Over the last 3 years, remaining optimistic has been a challenge for many of us. Optimism has served me well throughout life, but it’s not sufficient to deal with some of the stark realities we face. Perhaps the greatest challenge today is with our workforce. All industries are impacted by the “great resignation” and the “silver tsunami.” In June 2022, the World Economic Forum announced, “The Great Resignation is not over: A fifth of workers plan to quit in 2022.“ The COVID pandemic may have achieved endemic status, but the AMA reported in November 2022 that physician burnout is nearly 63%. Not all of that can be attributed to COVID. In May 2022, the Surgeon General of the US reported, “The pandemic has since affected the mental health of health workers nationwide, with more than 50% of public health workers reporting symptoms of at least one mental health condition, such as anxiety, depression, and increased levels of post-traumatic stress disorder (PTSD).”
Throughout the world, the psychological impact of COVID-19 on patients, families, and populations has been unequaled. Recovering from our shared trauma is critically important. Adding to our psychological suffering is the polarization in politics which has bled over into other parts of our lives. Divisive political zealots use social media, press, and TV programs to fuel anger. Anger is contagious, and the polarization is likely to continue until we recapture the best parts of our humanity. We have the clinical tools to help our bodies recover – now it’s time to heal our spirits. We’ll have a short respite post-mid-term election, but we know that the political rhetoric will pick up sooner than anyone really wants.
Polarization is the outcome of distrust and misunderstanding and is an impediment to progress and kindness. Adding to polarization is social media. It’s simply too easy to attack, sometimes viciously and often like a bully, those whose opinions are different. Handled poorly, social media threatens our democracy and all its institutions, including our healthcare and public health sector. We must find a way to reconnect – to restore trust, to heal the human spirit. Social distancing compounds the challenges of getting to understanding. The progress on removing polarization will be faster now that we can get into the same meeting room, shake hands, and talk face-to-face without a screen in between.
Healthcare is a people business. We need to remind ourselves and our coworkers that mercy and compassion, not anger, define our profession and us as professionals. We need to model mercy and compassion in our personal lives, in our interpersonal relationships, not just with family and friends, but with strangers and, equally important, our coworkers and business partners. One way to do that is through genuine listening in pursuit of true understanding – so easy to say, so difficult to do. Give others an avenue to express themselves. For your own sake, lower your defenses. As you create a list of resolutions for the new year, please add to it active and courageous listening, building trust, and treating everyone with kindness.
So, let’s start our list for a better, brighter 2023 based on a similar 2022 list. Each of the following is an opportunity.
1. Treat yourself, all your stakeholders, and everyone else you meet with kindness, mercy, and compassion. If you don’t pay attention to yourself, your ability to help others will be diminished. Be merciful and compassionate to patients, families, employers, employees, payers, vendors, and strangers. Forgive yourself and others who may stumble or request assistance. Remember that you and everyone you meet has lost someone or something of value over the last 3 years – a family member, friend, business associate, or job. Help them.
When you ask how someone is doing, don’t let “Fine” get in the way of the truth. Ask questions to get to the truth, but don’t let your desire to help violate their privacy. Model that behavior by thinking about both the positives and negatives in your life and, when appropriate, opening up to your friends and family. It’s often a gift to them when you ask them to help you when you need it.
Let’s not forget the impact on younger generations. I’ve witnessed the stresses on my own children and grandchildren. Like adults, children of all ages are susceptible to depression and anxiety – they catch it from their parents, the media, their teachers, and friends.
Unfortunately, we’re not always equipped to understand, express, or address our feelings. Though many events no longer require masking, there still is concern about COVID, RSV, and the flu. One or all of those are sure to increase stress. I’m not sure, however, that everyone is paying attention to the children who are still or may become stressed, depressed, or anxious due to conflicting messages.
Summon the strength and humility to seek professional help when necessary to modify your own behaviors to provide the support others need, to help all of us cope more effectively, to make sure that we have the tools and professionals to help us all weather the resurgence of the original or the appearance of a new storm. In a digital world, the human elements are essential.
