1 - Dr. Paul Dechant - Identifying the Key Drivers of Burnout

Hello everyone and welcome to the uncommon leader podcast - Episode 001

These are interviews that will equip you with stories that you can consume on your commute, while you exercise or as part of your regular leadership development journey. Now my approach is to invest time with uncommon leaders that I've had the privilege of learning from at some point in my life's journey, people who want to make a difference, and have certainly made a difference in my life.

Now, my first guest is one we all need to hear from. Dr. Paul Dechant is a former healthcare CEO, a consultant to C-level healthcare executives and a practicing physician, as well as an author, an expert in burnout and organizational dynamics. And  I'm glad to say that he is a friend of mine as well.

I had the privilege of working directly with and learning from Paul at a large consulting organization for a few years.

You're going to love this conversation from Paul as he discusses how leaders can identify the key to identify the drivers of burnout. And the motivation leaders should have to make things better. So enough from me, let's get this started.  You can stay in touch with Paul on many platforms, including Twitter and LinkedIn, and his website www.pauldechantmd.com

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Transcript

0:26

Hello everyone and welcome to the uncommon leader podcast. I gotta tell you I'm energized to be kicking off this first edition of the podcast and confident that the interviews I'm going to have are ones that will absolutely help you, your team, your family, or your organization to succeed in business and life. These are interviews that will equip you with stories that you can consume on your commute, while you exercise or as part of your regular leadership development journey. Now my approach is to invest time with uncommon leaders that I've had the privilege of learning from at some point in my life's journey, people who want to make a difference, and have certainly made a difference in my life. Now, my first guest is one we all need to hear from. Dr. Paul Dechant is a former healthcare CEO,a consultant to C-level healthcare executives and a practicing physician, as well as an author, an expert in burnout and organizational dynamics. And I'm glad to say that he is a friend of mine as well. I had the privilege of working directly with and learning from Paul at a large consulting organization for a few years. You're going to love this conversation from Paul as he discusses how leaders can identify the key to identify the drivers of burnout. And the motivation leaders should have to make things better. So enough from me, let's get this started. Paul, thanks for being a guest. I'm looking forward to this. I know we've worked together for a long time and you have a great story to tell. So I appreciate you being on. John, I'm just so excited to be here. And I really appreciate you inviting me. You know, I'll never forget when we first started working together seven years ago and how you were such a mentor to me in my new role, having gone from being a CEO to now being a coach and consultant, very different approach. And I wasn't really sure how to do it well but you really helped to get me on the right path. So that's a really a pleasure to be here. Well, Paul, thank you very much. I appreciate those kind words. And we're going to get to know a little bit more about you today, even before those seven years. So before we jump into the nuts and bolts of the topic for our podcast today, though, I like to start off each podcast, getting to know you a little bit more. And I asked the guests really pretty much the same question. What story do you have from your youth and you just, you determine what youth means in terms of going through that, that still impacts who you are or the way you are today? Yeah, it's a great question. And I would have to say from my youth, I really struggled with thinking about what that would be, but I know I had this relationship with my father, as it, particularly as a teenager, you know, I grew up in the sixties, I was kind of a liberal, radical kind of guy. My dad was very much conservative, Republican. We got into it a bunch. I didn't think he and I were very similar. And then he passed about 20 or so years ago. And going through his stuff. I realized, as I found a master's thesis, he had written when he did his MBA of New York university that focused on empowering frontline workers. And then I found this picture in his stuff, which I don't know if you can. No, but it's just the story of my life. And it shows this, this person trying to pound a square peg into a round hole. And I felt my life has been very similar to that where I'm always not quite in jive with the organization I'm in mostly because I'm seeing things ahead of when everybody else is ready to understand them. Certainly that's been our experience with lean and healthy. No, pretty much been pioneers. And in, in recognizing that the opportunity is there. Learning to have the patience or the way to connect with people and not threaten them with these new ideas, but get them to come along has been a real challenge for me, but it struck me so much. I wished after I saw these things that I could actually go back and have more conversations with my father, because it was. I, I didn't realize the connections that we deeply held. Most of what I remembered was much more, you know, growing up with long hair and my mom trying to cut my hair at the dining table, stuff like that. Well, gosh, I mean, this is certainly while I didn't ever grow my hair long, but I know that it's funny. I'm just sharing a story, just sharing a laugh. Hey, I appreciate you sharing that. And I'm thinking of the times recently, even when my wife has tried to influence my sons and