Clinician well-being has become one of healthcare’s most pressing challenges; burnout, stigma and emotional exhaustion are straining clinicians while threatening workforce stability and patient safety. Leaders in behavioral healthcare are looking to change that through policy shifts, peer-to-peer support groups and technology.
“Clearly, there’s a toll [from] the intensity of the work that we do, and just by nature of the complex patients,” Leopoldo Pozuelo, MD, center director of adult behavioral health at Cleveland Clinic, told Becker’s. He pointed to the impact of traumatic patient events, workplace violence and staffing shortages as drivers of strain.
“We are our own worst patients,” Ken Dunham, MD, executive director of medical operations for behavioral health at Norfolk, Va.-based Sentara, told Becker’s, noting that many clinicians delay care for themselves while carrying the emotional toll of treating others.
Stigma and other barriers prevent many from reaching out. Rebecca Chickey, senior director of behavioral health clinical affairs and workforce at the American Hospital Association, told Becker’s that longstanding licensure and credentialing questions discouraged clinicians from seeking care.
“Questions like, ‘Have you ever been treated for a psychiatric or substance use disorder?’ Well, yes, when my mother had major dementia and Alzheimer’s, I was her sole caregiver,” she said. “I [sought] therapy because that was a lot when you also had two young kids. But that answer alone, for a physician, could mean that their whole future in practicing medicine is gone.”
While the personal toll is severe, there are numbers that are also concerning.
Ms. Chickey noted that replacing a physician can cost about $500,000, while replacing a nurse costs $88,000 to $100,000.
At Cleveland Clinic, Dr. Pozuelo said coaching and mentoring programs have delivered measurable results.
“[These programs] had studies of their enrollment and their success, and what they found is that it actually has a positive ROI, because these types of programs really help re-engage clinicians,” he said. “They help energize them, and there’s actual good data that really factors into retention rate.”
Cleveland Clinic has invested in multiple layers of support. Its Caring for Caregivers program employs more than 20 therapists dedicated to the staff, and the Emerge Stronger program pairs clinicians with trained physician peers after traumatic events. These coaching and mentoring programs provide leadership and resilience training, Dr. Pozuelo said.
Across Sentara and Cleveland Clinic, technology has provided relief as well.
Dr. Pozuelo described the rollout of AI scribes as transformational for so-called “pajama time.” “In my career here, there is a before and an after the AI scribe came out and [it] was really a decision … that has decreased perceived burnout,” he said.
Dr. Dunham shared a similar experience with Epic’s DAX system, an AI note writer.
“After two weeks of our providers using this, they can learn enough of it and use it enough where they’re saving at least two hours a day in note writing time,” he said. “Usually they’re able to actually complete a majority of their notes by the end of the encounter, which is pretty remarkable.”
The AHA has partnered with the Lorna Breen Foundation to drive national reform, pressing states and hospitals to remove intrusive questions from licensure and credentialing.
“In just the last 18 months, 10% of hospitals have … changed their credentialing questions so that those intrusive questions are no longer there,” Ms. Chickey said.
For leaders, the message is clear: Clinician well-being must be treated as a strategic imperative as well as a moral one.
“This isn’t just about retention or finances, though those matter,” Ms. Chickey said. “It’s about creating a healthcare culture where clinicians can thrive so patients can, too.”
