 is president of CompHealth, the nation’s largest provider of locum tenens physicians and founder of the traveling physician industry. She joined CompHealth in 2001 as a sales consultant and served in a variety of management roles prior to being named president in 2017. Lisa is passionate about building lasting relationships and helping her team members reach their highest potential.

Lisa Grabl 

I really enjoy my job. I appreciate the people I get to work with and feel like the work we do really matters. That’s why I’m willing to put in extra hours and effort to ensure the job is done well. I believe physicians do the same thing. They work hard, they’re dedicated to their patients and their jobs and most love what they do. That makes putting in the extra work easy.

However, even at my busiest I don’t think I could or would average working 80+ hour weeks. I’m also not responsible for making literal life and death decisions on a daily basis. The expectations we as a society put on physicians is that they will always be there when we need them, regardless of when or where. Physicians embrace that responsibility and they are there when we need them most. This often comes at the cost of their personal lives and was a regular part of medicine for an extremely long time.

, who graduated from medical school in 1981, had this to say:

“When I entered the world of medicine, there was no such thing as physician burnout or work/life balance. It was a privilege to become a physician. The chosen few admitted to the hallowed halls of medicine expected to devote 100% of their lives to this sacred calling… as a product of that generation, the drive to excel as a physician significantly postponed my family plans, almost permanently.”

Later in his career Dr. Wilner found it was possible to have a life separate from medicine while still maintaining a successful and positive career as a neurologist while still spending time with his family.

Young physicians today have a different outlook and a recent 

 by CompHealth’s parent company, CHG Healthcare, found the number one factor new physicians are looking for in a job is work-life balance. This was followed closely by work schedule and location. What makes this more interesting is that CompHealth asked a similar question in a 

 CompHealth back in 2018. Work-life balance was number one on the list as well. However, in 2018, 63% of physicians listed it as their number one factor, this year that number jumped up to 85%.

Achieving work-life balance isn’t just good for physicians it is also good for their patients and the facilities they work. Even before the pandemic 

 was seen as an issue that caused adverse patient reactions. Add in COVID-19 with physician burnout at an all-time high and negative patient impact is even higher.

“For as many as 50% of physicians, burnout symptoms of cynicism, exhaustion, and reduced effectiveness overshadow their personal and professional lives,” says Dr. Wilner. “Like the coronavirus, burnout has reached global epidemic levels. Responses by academic institutions, government, and private industry to systemically address the burnout epidemic are woefully inadequate.”

Burnout is often a direct result of a life out of balance. Having that time outside of work to rejuvenate and focus on family or other interests keeps physicians fresh for when they return to work. In our role of placing locum tenens physicians in temporary jobs around the country I have seen physicians that were ready to quit medicine find new life in their careers. They found that taking more control of their schedules and freeing up some time for themselves made a huge difference in their personal and professional lives. The physicians that work with us still work long, demanding hours but the difference is they are choosing when and where to work and if they need a break, they can control their schedule.

Physicians are integral parts of our community and it’s important we recognize they deserve a healthy work-life balance as much as anyone else. New physicians are making job decisions based on this need and if we want the profession to grow, we need to do whatever we can to fight burnout and promote balance in physicians’ lives.

Lisa Grabl is president of CompHealth, the nation’s largest provider of locum tenens physicians and founder of the traveling physician industry. She joined CompHealth in 2001 as a sales consultant and served in a variety of management roles prior to being named president in 2017. Lisa is passionate about building lasting relationships and helping her team members reach their highest potential.

Articles

Work-life balance is the key to staving off burnout.

Physicians want work-life balance

The traditional primary care model is changing. According to a 

, one in five patients (for millennials, it’s one in two) uses an alternative site as their main source of primary care. Even more alarming, only 35% of respondents were confident they’d still use their primary care provider in a year. Add to that the emergence of retail clinics in pharmacies and big-box stores, like CVS and Walmart, and traditional primary care practices are feeling the pressure. To remain competitive, primary care physicians need to adapt to consumer preferences and industry trends.

Here are five things primary care physicians can do to earn their patients’ loyalty.

5 Tips to retain patients

CompHealth locum tenens division, the nation’s largest provider of locum tenens physicians and founder of the traveling physician industry. She joined

in 2001 as a sales consultant and served in a variety of management roles prior to being named president in 2017. Lisa is passionate about building lasting relationships and helping her team members reach their highest potential.

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These tips can help keep your patients coming back.

