Investing in time management to make space to address stress, burnout

Chances are, if you’re a healthcare leader, you’ve got several stressors daily and the potential for burnout — and while April was dubbed the cruelest month by T.S. Eliot, it’s also a time to recognize how you are handling it.

To kick off National Stress Awareness Month, an April 2, 2024, MGMA Stat poll found that 75% medical group leaders say their levels of stress and/or burnout have increased in 2024, while only 16% report it has stayed the same and only 9% decreased this year. The poll had 564 applicable responses.

These results show little improvement from a similar poll from September 2022, in which eight in 10 practice leaders (80%) said their level of stress or burnout increased that year, while 14% noted it stayed the same and only 6% told MGMA they reduced stress or burnout in 2022.

Confronting today’s top stressors and burnout factors

Let’s start by hearing from respondents who managed to decrease their stress or burnout this year. Their secrets?

• Taking more time off and investing in personal mental health
• Switching jobs to new organizations with more opportunities for specialization or personal growth
• Reaping the benefits of less staffing disruption/worker turnover
• Adding physical activity into daily routines
• Setting new boundaries between work and home life
• Seeking out peer support and/or executive coaching.

As for those whose stress and/or burnout has held steady or worsened this year, the key factors are unlikely to surprise anyone following the healthcare industry:

• Financial struggles from lower Medicare reimbursement and interruptions to revenue cycle from the recent Change Healthcare outage, as well as the difficulty in adjusting budgets to operate leaner
• Ongoing staffing struggles from physician shortages and continued worker turnover
• Intensifying administrative burdens from third parties, such as prior authorizations and payer audits
• The cultural shock of organizational ownership changes from mergers and acquisitions, as well as the burdens of updating technological systems because of those moves.

MGMA resources

• “How practice leaders can manage burnout and stress” (Podcast)
• “How eliminating the ‘stupid stuff’ can reduce clinician stress and physician burnout” (Podcast)
• “Time management and efficiency tips to boost medical practices and their leaders” (Article)
• “Effective meetings: Building alignment, accountability and trust in your practice” (Article)

Managing time and energy through better priorities and habits

Recognizing that many healthcare leaders can be overwhelmed by the pace of the business of medicine, MGMA consultant Katie Lawrence, MHA, CMPE, Willow Strategy Group, dedicated her recent 2024 MGMA Summit presentation to providing strategies for practice managers who often are left wondering, “Where does the time go?”

Just as patient access challenges are a challenge from lack of available time in provider schedules, the list of to-do items for managers starts to fill the metaphorical personal waiting room each of us has, Lawrence noted, until you begin to claim time and energy.

“We're all limited to just 24 hours a day. … With the energy that we no longer waste, we can spend time with our families and our friends [and] we can make a bigger impact on healthcare.”

Better prioritization and helpful habits can be among those changes to free up mental energy. Lawrence recommends writing down tasks to manage them. “Take the time every week to do a brain dump of all the things that you need to get done,” Lawrence suggested. “Put them in one place so that you remember them and you don’t have to spend your active working energy trying to keep them in mind.”

Managing email overload

Sorting through your inbox to distinguish between urgent/important matters and spam can significantly eat up a lot of energy. Lawrence recommends these strategies for managing an overloaded email inbox:

• Focus time: Consider turning off notifications and dedicate 30-minute segments of time for email work.
• Sort by subject line, skim for action: Avoid chronological reading; instead, skim the inbox to identify tasks that can be acted upon immediately.
• Context: Read the whole conversation, then respond.
• Maintain an action-oriented inbox: Categorize your emails into three groups: things to respond to, things to act on and things outside of your control. Declutter your inbox by archiving or deleting conversations after you’ve responded, and issues are resolved. “The only emails that you should have left in your inbox are things that you are waiting for a response or things that you have to take action on,” Lawrence said.
• Optimize your outgoing communications:
  • Use clear subject lines and bullet points to make emails easy to read and respond
  • If you have a lengthy response, consider a summary near the top to help avoid overwhelming a recipient with too much information.
  • Remember that emails don’t disappear, so choose words you are intentional about and don’t seem harsh: “Write as if everyone in your organization might read” it, Lawrence recommends.

Better file management

As noted in Harvard Business Review, our physical environment significantly influences our cognition, emotions behavior and (ultimately) our decision-making and relationships. A cluttered state — papers on your desk or of files on your computer’s desktop — can negatively affect stress levels.

Lawrence recommends a simple filing system for tangible and digital records:

• Throw away physical paper unless you need it.
• Delete digital files unless you know you're going to refer to them.
• Use consistent labeling.

Ultimately, any system is useful. “The biggest thing that we want to do … is just remember to take care of it,” Lawrence noted. “The quicker we take care of filing, the more is out of sight, out of mind and available if we needed it again.”

Better meetings

Though unproductive meetings may seem unavoidable, incorporating basic elements into your regular meetings can sharpen their focus and enhance their effectiveness:

• Set clear expectations: Have an agenda with a time slot for each subject and share it the day before the meeting.
• Encourage attendees to write down what’s on their mind for the meeting and encourage sharing to ensure participation and mental engagement.
• Summarize action steps at the end of each meeting.
• When possible, shorten scheduled meeting times (e.g., from 30 minutes to 15), and adjust schedules as needed (e.g., eliminating meetings when there is no agenda, or adding more time for longer agendas).

Limiting meetings to two or three specific days of the week is another method Lawrence offers for grouping similar activities together, as it can help avoid distractions and improve productivity. The timing of your meetings also matters: Younger brains tend to function best in the afternoon, while older brains are more alert earlier in the day, Lawrence said.

Other considerations

• The myth of multitasking: A 2013 study found that multitasking can lead to worse outcomes compared to those who focus on one task.
• Task management tool: Lawrence recommended using an Eisenhower matrix to prioritize tasks by categorizing them as urgent versus important, and delegating tasks that are neither urgent nor important.
• What do you value? Lawrence emphasized that values play a crucial role in guiding decisions and actions and aligning them can lead to better team performance.
• Solo versus team: Practices often prioritize incentivizing and goal setting around individual performance over teamwork, leading to mismatches and suboptimal performance when trying to promote collaborative efforts.
• Build your bench: Lawrence acknowledged the importance of delegation in leadership, citing the need to develop team members and free up time for more important tasks. Delegation involves defining expectations, starting small and teaching back understanding to ensure team members have the skills and autonomy to complete tasks successfully.

Conclusion

Practice leaders can improve time management and mitigate stressors and burnout by forming habits through cues and rewards. Changing habits involves identifying and modifying those cues and rewards.

“When everything around us is changing, it’s tempting to wish that things could stay the same. It’s even more tempting to wish they could go back to the way they used to be, when we didn’t have to think about integrating new care models or new pieces of software,” Lawrence said. “Things were easier because the habits that you developed aligned with the way the world was.

“But when plans change, when the environment changes, our habits have to change, too,” Lawrence said.