get them to get better haircuts, as well as, as they go through in their early twenties to be presentable for job interviews and things like that. So that is, that is a great story in it. And then to your point, whether it influenced you, then it is something that you, you look at now and see. How much you really were alike and the apple doesn't fall too far from the tree I'm sure that has been pretty powerful and a good memory for you. Indeed. So, all right, let's jump into the topic, then it really some of your expertise with regards to being a former CEO and a consultant, and now a consultant to C-level executives. You've re you're an author. So there's lots of things. I talked about inter introduction before we started the interview, but I do have a question and something that rings in me because I, I know that you are different. I mean, even the story with, in your approach, your style, what is it that you understand that's necessary for success that most common leaders wouldn't believe today in terms of being successful? You know, the thing I see the most is. Yeah. People don't understand that the problem with burnout is the workplace, not the worker. And the other way to think about that as the opportunity with burnout is the workplace it's fixing the workplace, not fixing the worker or making workers more resilient. In fact, Christina Masloch, who I've had the pleasure to get to know well in the last seven years, and she's the, you know, the guru of burnout, she wrote them Masloch burnout inventory, has multiple articles in books. She has a statement that says when she sees burnout in an organization, it indicates to her that this is there's dysfunction in the organization. And it says more about the organization than it does about the employees and the workers in that organization. And it makes sense when you realize that what's driving burnout are, are a number of key things that the workers themselves have various control over, but the C level leaders in particular have complete control over or certainly very significant control. I know if the problem with burnout is the workplace. Well, who controls the budget? Who controls, staffing, who controls processes, who controls supplies, equipment you know, who controls production, expectations, and pricing. Oh, ultimately, it's the C-suite that controls all of those things and the opera. And they're controlling those things in an effort to have the organization succeed. But what they miss is they're not tapping into the power of their frontline employees. And, and so they consider the employees to be one more of those commodities or line item expenses that they need to manage, just like they manage budgets and supplies and, and the, like when in fact they could by empowering employees while aligning them around organizational success you can create amazing opportunities. So that's the core concept, and I'm happy to really unpack that. There's a lot to understand about how that works, but this relationship between burnout and organizational success. In fact, we now talk about it as we're pursuing organizational resilience. And worker well-being rather than what rather than worker resilience. Because when we, when we create this, right, the organization becomes incredibly resilient and able to withstand external forces that make it a challenge to succeed. Well, it's an interesting paradigm shift in the message, and I appreciate you sharing that. Is that a move from. Employee resilience to organizational resilience. Absolutely. I mean, again, as we work together in our past life, one of the, one of the primary ways that we lead with organizations and C-suites is that lean is built on two principles, continuous improvement and respect for people. It's not one, or it's an, and as it goes through. And when you think about putting the process in the front of the person with regards to what needs to be fixed. That is generally not that's respect for people helping to provide them with an environment that makes it easier for them to get their work done. That's really what we talked about, whether it's as consultants or I'm sure you did as a leader as well. So yeah, let's, let's unpack that a little bit. If organization dysfunction is a primary, cause if you will. Of employee or physician burnout, then what is the prescription for eliminating that organizational disfunction or at least minimizing that organizational dysfunction if we can't eliminate it? Yeah. You know, it gets down to well, you know, particularly in health care many other employees, clinicians in particular, doctors and nurses are highly skilled and knowledge workers. And Peter Druker's definition of a knowledge worker was a worker who, a frontline worker who knows more about what they're doing than the person managing them does. And you know, and in healthcare, when you've got doctors and nurses working in ICU, or, you know, managing psychosocial disorders or you name it, it's impossible for most managers in healthcare to know more about that work than the people doing the work. So it's a very different way than just managing somebody where you design a process and you tell them you do this, you know, pick this up, go over there, put it there, that kind of thing that does not work. And yet, so many days, so many times these days clinicians feel like that's, what's happening to them know in a reaction to a financial challenge, you know, clinicians will be told, well, just work harder to take care of more patients without addressing the, all the challenges that underlie that I'm thinking deeper into that and understanding how that results in burnout really provides us some good lessons, The manifestations of burnout are emotional exhaustion, meaning we've given everything we've got, we've got nothing left to give. When we get to that point, then we have to protect ourselves. And