1st Edition
Joy in Medicine? What 100 Healthcare Professionals Have to Say about Job Satisfaction, Dissatisfaction, Burnout, and Joy
Eve Shapiro has been writing about patient-centered care, physician–patient communication, and relationships between doctors and their patients since 2007. In Joy in Medicine? What 100 Healthcare Professionals Have to Say about Job Satisfaction, Dissatisfaction, Burnout, and Joy, Eve turns her attention to those on the healthcare delivery side of this "sacred interaction."
These healthcare professionals share their enthusiasm, joys, frustrations, disappointments, insights, advice, stories, fears, and pain, explaining how it looks and feels to work in healthcare today no matter who you are, where you work, or what your position is in the organizational hierarchy.
The healthcare professionals who provide patient care deserve our collective interest in their humanity. Without some insight into who they are and the forces with which they struggle every day, we cannot fully appreciate the obstacles to providing the care we all want for ourselves and our families during the best of times, let alone in the uncertain times that lie ahead.
Contents
Dedication
Foreword
Preface
Acknowledgments
Introduction
Section 1. What Promotes Joy
Section 1 Introduction
Passion for the Work
- Sebastian P., MD, primary care physician and instructor of medicine
- Miguel G., MD, former military medicine primary care physician; surgical resident in obstetrics and gynecology
- Theodore B., RN, BSN, insurance company healthcare consultant
- Emily P., MD, FACP, retired internist, and medical school teacher and mentor
- Derek Van Amerongen, MD, vice president and medical director of Humana of Ohio
- Neal G., MD, emergency medicine physician; family practice-urgent care physician and entrepreneur; and chief medical officer for his state’s federal health insurance program, retired
- Mary R., MSN, perioperative educator
- Rachel M., MD, pediatric radiologist and professor of radiology
- David L., MD, MPH, ophthalmologist
- Owen R., BS, MS, city director of emergency and safety services
- Rebecca L., MS, retired psychologist in private practice
- Grace Y., RN, operating room nurse
- Gary Kaplan, MD, chairman and CEO of Virginia Mason Health System and practicing internal medicine physician
- Gene Lindsey, MD, retired physician and CEO emeritus of Atrius Healthcare
- Mark Huth, MD, president, CEO, and family physician at Group Health Cooperative of South Central Wisconsin
- Tom Foels, MD, MMM, chief medical officer of a not-for-profit health plan
- Donald Lappé, MD, FACC, FAHA, executive director of the cardiovascular clinical program; chairman, cardiovascular department; and chief of cardiology at Intermountain Healthcare
- Chris DeRienzo, MD, MPP, neonatologist and chief quality officer for a large integrated health system
- Virginia J., MSN, RN, chief population health officer for an integrated health plan
- Charleen Tachibana, DNP, RN, FAAN, health system senior vice president for quality and safety and chief nursing officer
- Carol M., MD, hospital internist specializing in allergy/asthma; hospital executive director; director of graduate medical education; and medical director for provider services
- Peter R., MD, former president and CEO of an integrated healthcare system; strategic advisor/consultant
- Laura Spero, MSW
- Myron Glick, MD, family physician; founder and CEO of Jericho Road Community Health Center
- Mark K., MD, primary care internist for a rural integrated health system
- Andrew M., MD, professor of family medicine and family physician
- Ruth F., BSN, public health nurse/community health nurse at a rural integrated health system
- Eliot D., MD, internal medicine officer for a rural integrated health system
- Paula C., MD, orthopedic hand surgeon
- Angela DeVanney, BA, executive director of the AMD3 Foundation
- Amir F., MD, FACP, internist and vice president of a small internal medicine group practice
- Cathy U., MSN, administrative director of perioperative services for a large academic medical center
- Elana G., MD, pulmonary and critical care physician; medical director of an adult medical specialties group in an integrated health system
- Harlan Z., MD, total joint replacement surgeon
- Edward B., MD, medical director of an alcohol and drug detoxification program
- Meghan Pillow, MSN, critical care nurse
- Sarah D., MD, physician and practice manager of a small group gynecologic private practice
- Kevin S., MD, senior vice president and chief medical officer for an integrated health plan
- Haley N., MA, music therapist
