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Relieving physician burnout: Getting the right partners involved


The director of the National Institute for Occupational Safety and Health discusses its role in creating a healthy workplace for health care workers.

physician burnout: © N Felix/ -

© N Felix/ -

Physicians, other clinicians and their supporters are awaiting congressional action on the next version of the “Dr. Lorna Breen Health Care Protection Act.”

While vitally important, that legislation is far from the only effort taking place to improve workplace conditions that contribute to burnout in doctors and their medical support staff.

This year, the National Institute for Occupational Safety and Health (NIOSH) published the Impact Wellbeing Guide. It is a free online resource with six steps for hospital and health care system leaders to create long-term plans and promote workplace practices that contribute to worker wellness.

© NIOSH/Dr. Lorna Breen Heroes' Foundation

© NIOSH/Dr. Lorna Breen Heroes' Foundation

The National Academy of Medicine, the U.S. Surgeon General’s Office, the Dr. Lorna Breen Heroes’ Foundation, and various hospitals all contributed to the guide.

John Howard, MD, MPH, JD, LLM, MBA, is in his third term as director of NIOSH. Working under the U.S. Centers for Disease Control & Prevention, NIOSH is a research agency that focuses on worker safety.

This spring, he spoke with Medical Economics about identifying the problem and the interconnected roles of Congress, the executive branch of government, and the health care sector in the combined efforts to relieve burnout in health care workers.

This transcript has been edited for length and clarity.

Medical Economics: Can you explain how NIOSH was involved with the “Dr. Lorna Breen Health Care Protection Act”?

© National Institute for Occupational Safety and Health

John Howard, MD, MPH, JD, LLM, MBA
© National Institute for Occupational Safety and Health

John Howard, MD, MPH, JD, LLM, MBA: Well, the act gave us the permission, so to speak, from the appropriators, the authorizers in Congress to say, this is an important national issue, and you at NIOSH need to do something about it. And I think that's extremely important because we're an organization that responds to stakeholder demand, stakeholder issues, and certainly one of our major stakeholders since they fund our activities is congressional authorization and Appropriations Committee. So the act, I think, really said to us, you need to do work in this area. And we were very excited to do it because our research, as I mentioned before, had shown that this issue of health care worker burnout was a significant one.

Medical Economics: Renewal of the “Dr. Lorna Breen Health Care Protection Act” is pending in Congress now. Is NIOSH able to endorse that act or a different piece of legislation regarding burnout and health care. And if possible, can you discuss why that renewal is necessary?

John Howard, MD, MPH, JD, LLM, MBA: Well, taking the first question, we are a part of the executive branch of government. So, we're not allowed to, to put legislation in front of the Congress or to say this one's good, this one's bad. Sometimes we're asked our views from a technical perspective, and we wait for congressional members or staffers to ask us those questions. We're happy to do that, but we don't take positions. The administration itself the executive branch does do that from the White House. We don't do that from the agency level. With regard to the second part of your question, we think this work is extremely important, and we're not 100% sure that a couple of years of effort, because we've just really started as we will probably discuss in terms of our workplace guide that we hope employers will take up and utilize. We're just at the beginning of that, our launch was just a few weeks ago. So, we think we're at the beginning of what we think will be a long journey. We're really happy that the Congress would again look at the original act and be able to say, we want to stand behind it again. That gives us a little wind in our sails, so to speak, that you're on the right track and keep up the good work. That's the way we interpret it.

Medical Economics: Can you discuss how the “Impact Wellbeing” guide was created?

John Howard, MD, MPH, JD, LLM, MBA: It's a partnership. You know, they say no good things come from a committee but in our in our case, our partnership with the Dr. Lorna Breen heroes Foundation, with the National Academy, with the surgeon general, with the group of hospitals that helped pilot our guide. We don't take credit for being the sole author or prime mover. What we want to do is be the honest broker to bring partners together that are specifically able to be technical experts and subject matter experts. We at NIOSH do not operate hospitals. We need people that are on the front lines, like the Dr. Lorna Breen Heroes Foundation, like the hospitals that helped pilot our guide and say, yeah, this works, this doesn't work, we'd like to see this change. We're just maybe at the head of the parade, and I'm happy to acknowledge that the guide is a product of partnership.

This spring, NIOSH announced the Institute and the Dr. Lorna Breen Heroes’ Foundation hosted a three-part virtual workshop series to dive deeper into the “Impact Wellbeing Guide,” which helped hospital leaders better understand how the Guide can be used to accelerate professional wellbeing efforts. The workshop series, which will be available to view on the Impact Wellbeing website, walked participants through each of the Guides’ six actions and featured leaders from organizations nationwide who shared their real-world experiences implementing wellbeing work that aligned to the Guide.

The campaign offers resources for health care workers including, tips for discussing mental health and burnout with peers, and ways to advocate for the use of the Impact Wellbeing Guide within their hospital.

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© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health