so we see the second manifestation of burnout, which is cynicism, where people are reacting to say, I have to protect myself from my patients and from my organization. So I'm going to separate. And when we, those two things are happening, then clinicians start to feel as though they're really not making a difference. That sense of inefficacy, which in many ways, it's the saddest because in every patient interaction or in most patients truly value that interaction value the value, what a doctor and a nurse brings to them. And yet the doctor or nurses they're burned out. It feels as though that they're not making any difference at all in that interaction. So those are the manifestations. What's been fascinating for me is learning where they come from and then how to apply that in my leadership role, because the what Mas loch identified were six drivers of burnout. The first being work overload. And in fact, in the healthcare, as in many industries these days, we see chaotic time pressured work environments with incredible information overload as well. There's just so much new knowledge coming at us when we're overloaded. We start to feel as though we're losing control and loss of control is the second driver of burnout. Well, control, certainly a big deal to clinicians, to doctors and nurses. We go through so much training and gain so much experience so we can take control when we need to, when there's a crisis, patients want us to do that, and yet we're not able to and in. And so we're really missing out on one of the intangible rewards we really were bargaining for when we joined the healing professions. And in fact, insufficient reward is the third driver of burnout. And and it's not just control. There's also that professional recognition and respect. And we've talked about respect already and. Healthcare people are great. People like sense of collegiality, of being connected with doctors and nurses is just, it's a wonderful, warm feeling, but we're also seeing a breakdown in the fourth driver of burnout now, which is breakdown of community, that loss of that collegiality as we get separate. And it's just, people are so busy. You know, many clinicians have split up their work and sub-specialized to the point where primary care doctors don't go to the hospital anymore. Different sections of the hospital really don't talk to each other. The knowledge is so refined and specified that it's sometimes hard. So as, as we break, as we get separated from each other, And we're living these kind of miserable lives. We start to feel like we're not being treated fairly. What absence of fairness is the fifth driver of burnout. And we certainly see that when we are disrespected, when our, when our knowledge and value isn't, isn't re you don't truly engaged in properly. And and there's a growing issue, certainly in healthcare workforce of another aspect of fairness, which has to do with the the changing demographics of the workforce. And this one's a little hard for me to talk about. You know, I'm an older, white guy. I'm a, I call myself a pale stale. No, I've never had someone challenged my credibility based on things that I have no control over, like my gender, my skin color, or my national origin and yet stuff, actually, probably now the majority of clinicians have those challenges to do that. And are absolutely unfair and inappropriate, but they are there and they create these micro aggressions throughout the course of the day in the workplace. That just make it, you know, just take another edge off of things and sometimes take a big edge off of things. The final driver of burnout Is conflicting values. When we feel as though our values are not aligned with the values of the organization that we're working with them and PR you know, and again, in many or many industries have, have our values driven, but certainly healthcare is deeply values driven. So that becomes a big issue as well. The fascinating thing to me then was Masloch and her, co-researcher Michael Liter, they identified that manifestation of burnout, emotional exhaustion is driven by the work overload, that first driver of burnout. Then the other five that other manifestation of burnout cynicism is actually driven by the other five drivers of burnout. And that's. So when you think about when you lose control, Reward, community, fairness and values, that drive cynicism. Well, if we address both of those properly, you know, what are the opportunities there? Well, the opportunity by reducing work overload is that we give people capacity, one to regain work-life balance, and second, to have the capacity for a discretionary effort to really help make things better. And when we address cynicism and those five drivers, the opportunity becomes growing engagement. Now, I don't know about you, but I have not found an organization yet that isn't focused on employee engagement and they're doing all sorts of engagement surveys that ask whether somebody likes their manager or something like that, you know, and, and yet they're missing these key points by deeply addressing those five drivers of cynicism and reversing them there's so much opportunity to grow engagement. People want to work in a place that values them that gives them control, reward, collegiality treating fairly and being aligned. That's something that's truly missing in many leadership approaches these days, people are struggling with engagement surveys, help us be better off doing the burnout surveys associated with the surveys that measure the drivers of burnout and work from that standpoint. Sure, absolutely. Paul that's, I mean, that's phenomenal in terms of some of those, those key drivers of burnout and they have the resulting feeling of feeling, not feeling but actual response of cynicism coming out of it ultimately. And it became, it becomes very difficult then for