Minimizing Medical Burnout: John Guiliana Of ModMed On How Hospitals and Medical Practices Are Helping To Reduce Physician and Healthcare Worker Burnout
An Interview With Dan Rodrigues
Be properly staffed. This not only means the appropriate number of employees, but also the right type of employees who fit into the organization’s culture.
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 Dr. John Guiliana.
Dr. John Guiliana is a nationally recognized speaker and author on topics pertaining to medical practice management. He has authored numerous columns in various journals and is the co-author of 31 ½ Essentials to Running Your Medical Practice, as well as The Million Dollar Practice…Keys to Success. Dr. Guiliana is currently the Medical Director of Podiatry for ModMed®’s award-winning technology.
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’m a quintessential “Jersey Boy.” I was born and raised in New Jersey but recently moved to Florida. The foundation of my interest in business (and now, particularly my focus on the business of healthcare) was inspired by my Dad. He was a very philosophical person with natural and self-taught (untrained) business knowledge.
What or who inspired you to pursue your career? We’d love to hear the story.
I am the first medical professional in my family, and I am proud that two of my sons have followed in my footsteps (that’s an unintended pun given that I am a podiatrist!). I was inspired to pursue podiatry after meeting a local podiatrist and becoming exposed to that specialty. I initially became a pharmacist but immediately changed direction after receiving that degree.
What are some of the most interesting or exciting projects you are working on now? How do you think that might help people?
The most interesting projects that I often engage in always involve helping physicians improve their practice. This effort has numerous variations and might entail helping them understand the cost/benefits associated with modernizing their practice’s technology, understanding their business processes and KPIs, helping them communicate more effectively with patients and guiding them on prudent business decisions.
Currently, my most interesting project involves a large group practice and helping them use and interpret data to practice more cohesively through clinical protocols. This will ultimately lead to improved patient outcomes and satisfaction, as well as lower operational costs.
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?
I can take no credit for these traits. I was genetically predisposed to these by my Dad.
- A persistent search for excellence — I am always striving to improve. I don’t let mistakes or failures affect me. In fact, my failures have taught me more about life than any of my formal education.
- Communication skills — the ability to communicate effectively, influentiallyand empathically has helped me not only in practice but in all of life’s encounters. Early on, I became a student of communication experts and continue to learn and practice those skills today.
- This last trait might sound simplistic, yet it not only has helped me live a successful life, but I frequently notice an absence of this trait in those who struggle. Growing up, I was taught that “if you are 10 minutes early, you are ON TIME. If you are on time, you are LATE. And if you are late, you have failed”. Being on time and delivering on time is an important success trait that is frequently underestimated.
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?
I don’t believe that physician and healthcare worker burnout differs much from burnout caused by other forces. Burnout is simply the terminal effect of chronic stress. Unlike acute stress (fight or flight), chronic stress causes psychological and physiological changes that have a profound effect on our bodies. Eventually, burnout will ensue, leading to fatigue, apathy, illness, mood swingsand inability to concentrate.
How would you define or describe the opposite of burnout?
Burnout’s antithesis would be motivated, fulfilled and engaged.
From your experience, perspective, or research, what are the main causes of physician and healthcare worker burnout?
The healthcare landscape has changed dramatically over the past few decades. Change is a harsh stressor. Increased regulatory issues, the complexities associated with maintaining economic viability in the face of declining reimbursements, and striving to provide good patient outcomes despite the former challenges, can eventually take their toll. More than ever, healthcare workers need to be engaged in stress management.
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 first signs of burnout in an organization will usually manifest as increased co-worker conflicts and generalized employee apathy, turnover and absenteeism.
Does your practice currently offer any mental health resources for providers or clinical staff? We’d love to hear about it.
Our organization does.
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.
Absolutely! Guiding an organization through the adoption of technology, while initially stressful, will lead to long-term benefits that will make jobs more efficient, fulfilling and less stressful. Automation can have a very positive effect on burnout. At the same time, it can also reduce the organization’s dependence on human resources and, therefore, lower operational costs.
Fantastic. Here is the main question of our discussion. Can you share five things that hospitals and medical practices can do to reduce physician and healthcare worker burnout?
- Keep employees engaged. Empower them. Inspire them. Easier said than done, but good leadership skills involve building a motivated and fulfilled team. This all starts “at the top,” and healthcare supervisors should be required to undergo leadership training.
- Leverage technology to reduce workloads (discussed above).
- Sponsor fun team-building events and/or outings.
- Be properly staffed. This not only means the appropriate number of employees, but also the right type of employees who fit into the organization’s culture.
- Provide constant monitoring for early signs and chronic stress and offer professional stress management training.
What can concerned friends, colleagues and life partners do to help someone they care about reverse burnout?
Listen and be compassionate. Allow them to “vent.” Suggest stress management training.
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?
Often, without self-reflection, we might get frustrated and impatient with ourselves (or others). It’s important to be sensitive to the fact that this can happen to us or anyone, and reversing it will require being able to identify it, avoiding denialand taking action.
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 takeaway did you learn from that?
In both elementary and high school, I was a D+ student. I just didn’t care about school (with the exception of sports and girls, of course). Looking back, I feel that my teachers could have done more to motivate me, but, nevertheless, I was 100% responsible for my grades. Chemistry was my only academic interest, and at that time, I knew that I wanted to become a pharmacist. But gaining entry to a college of pharmacy was highly competitive, and a D+ was simply not going to “cut it”.
As I approached my senior year in high school, my guidance counselor called my parents and told them to “not waste time or money on college applications.” She felt I would never make it through a college curriculum. Well…that was EXACTLY the challenge that I needed! I applied to a community college and received straight A’s. I then used that transcript (along with some persuasive communication skills) to gain entrance to St. John’s University College of Pharmacy, where I graduated with a 3.5 GPA. I then went on to Temple University College of Podiatric Medicine, where I graduated second in my class of 110.
The moral of this story is that I learned and became self-aware of my need for challenges. Challenges and struggles are what inspire me. I now leverage that need to help other physicians.
Can you share your favorite “Life Lesson Quote”? Why does that resonate with you so much?
My favorite quote comes from Napoleon Hill: “Some people dream of success, while others wake up and work hard at it.”
I believe that success is NOT a status that anyone achieves…rather, it’s an ongoing work in progress.
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 to the greatest number of people, what would that be? You never know what your idea can trigger.
We are living in very divisive times. This negatively affects everyone. Divisiveness, itself, can lower the threshold for burnout. I would love to see a movement in which we commit to each other to be more respectful of other people’s viewpoints (as long as they are lawful, of course). Disrespect triggers divisiveness. And divisiveness actually triggers further divisiveness! Only mutual respect can break this cycle.
How can our readers further follow your work online?
This was truly meaningful! Thank you so much for your time and for sharing your expertise!
About The Interviewer: Dan Rodrigues is the founder and CEO of Kareo, a Tebra company, a leading provider of cloud-based clinical and practice management software solutions for independent healthcare practices and billing companies. Rodrigues is known for his visionary leadership in the healthcare technology industry. Rodrigues’ future-forward expertise has led companies such as Scour and Skematix. He is highly committed to providing patients with a seamless, digital experience in healthcare. Rodrigues’ business insights have been featured in publications including Forbes, Fierce Healthcare, and AP News.
