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David Kopacz, M.D. Buchanan Rehabilitation Centre, ADHB

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Presentation on theme: "David Kopacz, M.D. Buchanan Rehabilitation Centre, ADHB"— Presentation transcript:

1 David Kopacz, M.D. Buchanan Rehabilitation Centre, ADHB

2  Collaboration in decision making  Respect for human needs of the individual  Empowerment of the person in their own healing  Self-responsibility  Instill hope  Focus on strengths, not just symptoms or deficits

3  60% decreased enthusiasm practicing medicine  87% said physician morale decreased - past 5 yrs.  74% reported excessive administrative duties  56% lack of time for families, hobbies, friends  54% dissatisfied with lack of autonomy

4 MBI* SubscaleLow BurnoutMedium BurnoutHigh Burnout Emotional Exhaustion 48.1 %22.2 %29.7 % Depersonalisation 50 %25.6 %24.4 % Personal Accomplishment 31.2 %36.5 %32.2 % *Maslach Burnout Inventory

5  Negative attitude toward self, others, work  Distancing from patients emotional needs  Overprescribing medication  Emotional Exhaustion  Decreased creativity  Nonproductive hyperactivity  Low sense of personal accomplishment & job satisfaction

6  Decline in quality of services  Climate of mistrust & hostility  Impaired communication  Decisions made in isolation  Increased sick leave  Increased staff turnover

7  When their work is challenging  When individual growth is promoted  When they can make a difference in other people’s lives

8  Increased patient satisfaction & improved health outcomes  Increased patient trust in their physician  Better long-term adherence to therapies.  Enhanced physician retention  Fewer malpractice suits

9 “The relentless urgency that characterizes most corporate cultures undermines creativity, quality, engagement, thoughtful deliberation, and, ultimately, performance,” (3).

10 “The ethic of more, bigger, faster generates value that is narrow, shallow, and short term. More and more, paradoxically, leads to less and less,” (4).

11 “‘How can we get more out of our people?’ leaders regularly ask us. We suggest they pose a different question: ‘How can I more intentionally invest in meeting the multidimensional needs of my employees so they’re freed, fueled, and inspired to bring the best of themselves to work every day?’” (20-21).

12 MULTI-DIMENSIONAL NEEDS OF HUMAN BEINGS Significance (Spirit): What I stand for and believe in – what gives me a sense of meaning Self-expression (Mind): Freedom to develop and express my unique skills and talents Security (Emotions): Feeling appreciated, cared for, valued for who I am and what I do Sustainability (Body): Being able to regularly renew and take care of myself, so I’m healthy, fit, and resilient

13 Organizational Example: GOOGLE  Time set aside for following personally-driven creative work that relates to the company  Exercise facilities on site  Weekly group walks to brainstorm  Time limits on meetings  Organic food in cafeteria

14 “the very institutions in which we practice our crafts pose some of the gravest threats to professional standards and personal integrity. Yet higher education does little, if anything, to prepare students to confront, challenge, and help change the institutional conditions under which they will soon be working,” (199).

15 “it is the heart of the healer, not the system, that education has the best chance to touch and transform.”

16 “Can we think of her [the trainee physician] not as a victim but as a moral agent uniquely positioned to challenge and help change the institution before, during, and after the moment of crisis?”

17 A new professional is “a person who not only is competent in his or her discipline but also has the skill and the will to resist and help transform the institutional pathologies that threaten the profession’s highest standards,” (202).

18 “At the heart of every profession is an implicit affirmation that the mission of the profession must never be confused with the institutional structures in which it is pursued…We need professionals who are ‘in but not of’ their institutions, whose allegiance to the core values of their fields calls them to resist the institutional diminishment of those values,” (204).

19 Both Palmer and Schwartz recognize that there are fundamental human needs and dimensions that must be recognized and supported in order to create institutions in which people can be fully human, empowered, happy, and maximally productive. Schwartz emphasizes the responsibilities of the organization to the employee. Palmer emphasizes the responsibilities of the professional to the client, to self, and to the organization.

20 To empower the clinician as a new professional. To support the clinician’s body, mind, emotions, and spirit… in order for the clinician to support the client’s body, mind, emotions, and spirit.

21 To provide excellent technical treatment. To support & empower clients in body, mind, emotion, and spirit. To care for one’s own body, mind, emotions, and spirit. To be the ethical conscience of the organization when its policies undermine the human needs of the staff and clients.

22  The way people are treated influences how they treat others.  Empower professionals to empower patients.  Collaborate in decision making and policy development.  Respect the role of employees as new professionals.  Support the human reality of professionals for peak productivity.  Instill hope.  Focus on developing strengths of professionals, not just a focus on weaknesses.  Encourage new professionals to take self-responsibility in their work and workplace.

23 InstitutionProfessionalPatient

24 Institution Professional Patient

25  Lee Lipsenthal, Finding Balance in a Medical Life, Finding Balance Inc, 2007.  Kaiser Foundation web.  Parker Palmer, The Courage to Teach: Exploring the Inner Landscape of a Teacher’s Life, John Wiley & Sons, 10 th Anniversary Edition 2007.  Alan Peterkin, Staying Human during Residency Training, University of Toronto Press, 2008.  Tony Schwartz, Jean Gomes and Catherine McCarthy The Way We are Working Isn’t Working: Four Forgotten Needs That Energize Great Performance, Free Press, 2010.  Lois Surgenor, Ruth Spearing, Jacqueline Horn, Annette Beautrais, Roger, Mulder, Peggy Chen, “Burnout in hospital- based medical consultants in the New Zealand public health system, New Zealand Medical Journal, 7 August 2009, Vol 122 No 1300, p. 11-18.


27  “Not just the system failed in this case. The heart of the healer failed as well, a heart that surely knew what was occurring but refused to recognize the fact. And it is the heart of the healer, not the system, that education has the best chance to touch and transform.  What caused the ‘heart failure’ in this resident, apparently leaving her with the sense that she had no option but to play the stacked hand she had been dealt? Can we think of her not as a victim but as a moral agent uniquely positioned to challenge and help change the institution before, during, and after the moment of crisis?  If so, what might happen in residency programs to support the healer’s heart – and the courage to follow it – when conditions under which medicine is practiced threaten the heart’s imperatives?” (201-202).  (emphasis added)

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