- Marianne S., PhD, counseling psychologist in private practice and adjunct professor
- Irene J., MD, OB/GYN hospitalist for a small community hospital
- Francine J., MD, internist in a solo concierge practice
- Anthony M. DiGioia, MD, orthopaedic surgeon and medical director of the UPMC Magee-Womens Hospital and the UPMC Innovation Center
- Connie E., DNP, Level 2 staff nurse at a quaternary care pediatric hospital and assistant professor of nursing
- Tyler M., MD, chief medical officer for an integrated health system
- Joseph B., MD, retired professor, researcher, and practicing gastroenterologist; president of a board review company in gastroenterology; and head of a monthly gastroenterology journal club
- Adam B., MD, pediatric pulmonologist and sleep specialist at a quaternary care children’s hospital
- Caitlin G., MSN, assistant clinical professor, hospital and home care nurse, and PhD student
- Monica T., MD, Assistant Professor of Pediatrics and Attending Neonatologist at a Quaternary Care Pediatric Hospital
- Walter G., MD, general surgeon
- Nancy W., RN, PhD, nurse, clinical psychologist, faculty member, and clinical consultant
- Nicole A., MD, MPH, medical director of a neonatal intensive care unit at a quaternary care pediatric hospital
- Amy I., MD, pediatrician and chief of staff for an integrated health system
- Justine M. BS, retired nurse manager
- Gail M., BSN, BS, labor and delivery nurse
- Eric Cannon, PharmD, FAMCPP, assistant vice president of pharmacy benefits
- Jennifer F., MSN, nurse practitioner for an integrated health system
- Angela R., retired medical assistant/office manager
- Dana D., LICSW, clinical social worker at a pediatric hospital
Passion for Leadership
Passion for Treating the Underserved Globally and Domestically
Autonomy and Control
Working in Multiple Roles
Being Part of a Team
60. Karen L., MSN, board-certified family nurse practitioner at an academic medical center
61. Gloria K., MSW, hospital neonatal intensive care unit social worker
Finding Work-Life Balance
62. Sharon D., BSN, perioperative nurse and operating room educator
63. Vivian G., PhD, psychotherapist in private practice
Section 2. What Diminishes Joy
Section 2 Introduction
Pressure, Stress, and Fatigue
64. Charles G., MD, radiologist
65. Jamie Cieplinski, RN, clinical unit leader and floor nurse at a community hospital
66. Carrie L., MD, emergency medicine physician
67. Paul T., MD, neurosurgery resident
68. Leonard R., MD, pediatric radiology resident
69. Ruby A., MSN, pediatric nurse practitioner at a federally qualified health center
70. Raymond J., MS, emergency medical technician, director of operations for an ambulance transportation company, and captain of an emergency medical services provider
71. Wayne K., MPH, part-time volunteer emergency medical services technician
72. Anthony F., MD, internist, associate medical director for the insurance division of an integrated health system, and adjunct associate professor of medicine
73. Margaret E., LCSW/PAC, physician assistant for an integrated health system
74. Melanie C., MD, pediatrician in private practice
75. Victoria N., DNP, MSN, FNP, nurse practitioner and director of a university health clinic
Administrator-Clinician Disconnect
76. Stephan D., MSW, senior therapist, city department of health and community services
77. Alice H., MSN, nurse, surgical services educator
78. Craig M., Registered polysomnography technologist and manager of a pediatric hospital sleep laboratory
79. Lawrence W., MD, retired obstetrician/gynecologist and professor of obstetrics/gynecology at an academic medical center
80. Lisa W., MSN, family nurse practitioner in a small internal medicine group practice
Disrespect
81. Tina J., radiographer/assistant director of radiology at an academic medical center
82. Helen H., environmental services associate for an academic medical center
83. Judith S., MSW, retired clinical social worker
84. Bonnie M., RN, hospital neonatal intensive care bedside nurse
Section 3. What Destroys Joy
Section 3 Introduction
Lack of Autonomy and Control
85. Diane L., MD, rheumatologist in solo private practice
86. Michael V., MD, endocrinologist, professor of medicine, and senior staff physician at an integrated health system
87. Natalie B., MD, obstetrician/gynecologist
88. Harold J., MD, surgeon in urology
89. Charlotte J., MD, internist in private practice
Lawsuits
90. Jacqueline M., MD, internist, attending physician, and assistant professor of medicine
91. Gregory C., MD, vice chief of staff of a large suburban community medical center; hospital informaticist; and director of provider relations