organizations to come out of that hole. So aside from changing the leader, which happens frequently, where they put a new leader in, because people are not engaged and not working well on workplace, how do they, how do these organizations go about fixing it?. Well isn't that, that, that saying, you know, you changed the, I think you taught me this one, you to change the leader or you change the leader, right? That's right. Change the leader or change the leader. Yeah. As leaders, it's our responsibility to change ourselves. So that we can implement these changes in our organization. You know, we know change is hard. Nobody wants to change, especially very successful adults. Who've worked their way into positions of authority. And control and power. They've worked a certain way to get there and yet they're struggling. And when we come along and say, well, you know, you really should do this differently. Justifiably people in leadership positions, think why should I do it differently? I've done what I've done has gotten me where I am now, you're coming along and you're telling me to change that just, you know, I, I, this is the way I've lived my life. But the truly uncommon leaders, the ones that lead those organizations that are truly stellar, they have made that change. They've come to that realization that they can actually, they themselves thrive by putting into place management systems and cultures that actually. Empower their frontline workers while aligning them with enterprise wide success. And it can feel scary at first because that word empowerment, certainly for me as a CEO of a medical group with 350 docs in it to think that I'm going to empower all these doctors, who've been whining at me about how they're not getting paid enough and I'm working too hard. I give them power and you know, what are they going to do? They're going to go out and hire a whole bunch more staff that we can't afford without improving the processes, because that's what their idea that they thought would fix things. There's a way to approach this so that you do it collaboratively and everybody's mutually supporting each other towards these goals, but it starts with the top. If the leader is not engaged in this. And, and, and then the, at some point in the organization, people are asking others in the organization to change. Yeah, they'll look to the C-suite and if the CEO is not actively engaged, People who don't want to follow. They won't, they'll sit back and wait. But when the CEO particularly is deeply engaged, then people will follow and change. Now, if you're leading one small section of an organization and you have your direct reports, you can do this within that span of control that you have. It's a little trickier sometimes making sure you're not doing things that could take you off the rails from the organization overall, but the relation, when you think about it, You know, you can work with your team to start to solve little problems that can help reduce work, overload you in helping them come up with a solutions. They start to get control. They can, and as you recognize them for the great things they're doing, they get reward. You're working together as a team. So you're creating community. You can certainly do this in a way where people do feel yeah. Treated fairly because their ideas are being acknowledged and, and engaged with and setting the values overall, you know, that you do, you work on making the connections for people from what they're doing to how that's making a difference for themselves, for your unit, even potentially for the organization. So it doesn't have to be the C-suite, you have more opportunity at that level, but you can do this at pretty much any leadership level that you're at in an organism. I love that, Paul, because again, our listeners are not all C-suite, but we can, as leaders move toward uncommon by changing our behaviors by modeling the way, including helping our team, our staff, our frontline leaders to do their job in a more effective way. Thus reducing, again, some of that, those burnout things that you're talking about. I mean, let me personalize this a little bit. So, you know, the story that you told about an uncommon leader, right, is, is one that you had to go through on your own. So you were a practicing physician, you moved your way up into the ranks. You talked about the 350 physician that you'd lead, ultimately when you became CEO. And that that leader has to change once they got there. What got them there won't keep them there. Well, tell me, tell me a personal change you had to make when you got into that role that allowed you to be more successful as the leader of that group. It'd be more uncommon. Yeah. So, you know, I never really thought back when I was going through medical school and residency, I never thought I wanted to be a leader of anything. I thought I'd just go be a family doctor in the mountain somewhere, but I couldn't ever keep my mouth shut when things didn't go right in my office. And so people then put me on committees and then I chaired committees and it became medical director gradually worked my way up into these higher levels, but the motive, a key thing for effective uncommon leaders is their motivation. If your motivation is to have a title or to have power or to have that big fat salary at the top you're not likely going to be as effective a leader. If your motivation is to make things better for your people and for your clients, whoever they may be. That's where you have the opportunity. What I found when I got into my level, I was CEO of a 300 physician group. That's part of a large health system. And within the, within the group I had to learn to empower the people reporting directly to me so that they then re empowered the people reporting directly to them. In fact, I kind of like to think of it. I have direct reports, but