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Elizabeth Spurlock on Preventive, Personalized Approaches to Burnout for Community Oncology Practices


At the 2022 Community Oncology Conference, Elizabeth Spurlock, MA, PHR, director, Human Resources Business Partner, Texas Oncology, discussed the prevalence of burnout among physicians, staff, and administrators, and several strategies to reduce risk and support the health care workforce.

As COVID-19 brought to light long-standing issues of labor shortages and strained health care practices, strategies that are intimate, personal, and flexible to each community site are warranted to reduce risk of burnout and support their needs, said Elizabeth Spurlock, MA, PHR, director, Human Resources (HR) Business Partner, Texas Oncology.

Spurlock participated in a panel discussion at the 2022 Community Oncology Conference, titled, “Dealing with Physician, Staff & Administrator Burnout: Lessons From COVID-19.”


Can you speak on the impact of physician burnout on patient outcomes? How may the community oncology setting exacerbate risk?

It's a great question. I think it's very real what our physicians, providers, our staff, everybody is feeling. I tend to think about it as a whole system. So, how is the whole system either contributing or taking away from those patient outcomes?

So, if one part of the system is broken, like labor shortages, that is going to contribute to overall burnout and really the quality of care. So, whether it's nursing or revenue cycle, patient facing or non–patient facing—all of those things—I think it's really important to understand how we contribute upstream and downstream so that our physicians get what they need.

What influence has the pandemic had in changing the perception regarding burnout in health care workers?

This question is, again, very real and I think touches the entire health care ecosystem. I think it probably exacerbated some things that were already there. We already had some labor shortages before the pandemic. There were already a lot of strains before the pandemic, and I think with COVID-19, it just really brought a lot of that to light.

I think that it made it important to focus on really what's critical to people personally and professionally, because through the pandemic, those boundaries were blurred. And so, [it’s] really been important to tie back to the purpose, to the vision, to the commitment of our stories, of our patients. And I think that's really what's helped get us through.

But the realistic nature, too, is how do you solve this? How do you provide resources? How do you provide support and make it a safe space where I think sometimes there might have been some taboo about some of that.

Recently, I read a Forbes article on the airplane to the 2022 COA meeting and it said by 2025, 75% of providers, nurses will leave the health care organization. So, what are we doing now to help prevent some of those things? That's what I think is really important to focus on.

What preventive approaches has Texas Oncology undertaken to reduce burnout risk among its health care workforce?

I think the first step is acknowledging it—that it is real and that it is okay. And I think talking about it makes it real and okay. I think the second approach is really teaching our leaders to be empathetic. And I know it's hard. Whenever you're burned out, you may not be as strong, but having that empathy and that connection is really important.

The third is getting really practical on what we can do to fix it. I think sometimes we either spiral up or spiral down—we could do this and we could do that. We could do all these great things. We have the idea fairy floating around a lot, and so how do we really ground ourselves to focus on what we can do.

We're getting creative in how we're staffing and recruiting talent, whether that's telling our story in different channels, different ways—really ensuring that our internal HR structure, for example, is set up in the right way to address some of these issues.

Another way is to try to figure out where there's waste in the system. There's a lot of processes that probably can go away, a lot of paper trail that probably could get away from the HR side, in particular. So, how are we removing some of that waste so that we can really focus on what's important for our patients, for our employees, and for our physicians.

How are symptoms of burnout different in any way among physicians and administrators?

I really thought about this question quite a bit. One of the things that we recently did in Texas Oncology is we launched our employee opinion survey. This is something we've done for 2 years in a row now, and it does tend to gear towards more of our staff, nurses, APPs [advanced practice providers], for example, but a lot of the themes that came through that survey, I think, also relate to our physicians as well.

So, timely communication, recognition, and feedback; knowing what's really important at that point in time; if there's changes coming; COVID-19 policies—all of those things that tend to be noise in that system, how can we be more proactive in communicating those things

I don't know if, holistically, there's a lot of differences, but I would say our regions, our sites are more empowered to take either the results from that survey, first-hand knowledge, conversations—we've done a lot of focus groups, for example—are really empowered [them] to manage those nuances at a site level, because we know, yes, all across the state of Texas we're focused on certain things and certain priorities. But how do you scale that while also keeping that intimate, personal, flexible approach in our sites?

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