Knowledge Center

Leadership Burnout at the Intersection of Board, Physician, and Executive Work

Too many hospital board members complain that their time and talents are not being well used. As a result, it is more difficult to attract and retain the best and brightest board members in their early and mid-careers; and the risk of whistleblower lawsuits and buzz over the Department of Justice’s Yates Memo can result in anxiety over new personal liability.Board work is getting less fun and more frustrating. Board burnout is growing.

The negative consequences of stress and burnout among their executives, nurses and physicians colleagues is also blowing back to weaken the resolve of board members. Unfortunately, some of the same pressures that challenge these health professionals are also becoming evident among board members. Board burnout is a factor that will need more discussion in the months ahead.

I like this Quiz to gauge board stress and burnout risk but perhaps, it may not be so funny?2

Take this quiz to find out if it's time to re-evaluate your part-time board job:

1.     You spend more the 50% of your therapy session talking about your board job.

2.     Your spouse is threatening to name your nonprofit as the correspondent in your divorce proceedings.

3.     The meetings of your board are so unpleasant that you find yourself day dreaming of the good-old-days when you were on the front lines as an infantry officer in Vietnam.

4.     You dread a call from your organization to volunteer so much that you have a written list of excuses posted on the wall in the kitchen.

5.     You fantasize that if you won the lottery, the first thing you'd do would be to start another nonprofit to put the one you volunteer for out of business.

6.     Your board service is so stressful and your use of medication has increased so much that your health insurance company has offered a large donation if you will resign.

7.     You send all of the e-mails from your organization directly to spam, despite the fact that you are chairman of the board.

8.     You hire a consultant with your own money with the goal that you can get through a committee meeting without a member bursting into tears.

9.     You have gained more than 30 lbs, tripled your alcohol consumption or taken up smoking.

10.  You and another member of the organization are thinking of leaving together. The only thing you haven't decided for sure is who will be Thelma and who will be Louise.

Okay, these may only be a tongue-in-cheek distraction, but there are five factors that are likely to be serious concerns and stressors for your health system board work during the next three years:

1.    Tight Revenue: The squeeze on revenues from new forms of value-based payment will make it difficult to have positive margins, therefore constraining the ability to finance new technologies and program innovations;

2.    Not Enough Health Professionals: The ability to recruit new physicians and advance practice nurses will frustrate capacity to grow service volumes and market position in key clinical service lines;

3.     Health Disparities: The call to establish and govern community health partnerships to reduce the implications of social determinants of health will strain traditional business planning processes and performance management tools;

4.    Worker Frustration: Employee morale erosion from cultures of disengagement will spill into community affairs in ways that weaken political and philanthropic support for your mission; and

5.    Better Care: Calls for board decision-making to be faster, wiser, as well as more focused on  transparent, ethical, and accountable care that is safer, higher quality, and less expensive will grow tension in the boardroom as the risk for regulatory oversight expands from governmental and media oversight bodies.

Burnout is not just in the boards of hospitals and health systems; it is also in many not-for-profit community organization boards…

Burnout is inevitable. No matter how committed your nonprofit board members, each will suffer from burnout from time to time. You can count on it. Just don’t fear the burnout—it’s a sure sign that your board members are working hard to help your nonprofit achieve its mission.

Once you adjust to the fact that burnout is coming to a board member near you, prepare to tackle it. Follow the link below for five tangible steps you and your nonprofit board members can take to work through burnout. 3

So how can you inoculate your board work from the threat of such burnout?

Our work with high performing client boards suggest you consider three imperatives to reduce the risk of board discouragement and burnout:

Imperative 1: Role Clarity: Enhance board members’ use of their time and talent with role clarity from a “Governance Authority Matrix” that defines the work and responsibilities of board, committees, and management. Recruit and orient new members with this roles and responsibilities document;

Imperative 2: SMART Decision-making: Support enhanced board decisions with better information made available in formats that are more accurate and timely via modern Board Portals. Meetings encourage more candid and “generative” conversations that are: Stakeholder engaged; Mission driven; Accountability expected; Resource mobilized; Transparency enabled.4

Imperative 3: Celebration Culture: Boards need to set visionary, stretch goals for the organization and management team, and then be assertive on candidly reporting progress to plans to staff, physicians, payers, the media, and the community. Boards must be visible with their expressions of appreciation to all stakeholders. Modern recognition and rewards help create the conditions within the organization is more likely to achieve higher levels of pride and performance.

 

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David Bjork, PhD, joined Integrated Healthcare Strategies, a division of Gallagher Benefit Services, Inc., as a partner in 1994 to start a division focused on executive compensation and incentive plans. Over the next decade, as practice leader, he helped develop the largest and best respected executive compensation consulting practice serving the health care industry.  He developed the standards the firm now uses in evaluating the reasonableness of executive compensation; advising boards on CEO performance ...

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William F. Jessee, MD, FACMPE joined Integrated Healthcare Strategies, a division of Gallagher Benefit Services, Inc. in October, 2011, after serving for more than 12 years as President and Chief Executive Officer of the Medical Group Management Association (MGMA).  He also holds an academic appointment as Clinical Professor of Health Systems Management and Policy at the University of Colorado School of Public Health.

Dr. Jessee is one of the nation’s leading experts on physician services management ...

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James A. Rice, PhD, FACHE is the Managing Director & Practice Leader of the Governance &  Leadership practice of Integrated Healthcare Strategies, a division of Gallagher Benefit Services, Inc.  He focuses his consulting work on strategic governance structures and systems for high performing, tax-exempt health sector organizations and integrated care systems; visioning for health sector and not-for-profit organizations; and leadership development for physicians and medical groups.

Dr. Rice holds master’s and doctoral degrees in management and ...

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