When a patient is sick, they want to see a provider that day, if not immediately. According to the Advisory Board, the ability to walk in without an appointment and receive care within 30 minutes is twice as important to a patient than whether or not they see a doctor versus an advanced practice provider and five times more important than a short commute to the clinic. Some are even willing to pay more for same- or next-day appointments. The bottom line is if you want to keep patients and attract new ones, it’s imperative that you offer on-demand access and make yourself available to patients when they want to be seen.

Patients want their healthcare to be simple and convenient. Not only do they want digital simplifiers like online scheduling and lab results, but they also want a primary care facility that offers ancillary amenities like onsite X-rays, labs, and a pharmacy. Patients also want the clinic staff to coordinate any follow-up care needed, including scheduling appointments with specialists and sending health records.

One of the biggest deal breakers for a patient is a physician and staff who aren’t friendly and dedicated to patient-focused care. In fact, it even outranked cost, travel time, and provider type as a customer preference in the Advisory Board study. They want a doctor who listens, is empathetic, and communicates clearly and effectively. Those qualities are also important when it comes to a clinic’s staff. You can accomplish this by creating a service culture at your facility. First, define what good customer service is and then make sure you and your staff execute on those service expectations.

4. Make APPs and team-based care part of your practice.

Although the Advisory Board study showed that patients prefer to see a doctor over an advanced practice provider (APP), that doesn’t mean they aren’t willing to see one, especially when it comes to routine, non-acute care. By incorporating APPs as part of your patient load strategy, patients will be seen faster, meeting their need for on-demand access. In addition, patients (especially millennials and Gen Z) also see team-based care as a nice to have. Team-based care offers a variety of advantages, most importantly expanding the patient’s access to high-quality care.

The pandemic has increased the use of virtual doctor visits, but that doesn’t necessarily mean patients prefer them. The Advisory Board study showed the most consumers (regardless of their age) didn’t view virtual care options as a critical component when choosing a primary care clinic. So, when incorporating telehealth into your primary care model, first understand your patient demographics and what their preference is before making it a big part of your care strategy.

With competition on the rise in the primary care market, making consumer preferences and trends a top priority will help your primary care practice remain successful.

 CompHealth locum tenens division, the nation’s largest provider of locum tenens physicians and founder of the traveling physician industry. She joined 

 in 2001 as a sales consultant and served in a variety of management roles prior to being named president in 2017. Lisa is passionate about building lasting relationships and helping her team members reach their highest potential.

These tips can not only help you retain patients, but also find new ones.

5 Ways PCPs can retain patients (and attract new ones)

One year into the COVID-19 pandemic, many healthcare workers have been pushed to their limits. Perhaps understandably, many are reevaluating their career decisions. We wanted to learn more about how the pandemic has affected providers’ career planning, work satisfaction, and burnout, so 

 more than 1,200 physicians, nurse practitioners, physician assistants, and registered nurses to find out.

The results revealed a workforce that’s burned out, overworked, and in need of greater work/life balance. While these facts are especially alarming in the face of an already existing provider shortage, the insights we received can also help employers better understand their employees and take steps to improve their experience.

Providers’ career satisfaction has declined over the past year, the survey showed, with 43% reporting that the pandemic has had a negative impact on how they feel about their jobs.

It’s also increased burnout, which already affected a substantial number of providers (80%) pre-pandemic. Nearly two-thirds (64%) of respondents reported that the pandemic has made their burnout worse, and that number was even higher for those working in frontline roles like emergency medicine.

Employer response to the pandemic was positive

Despite these grim numbers, the majority of providers (69%) felt their employers did a good job responding to the pandemic. Three-quarters (75%) felt they had sufficient PPE and 70% felt safety protocols were being followed.

That said, providers did find areas where they felt their employers were lacking, with many reporting insufficient staffing levels, inadequate compensation, and inefficient work processes. Nearly a quarter (22%) felt their concerns weren’t listened to, and 26% said they didn’t agree with the decisions their employers made.

We also asked providers what was most important to them in their careers. After a year of nonstop work for many and furloughs for others, it’s unsurprising that 83% reported work/life balance as the most important factor, followed by job stability (78%).

Workplace culture was also mentioned as an important factor, with 76% rating it as important, slightly ahead of compensation (75%). These numbers are telling, and employers should keep in mind that creating a positive work environment is equally important as a fair paycheck.

Despite the past year’s challenges, 95% of respondents said they plan to continue working in healthcare, and most (87%) plan to stay in their current role for the time being.

Yet when asked if they plan to continue in their current position past 2021, that number dropped to 76% -- meaning nearly a quarter of physicians may be looking to change employers soon.

