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Joy and Burnout on the Front Lines @laxswamy #GenQI #QF16

Lakshman Swamy: Joy and Burnout on the Front Lines

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Page 1: Lakshman Swamy: Joy and Burnout on the Front Lines

Joy and Burnout on the Front Lines

@laxswamy#GenQI#QF16

Page 2: Lakshman Swamy: Joy and Burnout on the Front Lines

https://thejaggedword.com

@laxswamy

Page 3: Lakshman Swamy: Joy and Burnout on the Front Lines

Existential crisis

Emotional exhaustion

Depersonalization

@laxswamy

Page 4: Lakshman Swamy: Joy and Burnout on the Front Lines

Broken systems predictably cause burnout.

Participation in QI can build resilience.

@laxswamy

Page 5: Lakshman Swamy: Joy and Burnout on the Front Lines

Sweetandsour, Getty Images www.gettyimages.com

@laxswamy

Page 6: Lakshman Swamy: Joy and Burnout on the Front Lines

@laxswamy

Page 7: Lakshman Swamy: Joy and Burnout on the Front Lines

Mr. VThe patient reports that he wants to die, wishing for someone to “put a gun to my head and pull the trigger.”

Sorrowing Old Man (At Eternity's Gate) by van Gogh

@laxswamy

Page 8: Lakshman Swamy: Joy and Burnout on the Front Lines

http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=26063

@laxswamy

Page 9: Lakshman Swamy: Joy and Burnout on the Front Lines

@laxswamy

Page 10: Lakshman Swamy: Joy and Burnout on the Front Lines

@laxswamy

Page 11: Lakshman Swamy: Joy and Burnout on the Front Lines

@laxswamy

Page 12: Lakshman Swamy: Joy and Burnout on the Front Lines

The Impact of Systems Issues“I'm just CONFUSED now”

“I have learned the CYNICISM OF MEDICINE”

“More BITTER and UNHAPPY”

“I have a NEGATIVE OUTLOOK”

Michael H Getty Images Stock http://www.gettyimages.com/

@laxswamy

Page 13: Lakshman Swamy: Joy and Burnout on the Front Lines

Perspectives changed… “Things are done just to PREVENT LAWSUITS”

“LITIGATION and INSURANCE dictate care”

“COMPLICATED system, FRACTURED communication” Andrew Unangst Getty Images Stock http://www.gettyimages.com/

@laxswamy

Page 14: Lakshman Swamy: Joy and Burnout on the Front Lines

…For the worse.“It's not altruistic.”

“No longer interested in primary care”

“I feel like PATIENTS ARE MY ENEMIES.”

Vincent Hazat, Getty Images Stock http://www.gettyimages.com/

@laxswamy

Page 15: Lakshman Swamy: Joy and Burnout on the Front Lines

In a word…“It is easy to become JADED”“I’m more JADED”“Doctors become JADED. This is unavoidable.”“Made me more JADED and frustrated”

Idea Images Getty Images Stock http://www.gettyimages.com/

@laxswamy

Page 16: Lakshman Swamy: Joy and Burnout on the Front Lines

We have institutionalized burnout.

@laxswamy

Page 17: Lakshman Swamy: Joy and Burnout on the Front Lines

@laxswamy

Page 18: Lakshman Swamy: Joy and Burnout on the Front Lines

@laxswamy

Page 19: Lakshman Swamy: Joy and Burnout on the Front Lines

“Accolade”For completing all of the MRI forms needed to get

a patient scanned quickly overnight!

Thomas Imo Getty Images Stock http://www.gettyimages.com/

@laxswamy

Page 20: Lakshman Swamy: Joy and Burnout on the Front Lines

“Accolades”Able to get cath records --from the DOMINICAN

REPUBLIC #BOSS

visual7 Getty Images Stock http://www.gettyimages.com/

@laxswamy

Page 21: Lakshman Swamy: Joy and Burnout on the Front Lines

“Accolade”When the entire system was down, he accessed the EMR with cellphone + wifi hotspot + laptop!

Miguel Navarro Getty Images Stock http://www.gettyimages.com/

@laxswamy

Page 22: Lakshman Swamy: Joy and Burnout on the Front Lines

“Accolade”Going to the pharmacy to pick up her patient's

medications - and paying for them!

Influx Productions Getty Images Stock http://www.gettyimages.com/

@laxswamy

Page 23: Lakshman Swamy: Joy and Burnout on the Front Lines

“Accolade”He rented a zip car to

drive a patient's meds to his rehab!

https://twitter.com/zipcarchicago

@laxswamy

Page 24: Lakshman Swamy: Joy and Burnout on the Front Lines

Broken systems push us to stop caring.

@laxswamy

Page 25: Lakshman Swamy: Joy and Burnout on the Front Lines

@laxswamy

Page 26: Lakshman Swamy: Joy and Burnout on the Front Lines

@laxswamy

Page 27: Lakshman Swamy: Joy and Burnout on the Front Lines

@laxswamy

Page 28: Lakshman Swamy: Joy and Burnout on the Front Lines

@laxswamy

Page 29: Lakshman Swamy: Joy and Burnout on the Front Lines

https://www.etsy.com/shop/aphroditescanvas

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Page 30: Lakshman Swamy: Joy and Burnout on the Front Lines

@laxswamy

Page 31: Lakshman Swamy: Joy and Burnout on the Front Lines

We institutionalize the creation of technicians in those who dreamt of

being healers.

@laxswamy

Page 32: Lakshman Swamy: Joy and Burnout on the Front Lines

Those who feel that they can change the system are impervious to

burnout.

@laxswamy

Page 33: Lakshman Swamy: Joy and Burnout on the Front Lines

Cause for Optimism

“Motivated to make system improvements”“Provided me with opportunities to improve”“It has inspired me”

@laxswamy

Page 34: Lakshman Swamy: Joy and Burnout on the Front Lines

Cause for Optimism

I am still here for the patient.

@laxswamy

Page 35: Lakshman Swamy: Joy and Burnout on the Front Lines

#genQI@laxswamy

Page 36: Lakshman Swamy: Joy and Burnout on the Front Lines

@laxswamy

Page 37: Lakshman Swamy: Joy and Burnout on the Front Lines

Martin Barraud Getty Images Stock http://www.gettyimages.com/ @laxswamy

Page 38: Lakshman Swamy: Joy and Burnout on the Front Lines

John Clutterbuck, Getty Images Stock http://www.gettyimages.com/@laxswamy

Page 39: Lakshman Swamy: Joy and Burnout on the Front Lines

It starts with you.

@laxswamy

Page 40: Lakshman Swamy: Joy and Burnout on the Front Lines

AccoladeExceptional bedside manner in leading a

difficult family meeting.

Sigrid Gombert Getty Images Stock http://www.gettyimages.com

@laxswamy

Page 41: Lakshman Swamy: Joy and Burnout on the Front Lines

AccoladeDiagnosed pericarditis w/ pericardial effusion on history and exam

alone.

@laxswamy

Page 42: Lakshman Swamy: Joy and Burnout on the Front Lines

AccoladeSaved a patient’s life

when he overdosed on heroin… on the street.

https://www.colorado.gov/pacific/hcpf/news/colorado-medicaid-now-covers-opioid-overdose-antidote-nasal-spray

@laxswamy

Page 43: Lakshman Swamy: Joy and Burnout on the Front Lines

@laxswamy

Page 44: Lakshman Swamy: Joy and Burnout on the Front Lines

Find the students.Learn from their experiences.

Empower them.

@laxswamy

Page 45: Lakshman Swamy: Joy and Burnout on the Front Lines

We are all #genQI

@laxswamy