In this episode of Tell Me Where IT Hurts, host Jay Anders, MD talks with Janae Sharp, founder of the Sharp Index, a nonprofit dedicated to reducing physician burnout and suicide and improving physician mental health, for a discussion about physician burnout and its intersection with healthcare IT.
Dr. Anders begins by sharing a personal story about physician burnout––one from his days as a surgical intern in Pittsburgh. It involved who had essentially ‘hit the wall’ with the aggressive schedule and demands put on a surgical resident. Eventually, this individual recovered and became a very talented orthopedic surgeon––but he needed some time away from that intensive, interactive, sleep-deprived state to get his mind back on track.
Throughout his career, Jay has seen other physicians face similar challenges, but this sobering encounter with burnout (just three months into his internship) was the most dramatic, and influenced his eventual decision to pursue a career as an internist rather than as a surgeon.
A Complex Problem in Need of Multiple Solutions
Sharp’s experience with physician burnout is deeply personal and life altering. After her former husband, an MD, died by suicide, she noted the disconnect with physician burnout throughout the industry, and realized that if our healers can’t be healthy, the health system will fail.
With a background in healthcare IT and patient engagement, she decided to contribute to the solution, and in 2018 founded the nonprofit Sharp Index with the goal of reducing physician suicide and burnout. Knowing that there was no cure-all for such a complex issue, and lacking a background in academic medicine she set out to determine where her values and knowledge intersected with healthcare and with healing. Today, the organization addresses solutions to help healthcare systems quantify and fix organizational problems that lead to physician burnout.
Donations to the Sharp Index go directly toward initiatives that are core to its mission––anything that ‘promotes the good,’ whether it’s making technology better, or empowering people to support themselves. The organization operates under the premise that everyone can make a change––whether it’s the CEO of a health system, the media, or suicide loss survivors.
As for the organization’s long-term goals, Sharp frankly states that she would like it to disappear because it’s no longer needed. “If I could have anything from the Sharp Index, it would be that people look back at it and are shocked at how bad things were and are shocked that it needed to exist.”
Resistance to Help Remains
Physicians and other healthcare workers are notoriously bad when it comes to admitting they have a problem or need help, a phenomenon noted by both Dr. Anders and Sharp. One telltale sign of the severity of the situation during the pandemic, Sharp shares, was a marked spike in inbound call volume, which eclipsed 100 calls per week at one point.
“It has to get real bad before you see physicians and nurses en masse saying, ‘We need help,’” she says.
Sharp says that what matters is having programs in place with options based on their employees’ needs: debriefings after traumatic events, modified scheduling, and a system that doesn’t require clinicians to do a lot of notes at home.
Advance Needed in Technology and Mental Health Service
So what does the industry need to be thinking about when it comes to burnout in healthcare?
Physicians and nurses are quitting. They want to be healers, Sharp notes, and they are taking back the power so they can be just that. The industry needs to understand that if you don’t innovate, you eventually get replaced––hence the entry of players like Amazon, Facebook, and Salesforce. Technology needs to pivot to allow clinicians to do what they want. But in healthcare, she maintains, there remains a huge divide.
Dr. Anders notes that the advent of the 21st Century Cures Act and the new Transparency Act, with their respective information sharing requirements, will only exacerbate the problem for clinicians by compounding the volume of information they must manage––and are responsible for.
Systems––EHRs in particular––remain difficult to use and are not helpful to clinicians or patients. Sharp maintains that EHRs are designed to help with billing codes, and shouldn’t be “hired to do a job that it’s not supposed to do.” We must work to find ways to make them more usable for clinicians while recognizing that this is separate from the job it was intended to do.
While burnout remains high, Sharp notes that there are some promising developments in mental health today, and many ways for people to get involved. The annual Sharp Index Awards even expanded the number of categories this year because of new market entrants dedicated to physician mental health.
“I want people to know that this is something that’s so important. It’s being recognized. And I think most people are tired. And that’s normal, but it’s not okay.”
Waving the health IT magic wand
Dr. Anders closes with his signature question, “If you could fix one thing in healthcare, what would it be?”
“I mean, I would make us all healthy all the time,” Sharp says. “However, if I had a magic wand and I could fix one thing in healthcare, I would make it okay to be imperfect. I would make it so we are able to see someone as a broken and not perfect human and love them anyway and have a place for them.”
NOTE: If you’d like to get involved, you can find the Sharp Index at sharpindex.org, and on LinkedIn, Facebook, and Twitter. The organization is giving direct grants to Mothers in Medicine Fund and scholarships for underserved people as well as funding research.