Revenue Cycle Management: Benefits and best practices

With large numbers of providers considering changing employers, organizations that are savvy enough to listen to providers’ needs can benefit. The insights provided by this survey are a good starting point to figure out how to attract – and keep – talented providers.

While compensation is clearly important, we’ve seen that many providers rank other considerations higher when making career decisions. Finding ways to promote true work/life balance among staff can lead to greater career satisfaction, less burnout, and happier employees.

Strengthening your workplace culture is also worthwhile, as we’ve seen providers find this just as important as compensation. At CompHealth, our strong workplace culture is always top of mind, and it’s helped us retain highly-engaged and talented employees. We make time to celebrate our successes, but we also take feedback seriously in an effort to continuously improve our workplace culture. 

The pandemic has negatively impacted many aspects of healthcare, and it’s also highlighted struggles providers have dealt with for years. Yet bringing attention to these deficiencies also gives us an opportunity to ameliorate them. It’s now more important than ever to consider how we can improve our healthcare providers’ experiences at work so they can keep doing what they do best—caring for patients.

, the nation’s largest provider of locum tenens physicians and founder of the traveling physician industry. She joined CompHealth in 2001 as a sales consultant and served in a variety of management roles prior to being named president in 2017. Lisa is passionate about building lasting relationships and helping her team members reach their highest potential.

It’s now more important than ever to consider how we can improve our healthcare providers’ experiences at work so they can keep doing what they do best—caring for patients.

Healthcare providers career satisfaction is dropping 

Nurse practitioners and PAs are crucial parts of any healthcare system, but determining how they can best contribute to the success of your practice or organization takes research and planning. Advanced practice providers (APPs) combined with physicians can help lower costs, improve patient outcomes, and deliver quality and timely patient care.

There are a variety of models for APP practice around the country. Regardless of which model you are using it is important to ensure you are using the fullest extent the law allows. Some states allow APPs full autonomy, but some practices are tempted to still have a physician see every patient so they can receive full re-imbursement. Utilizing APPs may let those practices bring in more patients allowing physicians to focus on higher acuity patients. Providers may be getting a reduced rate, but it could increase the volume they’re seeing for their practice.

It is also important to periodically check the state regulations for any changes, especially if those changes expand what APPs can do.

7 Financial Reports Your Practice Needs to Run

How your APPs provide care and interact with patients will vary depending on your facility’s goals and state regulations. In some facilities, physicians and APPs share a patient panel, while others have APPs manage their own patients.

Some specialties lend themselves better to APPs working independently. For example, a family nurse practitioner may be able to easily take on their own case load without physician oversight. On the other hand, surgery specialties often require the oversight of a physician but can be utilized for pre-op and post-op rounding, and even act as first assistant during surgeries.

Some facilities have patients first see a physician for diagnosis then schedule follow up visits with an APP. In some cases, this allows the facility to still bill under the original provider and get 100% of the compensation in ‘incident-to’ billing.

Facilities where APPs operate independently may not be able to bill as much for these visits, but it doesn’t necessarily decrease profit margins. Paying your APPs commensurate to the reimbursement rate can help you balance your profit margins.

“There’s a lot of gray area in work for APPs,” says Ronna Smith, manager of APP clinical education at 

. “The first thing we do as a leadership team when we’re analyzing whether or not a team should add an APP is get to the nitty gritty of ‘what is the work?’ What do they envision the APP doing? Is it billable? Does it require medical decision making? Is it provider-level work?”

It’s important to include APPs in making these types of decisions. They have great perspective and can bring ideas for how to set up your model.

“It’s important for physicians to understand the strengths and weaknesses that APPs come to the table with,” Smith says. “APPs can rise to any challenge you put in front of them. But to make it as successful as possible, you need intentional training and a good care model plan.”

Five ways to better manage workplace conflict

After incorporating APPs into their organization, Smith says the change at Seattle Children’s Hospital has increased provider flexibility and allowed them to provide better care and education to families.

“Our model is very collaborative where nurse practitioners and physicians work together within various teams,” says Smith. “If a child is on the schedule to see if they need a tonsillectomy, the initial work is done by a nurse practitioner. If the NP feels that child should move forward with a surgical plan, they pull in a surgeon who is working with them in the same clinic. The surgeon would verify the exam findings and the plan, answer any questions the family might have, and then that child would go on that surgeon’s schedule. So, in that same visit, the family would see an NP who would do the bulk of the work, and the physician can spend more time in the operating room.”