92. William C., MD, neurologist in private practice
Moral Distress
93. Sydney G., MD, MPH, retired critical care pediatrician
94. Rose S., internal medicine physician, medical director of a subacute rehabilitation/skilled nursing facility
95. Theresa E., licensed physical therapist for a large integrated health system
96. Daniel M., MD, psychiatrist in private solo practice
97. Sophia L., MSW, clinical social work student
Section 4. What the Experts Have to Say
Section 4 Introduction
98. Paul DeChant, MD, MBA, author, speaker, and coach in reducing physician burnout
99. Bridget Duffy, MD, Chief Medical Officer, Vocera Communications, Inc.
100. Alan Frankel, MD, Managing Partner of Safe and Reliable Care
Biography
Eve Shapiro, Principal, Eve Shapiro Medical Writing, Inc. is a Bethesda, MD-based medical writer dedicated to improving healthcare delivery, patient safety, and the quality of care by focusing on the factors that put physicians at the "sharp end" of badly designed systems and put patients at risk for unintended consequences and adverse events that often result.
Ms. Shapiro has written and edited more than 150 journal articles, feature articles, reports, white papers, toolkits, books, fact sheets, and brochures for print and Web publication on medical issues for clinicians, health care leaders, administrators, researchers, policymakers, the media, and the general public. Topics include patient safety, medical ethics, medical errors, patient-centered care, systems improvement, transitions in care, physician-patient communication, preventive care, hand hygiene, alcohol and drug abuse, juvenile justice, and psychiatry.
Most recently, Ms. Shapiro has coauthored the book, The Patient Centered Value System: Transforming Healthcare Through Co-Design, published in September 2017 by CRC/Productivity Press.
"Eve Shapiro, in this important book, has contributed two very meaningful insights. First, she has relayed the stories of 100 health professionals in their own words and has given us all a framework within which we can make sense of their stories. Second, she has engaged two powerful currents—burnout within health care and the worst public health challenge in a century—and has given us a reason for hope. This is a book all health professionals, as well as those in the public who care about their welfare, should read."
John R. Ball, MD, JD, MACP
Executive Vice President, Emeritus, American College of Physicians
Former Chair, Mission Health System, Asheville, NC
"In Joy in Medicine?, Eve Shapiro provides unique and valuable insights into understanding the challenge of clinician burnout. We will not fix the myriad problems in healthcare without a deep understanding of what contributes to both joy and burnout. Her in-depth interviews with clinicians provide insights that every healthcare leader needs to understand if they are serious about being part of the solution, rather than part of the problem."
Paul DeChant, MD, MBA
Author, Executive Coach, and Prior CEO, Sutter Gould Medical Foundation"A growing body of research about the physician/caregiver experience identifies the causes, consequences, and remedies for physician burnout and the factors most highly related to physician joy and fulfillment. While this research is certainly informative, in my view, in Joy in Medicine? What 100 Healthcare Professionals Have to Say about Job Satisfaction, Dissatisfaction, Burnout, and Joy, Eve Shapiro’s narrative approach, using firsthand interviews that illuminate real people in real settings, yields rich, qualitative information that has a much greater potential to impact physicians, teams, and organizations.
"Those she interviewed share their stories—about highs and lows in their careers, their frustrations and stresses, their joys and satisfaction—and they offer advice to others who seek fulfillment in the practice of medicine. Stories are like pollen. They engage and persuade. They move people to action. They spark conversations with ourselves and others. The stories shared in Eve’s book have that power. Individuals and organizations can use this book to understand and support caregivers and to identify and pursue improvement initiatives in our quest to achieve human-centered care and a gratifying caregiver experience."
Wendy Leebov, Ed.D.
Author, Creator of Language of Caring
www.languageofcaring.org"Eve’s Shapiro’s book, Joy in Medicine?, is a call to action to save lives: lives of patients and families, and lives of physicians, nurses, and all stakeholders inside (and outside) the traditional healthcare system. Eve interviews 100 men and women who work in the healthcare industry in our country today. She listens to understand, she reflects, and she shares their wisdom and insight (and her own) with the reader. Joy in Medicine? will teach healthcare leaders, people on the front lines of healthcare, patients and families, and communities what must be done to achieve betterment and bring joy back into medicine."
Thomas H. Dahlborg, MSHSM
President, Dahlborg Healthcare Leadership Group (DHLG)
Director Health Care, Global Listening Centre Board (India)