The doctor is (tuned) in: A powerful lesson in how listening can save lives

Preventing burnout in an industry whose practitioners are constantly tasked with being heroes requires a particular vigilance. But it’s not necessarily about reducing workload or hours, though that does help. And it’s definitely not about “self-care.”

Among other things, it’s about leaders fostering an environment of well-being by being trustworthy supervisors and good listeners.

This was the focus of the Health Care Leadership Collaborative event, “Accelerating Well-being Solutions and Transforming Workforce Cultures,” held March 18 at the Johns Hopkins University Bloomberg Center in Washington, D.C. and hosted by the Johns Hopkins Carey Business School Human Capital Development Lab in partnership with the School of Medicine Office of Well-being and All In: Wellbeing First for Healthcare, a coalition led by the Dr. Lorna Breen Heroes’ Foundation.

The risks of being a care provider

Health care providers have historically had higher risk of mental health challenges like depression. According to the National Academy of Medicine, 35 to 45% of nurses and physicians, and up to 60% of medical students and residents, report symptoms of burnout. In fact, the health care delivery industry is the industry from which the term “burnout” arose in the 1970s, when American psychologist Herbert Freudenberger used it to describe what happens when people in caregiving professions spend protracted time suffering severe stress under high ideals.

Often, they’re left on their own to combat the fallout. Dr. Lorna Breen, in whose memory the Dr. Lorna Breen Heroes’ Foundation was established, died by suicide three months into the COVID-19 crisis, overworked and afraid that seeking help would cost her her job. Now the foundation works to prevent burnout and ensure support for health care providers.

To take on well-being, health care delivery leaders need what Great Place to Work CEO Michael Bush calls the courage to change---to become the kind of leader who truly listens and coaches, advocates, and acts in response to what they hear.

Bush’s organization surveys 18 million workers in 170 countries at more than 26,000 companies, and has partnered with the Human Capital Development Lab to produce research-based reports on well-being at work.

“Leaders define 70% of the employee’s experience,” Bush told the nearly 200 health care professionals from more than 130 health care organizations, universities, non-government organizations, and government agencies gathered for the day-long event. “The only industry that tests that is health care, because people will say their experience is because of their team.

“The mission part of health care can make a person say, ‘I don’t like my boss and my boss doesn’t like me, the facilities [are poor], but I feel like I make a difference and that’s why I’m here.’”

But what they say may not tell the whole story about what they need.

Tackling the challenge of well-being for health care providers

An organizational culture that values more than the medical mission requires what Human Capital Development Lab Director Rick Smith refers to as the human capital development system: talent, which is the people; structure, which is about effectiveness, efficiency, systems, and processes; leadership, which is about priorities, plans, and capability-building; and culture—an organization’s common expectations, shared beliefs, and values.

Research has shown that employees are twice as likely to stay with their employer when they feel proud of the work they do. That’s where the “making a difference” part comes in for health care providers. But they’re four times more likely to stay when there’s a positive well-being culture.

That, according to Bush, takes nine high-trust behaviors not just on the team, but in a leader: listening, thanking, sharing, celebrating, hiring, caring, speaking, developing, and inspiring. None of them work without the first behavior on the list.

“If you don’t listen well, you can’t develop a person well,” Bush explained. “You can’t give candid feedback. You can’t inspire people. You don’t know how to recognize or reward a person in a way that matters to them.”

What “listening” really means

Journalist and author of You’re Not Listening: What You’re Missing and Why It Matters Kate Murphy shared some listening flags. For example: If every conversation is a validation, or if others are always agreeing with you, you may not be truly listening. And empathy isn’t everything; looking for commonalities in another person’s experience can backfire if you judge based on what you would do in their situation.

“Listening is having a conversation with someone or a group of people, and your mind is empty,” she said. “It’s a meditative practice.”

That can be significantly challenging in an environment of high-stress, high-stakes, long to-do-list work. Multitasking, turning toward the door, and even thinking about getting to the next meeting are obstacles to good listening—and supervisees notice.

To demonstrate the effect, Drs. Carolyn Cumpsty-Fowler and Lee Daugherty Biddison from the Johns Hopkins School of Medicine Office of Well-being led a spirited exercise. In pairs, attendees workshopped the experience of truly listening versus multitasking while their partner tried to talk to them. After, they asked the pairs how it felt.

“I actually felt my heart start to race,” one speaking partner said. “I tried to move around to get her attention, and I started to lose track of what I was trying to say.”

“She was looking away so I started looking away,” said another.

A third shared, “I just gave up. I was like, ‘You’re not listening to me, so I’m not talking.’”

The listeners, for their part, admitted it was hard not to listen, but also hard to do what they were trying to do instead.