Passion for Practice in the Wake of the “Great Resignation”

It is popularly observed that the same Chinese symbol is used to communicate both crisis and opportunity. But that’s not entirely true, says Katherine T. Kelly, PhD, MSPH, a psychologist, consultant, and speaker. In her new book, The Healer’s Path to Post-Covid Recovery (drkatherinetkelly.com), Dr. Kelly says that the symbol more accurately conveys the sentiment, “a crucial point when something begins to change.” As America moves beyond the COVID-19 pandemic, health care workers in particular continue to confront change. For many, the challenges of providing care over the past two years have sapped passion for their vocation. Worse still, they are overwhelmed by the challenges of maintaining and building staff in the wake of the “Great Resignation.”

Dr. Kelly emphasizes that while change can be challenging and sometimes painful, it’s necessary for growth. She finds an analogy in plastic surgery. Patients may endure injury, pain, inflammation, swelling—all to achieve an aesthetic outcome that they view as an improvement over their previous appearance. Just as surgeons identify this post-surgical discomfort as “part of the process,” they may identify current workforce challenges as part of building an even better practice. “They can reframe this in a way that will empower them,” Dr. Kelly says. “Often there were parts of practice that were broken already. Now we can look at this and see how to restructure in an even more vibrant and viable way.”

Ahead, Dr. Kelly discusses how practices can manage ongoing staffing challenges and talks about how physicians can re-ignite their passion for patient care.

How is the “Great Resignation” impacting physicians and their passion to provide care?

Katherine T. Kelly, PhD, MSPH: People don’t go to medical school or into other forms of health care unless they have a passion for it. There’s a passion to help. There’s often a passion for precision. The stress of trying to provide care in the middle of this pandemic has taken doctors away from being able to focus on the reason they went into their field. It’s been very treacherous for people, because if you lose focus on your passion, you lose the whole meaning behind your identity. You lose the meaning behind why you spent so many years in medical school or other health care training.

From an emotional standpoint, it hits right at the core of who you are. Part of the physician’s identity is to provide care in a particular way. Across the board, many are finding they can’t do that in the ways that they expect. They are forced to focus on a business model or trying to make numbers meet or something other than their passion. That does a number on a health care professional’s identity.

Additionally, I think most health care providers don’t make a point to ask themselves, “Did I make a difference today?” They are worn out and burned out and now have to spend so much more time on other tasks that they really don’t like—the other things that either they weren’t trained to do in their medical school training or don’t like to do. Therefore, they are not able to see the positives.

It’s important, as you’re walking out the work door, to ask yourself, “Can I say I made the kind of difference today that I wanted to?” I do this for myself every day, and I really try to emphasize this with the health care providers I work with.

Some physician practice owners or administrators view it as a personal failing when they can’t find or retain staff. Is there a more positive way to assess these situations?

Dr. Kelly: There is evolution in everything, and sometimes things have to fall apart before you rebuild. I’m seeing this with a lot of different practices. In fact, I’ve had several practices contact me to help them rebuild after COVID, once they found out I was writing my book. One of the things I’m trying to help them focus on is their mission statement, their vision statement, or both.

When they refocus on their mission statements and their vision statements, practice leaders often recognize that many of the people that are leaving either have not been able to live up to the missions and visions anyway, or they wouldn’t be able to contribute to that vision or mission in the long run.

That doesn’t negate the loss, but it helps to conceptualize that there’s change in everything. Change is a constant. I try to empower health care providers and the leaders within systems to realize that there’s going to be change. It just so happens that this pandemic has ignited a huge fire of change. But this also gives them the opportunity to revisit those mission statements and vision statements for themselves. They should ask “Do we need to redefine this?” and “How can we use this to ignite more passion, more energy, more excitement about rebuilding this practice?” It’s a little bit of a backwards approach.

Remember, most doctors are not HR professionals. They weren’t taught to do this. Most didn’t go to business school. So they have had to learn an entirely new skillset with how to interview, how to be discerning with who they hire and how to really look at what are they trying to create.

How can physicians hand over tasks that don’t match strengths?

Dr. Kelly: Play to your passions. We do best at the things we’re good at and we love. A lot of physicians think they should or could do it all. They should really look at the investment of energy they’re taking away from their passion by not letting someone else be in their passion by doing the books or doing the hiring or the managing. It’s actually healthier for a health care business or practice to have people in place that can do the things that the practitioners either aren’t trained for or don’t really like doing. They have to start looking at it as an investment that will pay off, usually in dividends.

There’s a book called Strength Finders that came out probably 12 to 15 years ago. The author had worked for the Gallup polls, and looking at all the information coming out of these polls that he was working with, one of the things he realized is that the people who were the most passionate about what they did and effective and productive were the ones who were playing to their strengths. The ones who were not in positions that they could play to their strengths actually hurt the businesses financially and also from a systems perspective. Research shows that a practice will be much more financially productive and also productive from a hands-on perspective if you put people in place who love what they do.

Whenever I hire someone, the very first thing I ask them is, “What do you love to do?” So if they were to start asking those questions, these practices could probably filter out many of the people who are not going to be productive for them. And if they ask themselves that question, they might be more able to put themselves in the role in which they would be the most productive and would love the most. Their own morale would improve as well.

Are there strategies for reigniting passion and reflecting that to staff?

Dr. Kelly: We increasingly see that employees are very burnt out or very tired. This can be especially problematic in medicine, because a lot of physicians are not taught to be sensitive in this way. Physicians are taught to get the job done in terms of whatever service or procedure they are providing. The health care providers in leadership roles are having to be much more aware than they’ve ever been. One of the tips that I give people is to go back to the mission and really emphasize the mission or vision.

Find something to help align the staff again. A community project or a shared effort that tends to align staff. It could be creating or updating a mission statement, a vision statement. People benefit from some time to decompress individually, but it’s also important to emphasize the potential to contribute to the whole. Let staff think about the identity of the practice itself and suggest different forms of things to boost morale. One thing I saw recently on a Facebook post was from the nursing floor of a health system where someone drew black outlines in different shapes on a whiteboard and left colored markers for others to come along to color it in. It’s fascinating that every one of the staff has started to come color in those places. It’s lightened the mood. Everybody’s talking about the mural now. Get creative on team building.

What are some of the less-recognized or less-discussed signs of burnout?

Dr. Kelly: The number one symptom of burnout that I think is not reported is cynicism. When a person becomes cynical about what they’re doing or the place they’re working, that is one of the first signs of burnout. Everybody gets fatigued and exhausted. Everybody blows their cork at times. Therefore, the typical signs of burnout—low energy, difficulty concentrating, feeling overwhelmed, fatigue—are common and aren’t definitive indicators of burnout. Anytime I start to see cynicism pop up, that’s when I know that it’s getting pretty deep.

Cynicism is much harder to break through than fatigue or feeling overwhelmed, because it’s almost like resentment. Once resentment sets in, it’s very hard to turn that around. I look at cynicism as the temperature gauge for burnout in a work system; if you see more than one or two people becoming cynical, they start to feed off of each other and then it becomes very rampant within that health care system.

Cynicism may spread among employees, but they may be unlikely to reflect their cynicism to managers. Instead, managers can look to rates of enthusiasm, which is “cynicism light.” If you start to see enthusiasm or the passion of work start to wane, that is one kind of filtered sign of cynicism. If there’s complacency about responsibilities or complacency about their role that is atypical of what they were like before, those are probably the main signs that there’s a deepening level of cynicism happening.