During the 2020 pandemic, the model has also helped the hospital be flexible and adaptable. “We have an 

, and those learners are assigned to multiple areas of the hospital during their training year,” says Smith. “They’re credentialed to be in multiple places, they’re used to changing assignments frequently. We had a whole contingency staffing model in place, and the adaptability of our past and present APP fellows on our staff is what made that model possible.”

Whether you run a hospital system or a small practice, including APPs in your healthcare staffing model can help you reduce cost and generate revenue while still providing high quality care to patients.

Nurse practitioners and PAs are crucial parts of any healthcare system, but determining how they can best contribute to the success of your practice or organization takes research and planning. 

Making the most out of PAs and NPs

Physician burnout was a problem before COVID-19 appeared, and the pandemic has only increased the levels of burnout among all of our healthcare providers. During a recent webinar with Locumstory.com, Dike Drummond, 

, shared how to spot burnout as well as ways to combat it.

The primary symptom of burnout is exhaustion, both physical and emotional, says Drummond. He compares doctors to parents: both often put someone else’s interests ahead of their own, regardless of the circumstances.

The second symptom of burnout is cynical sarcastic venting, also known as compassion fatigue. “Venting can be dangerous. It's never healthy but I see a lot of doctors who are under stress, and who will get upset for righteous reasons,” says Drummond. “They'll go and vent on the table, get angry, and vent just enough steam that it gives them the ability to go back out into their practice and keep doing the very same thing.

The final symptom is asking “What's the use?” or a loss of hope and vision. Drummond says this is when you begin to doubt the purpose and meaning in what you do, and you start to fear that if something doesn’t change, it may negatively affect your patients. 

Taking those traditional burnout symptoms and throwing in a global pandemic is not a recipe for success. The pandemic has added a whole other level to what physicians face on a daily basis. You may be treating COVID-19 positive patients and dealing with the stress that comes from that; or, you may not be treating any patients due to the drop in elective procedures and patients who are fearful of COVID-19.

”Everybody who's been involved in the carnage is traumatized. There will be PTSD in the wake of this,” says Drummond. “Then there's the economic impacts on you and your finances, on the shellacking the healthcare industry has taken, especially in the second quarter of this year, the general economy, then there's an election, political polarization, shooting in the streets, a potential second wave that we may be in the middle of right now. It just never ends.”

This perfect storm of stressors makes life at work harder while also making it more difficult to recharge when you are at home. Drummond talks about how these added worries make it more important than ever to focus on taking good care of yourself and your family.

“You also need to take care of the people that are closest to you on your work teams, the people that help you see patients in your intimate work team and your call rotation,” says Drummond. “Take really good care of each other, have each other's back, check in early and often. These are extraordinary times, and we are nowhere near the end of it.”

So, you know you’re burned out and the pandemic is just making things worse—what now? Dr. Drummond outlines three ways to help you identify what you can change to feel less burned out.

 Write it down. What kind of patients do you want to see, what do you want to do, how much do you want to be paid, etc. Keep writing until you have documented everything you are looking for.

 Compare your ideal practice with your actual practice. Identify areas where they overlap.

Build a plan to match your current practice with your ideal plan.

 Figure out what needs to happen to align your current practice with your ideal practice. Start by taking one item on your list at a time and start making plans for how you can change.

He recommends not doing this alone, and getting your team involved to help you make the changes. The best way to start this is with daily team huddles. Drummond says:

“Here's the basic huddle. Very simple. Twice a day if you have morning and afternoon patients. If you’re on the OR, huddle in the OR. If you're in a hospice, huddle however many times you need to. You can call a timeout at any time of the day and huddle up again if things get hairy. Your whole team. Run your schedule, bring it back, look at all the patients, look at all the vacant slots, tell them how you want to book. Make sure the patients have everything they need before they get there and make sure you know who's sick out in the waiting room. You're preventing fires in the first place, and ideally—key points here —this is a stand-up meeting where you go to them. I've seen doctors who gather the people around them as they sit like kings and queens at their desk in their office. That does not work. So, please stand up and go to them.” 

For the physicians that Dr. Drummond works with, he finds that 70% are able to make enough changes to their existing practice to recover from burnout. The other 30% start the process of a new job search to find their ideal practice.

Whether you just need to make changes in your existing job or find a new one, addressing burnout is crucial to your long-term happiness and success as a physician. For more tips from Dr. Drummond, you can watch the full webinar on 

Addressing burnout is crucial to your long-term happiness and success as a physician.