2. Collaborate enthusiastically. It was the collaboration of the scientists and clinicians that created not one but several effective vaccines. In 2020, radical collaboration was the key to our shared success. Radical collaboration means you seek to help others – don’t wait for them to ask. Pursue opportunities to work with others. The lesson is clear – the more collaborative we are, the faster we will get to success. That’s true in all aspects of our life – personal and professional. Collaboration often creates understanding and empathy that makes the world a better place.
3. Redouble your efforts to secure your IT environment. Our patients and providers have entrusted us to protect their data. Let’s ensure we’re doing everything possible to protect that sacred trust. Make sure you lead the efforts to enhance or create a culture of security and privacy.
4. Continue to evolve the IT organization – Embrace Digital Services (DS). We’ve seen what digital medicine can do. We have redefined normal. 2022 is brighter than 2021 because so many organizations have digitally transformed the provider, patient, and family experience. All parties feel a great degree of freedom restoring a sense of control to providers as well as patients and their families. If you have not already done so, begin referring to your IT group as Digital Services.
Use digitally enabled processes to deliver better care everywhere. Though home health has been delivering care at people’s homes for decades, there is renewed talk about “hospitals at home.” Telehealth, remote patient monitoring, at-home delivery of healthcare products and services, and new partnerships between traditional and non-traditional healthcare organizations help move us toward achieving the objectives of the Quadruple Aim.
5. Work diligently on short and long-term revenue enhancement and cost containment. Don’t focus only on cost savings. Explore new ways to enhance revenues. Identify risks to diminishing revenue and increasing costs so you can create practical and pragmatic solutions to mitigate the risks. Innovation and opportunities abound but it takes focus, prioritization, great governance, and collaboration to achieve the benefits.
Beware, however, of focusing only on the short-term gains. Do not sacrifice the future. Build a strong legacy with benefits now and for generations to come. Consider the ethical and moral implications of your decisions. Consider Michael Dowling’s 6 ground rules for cost-cutting.
6. Be open to new partnerships. There are far more nontraditional players in the health and public health sector than ever before. Create synergies. Try to move your key vendors – no more than a few – to partner status which will require commitment and work by both parties. Work with your payers. In general, the goals which may appear to be parallel often converge.
7. Challenge the status quo, respectfully. If you’re exploring outside innovations, remember pragmatism, practicality, and sustainability. Deploy solutions quickly and adjust rapidly with sensitivity to the power dynamic in relationships.
8. Embrace AI and ML, cautiously. Do so with a healthy mix of optimism, skepticism, and realism.
9. Address the increasingly important issue of Health Literacy. If you cannot understand healthcare and all the supporting activities, your chances of success as a patient or family member are limited. My blog “Digital Health – Health Literacy Matters” addresses the complex nature of health literacy. Visit the AHIMA Foundation website to see how “Health literacy impacts health equity”.
10. Address unhappiness with EHRs and other IT products and services. Improve the UI and reduce documentation requirements. Some of the burnout stems from poorly designed programs and processes. Measure user satisfaction regularly and adjust the environment to address issues associated with technology.
11. Revisit your ERP (enterprise resource planning) solutions. There is so much value that can be realized from reimplementing existing ERPs or installing new ones. Read Sue Schade’s blog to answer the question, “Will your ERP enable the business transformation you need?”
12. Do a self-assessment. Use the new year as an opportunity to inventory both your personal and professional life. Create a Life List (not a bucket list) of what to do with a fresh restart. We can all be our better selves. You may expect the best from others, but it’s more important to demand the best of yourself. Invest in yourself. Learn, teach, work, play, sleep, laugh, cry, talk, listen – exercise your mind and body. Sometimes the most selfless thing you can do is to focus on your own well-being. Become your best self, and if you fall short occasionally be as compassionate and forgiving of yourself as you are of others. Commit to a regular review of your life-work balance. Adjust as necessary. A better you makes a better us. A better us provides better care.
Hurrah for 2023! Let’s make the best of these opportunities to improve the health and care in our communities, our nation, and our world.