
Do patients, clinicians, and staff enjoy interacting with the software available to them? Vital has extraordinary utilization rates — close to 60%. We’ve achieved this by delivering a user interface that appeals to, and provides benefits to, patients and clinicians. This drives operational efficiency, improves the patient experience, and results in better patient outcomes — all of which lighten the demands and risk of burnout on healthcare workers.
What can concerned friends, colleagues, and life partners do to help someone they care about reverse burnout?
Be present. Lend a listening ear when needed. Be observant and know when to inquire if help is needed. Be supportive and understanding. Encourage them to talk about how they are doing and feeling. Create experiences that take them outside of their daily work life and instill a sense that there is more to life!
What are a few of the most common mistakes you have seen people make when they try to reverse burnout in themselves or others? What can they do to avoid those mistakes?
It’s common to see people ignore the problem or feel that it is expected of them to get over and beyond it by themselves. I know the feeling. Acknowledge what you are feeling and realize you are not alone. Don’t be hesitant to seek help and know that it is okay to do so. It’s important to recognize that short term fixes don’t work and aren’t sustainable. Self-care must be a daily practice, not something you do in response to burnout! I live by this philosophy and practice this mindset daily. In fact, I’m on a 4 year streak of going on a daily run.
It has been said that our mistakes are our greatest teachers. Can you share the funniest or most interesting mistake that occurred to you in the course of your career? What lesson or take away did you learn from that?
After I sold Mint.com, I was feeling a little too full of myself and decided to try to create a new mode of transportation using magnetic levitation. I was very ambitious, but after I calculated the cost of the materials for this idea, it was too expensive. This taught me that the best business ideas come from solving my own problems rather than looking for a problem to solve.
Can you share your favorite “Life Lesson Quote”? Why does that resonate with you so much?
“Our doubts are traitors, and make us lose the good we might have won, by fearing to attempt” by Shakespeare is my favorite quote because it was a quote that I relied on whenever I felt down toward the beginning of my career. Sometimes it can feel discouraging to try to solve these really big problems, but this quote helps me remember that I’ll feel accomplished as long as I give my all to what I’m working on.
Ok, we are nearly done. Because of your role, you are a person of significant influence. If you could inspire a movement that would bring the most amount of good for the greatest number of people, what would that be? You never know what your idea can trigger.
The more I uncover about the US healthcare system, the more I find ways to innovate in this space. Technology tends to be antiquated, the people who work tirelessly to care for their communities are increasingly burned out or leaving the field, and patients are paying far too much for the care they receive. From prescription drugs, to care coordination, to avoidance of hospital-acquired conditions, we, as a whole, can do better to support everyone involved in the healthcare process. My life’s goal is to make difficult, convoluted systems simple and more efficient. Brilliant minds abound in healthcare — we can fix this together.
How can our readers further follow your work online?
You can check out our company blog at https://blog.vitaler.com/ and you can follow us on LinkedIn at https://www.linkedin.com/company/vital-software and Twitter @Vital_EHR
This was truly meaningful! Thank you so much for your time and for sharing your expertise!
About The Interviewer: Dan Rodrigues is the Co-Founder and CEO of Tebra, a leader in practice growth technology and cloud-based clinical and financial software for independent practices. With an all-in-one, purpose-built platform to drive practice success and modernize every step of the patient journey, Tebra provides digital tools and support to attract new patients, deliver modern care, get paid quickly, and operate efficiently.