I have direct supports these people that report up to me or people I I'm most effective when I'm supporting them. When we get clear about you know, here's the overall vision, here's your role in it? How do I support you so you can play your role most effectively. And then the other challenge is I'm in my, you know, circle with this medical group, but there's this system around. Including hospitals that may have truly different goals, different values than the medical group itself does. And particularly these days that's playing out, you know, looking at value-based care versus fee for service. In many cases, the hospitals still do better financially when they're doing more stuff. And yet we know that that ideally we should be trying to reduce the cost of care, which in many cases means reducing the number of hospitalizations. So learning to play at that interface between. No working with the CEO of a hospital, I'm the CEO of the medical group supplying most of the medical staff was it, that was a tough challenge for me realizing that, gosh, we weren't truly aligned and then trying to find a way to work with that. And, and the person, both his hospital CEO and myself were reporting up to was a fellow who had also been a hospital CEO and came very much from that mindset and understandibly no, it was very focused on the financial performance because we need a margin without a margin we cannot pursue our mission. So being able to understand the full context of that certainly took work for me. Wow. That's that's that's really cool. Thank you for sharing Paul. Cause it really, I mean, I have three takeaways just from that one is and to get into that role, what is your motivation? That it's gotta be pure. And if it's to help others, if it's to serve others, you have a likelihood of success going through that. Absolutely. The second point I love the Paul ism. I've got my own that I still remember working with you, Paul and all the coming through, but not, you know, seeing it in, not as direct reports, but direct supports. I love that in terms of understanding. And then the third thing you really had to do what I listened to, and I know there was more than this, but what I heard in your response was that you not only had to learn to lead others who were direct support for you, you also had to learn to lead up in the organization and lead across and the organization with peers, which was different than you probably had to do as well. In your career, which makes it very challenging for any leader in a new role, they have to learn to lead their team, but they also have to learn to lead across with their peers and to lead up with their boss as well. Great. Now it says, go through.Paul I think it's been a great story share today. And I know that I'm going to be talking to you again, cause I need some more nuggets on how these organizations are going to fix it as well. So we talked about many of those things and, and your transformation as a leader. And I want to hear more about your story as we go through. As we get on time today. And I'd love to do this as well with, with the guests on the show. I got one more question for you, and then I'll give you the final word to close it out today. But if you had a billboard somewhere in one of the largest airports, let's say it's Atlanta, you come to the top of that escalator out of their subway system, and you have a billboard right at the top of that escalator that a million people are gonna. Every day, you get a chance to call those individuals to action. What did you, what do you want it to say on that billboard? What do you want to tell them and shake them up with? We can fix burnout by fixing the workplace, not fixing the workers. And the way to understand best, how are the way to get started quickly is for leaders to go to the workplace and see what's happening in that workplace? Too often we, as leaders, we get caught up in busy schedules. We're sitting in conference rooms with committees, reading reports and spreadsheets, making decisions that have direct impact on the workplace with no real deep understanding. Of what's going on in the workplace. And whether those decisions we make are helpful or harmful and, and that you're going to the workplace will help a leader to see directly what others will not tell them when about when things go wrong and it can create great motivation and empathy in a leader to be ready to make that personal change, because they realize the impact of the way that they're working. Love that: fix the workplace, get out of your office as a leader and go to the workplace to see it. Paul, thanks for sharing today. I think it's a great story to get started. I'll ask how, how would our listeners stay in touch with you or follow you so they can learn more about. Sure. Gosh, there's a lot of ways. I'm I have a website, PaulDechant md.com. You can email me Paul@pauldechantmd.com and on Twitter, I'm@PaulDechantMD, same thing with the LinkedIn. So lots of ways. And I've tried to stay real consistent with my brand. I'm learning this one, Paul Dechant MD. Just remember that. And you'll find me through email, through a website, through wherever. Awesome. And that Dechant D E C H a N T. And I'll post it in the show notes as well as we go through it again, Paul, thanks for your time today. And I look forward to talking with you again in the near future. John it's been a lot of fun. I really appreciate it. Well, that was awesome. That was a lot of fun talking to Dr. Deshaun on the first episode of the uncommon leader podcast. I hope you had a chance to enjoy this podcast. And if you did, and you want to receive future episodes, then I encourage you. If you listen on iTunes to subscribe, or if you're on Spotify to follow. Uncommon leader podcast. Or. dot net backslash podcast. www dot growing champions. Until next time go and grow champions.