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EBM for Physician Burnout
More than half of US physicians are experiencing substantial
symptoms of burnout.1 Alleviating this crisis leads to:
lower staff turnover,fewer medical errors, better communication,
lower liability cost, and improved patient outcomes.2
1
Sources: references on last slide
Imagine you discovered that there is an evidence-based
intervention for physician burnout available. How valuable
would that be to your institution?
2
EBM offers the only smartphone and computer based training
course demonstrated by clinical trial to lower objective bio-markers
of stress, as well as boosting positive emotions in daily life.
3
Clinical Evidence – Stress Reduction (I)
4
The EBM App (Monitor + Accept)
reduced cortisol reactivity during
a stressful event.
Source: Psychoneuroendocrinology 87 (2018) 63–73 Acceptance lowers stress reactivity:
Dismantling mindfulness training in a randomized controlled trial
Clinical Evidence – Stress Reduction (II)
5
Source: Psychoneuroendocrinology 87 (2018) 63–73 Acceptance lowers stress reactivity:
Dismantling mindfulness training in a randomized controlled trial
A. Systolic blood pressure responses during the post
intervention assessment as a function of study condition.
B. Diastolic blood pressure responses during the post-
intervention assessment as a function of study condition.
The EBM App is (Monitor + Accept) The EBM App is (Monitor + Accept)
Clinical Evidence – Positive Emotions
EBM reduces practical barriers associated with more intensive
group-based mindfulness interventions (MBSR) while delivering similar
benefits for positive emotions.
• A study accepted by a peer-reviewed journal provides well-controlled
experimental evidence that EBM boosts positive emotion in daily life.
• Parallel trial of EBM and MBSR showed 2 weeks of EBM app training
had similar medium-to-large effect sizes on positive emotions as 8
weeks of in-person, group based, MBSR training with a live instructor.
6
MBSR – Mindfulness Based Stress Reduction
Good Fit for Time-pressed Clinicians
• Instructor led group training workshops can be very effective, but they are
also very time consuming.
• It takes only 5 hours to complete our course of training, but it provides
proven results that are equivalent to much longer mindfulness training
courses.4
• Apps with smaller time commitments are likely too short for effective
stress resilience training. In fact, there is no strong direct evidence that
they work.
7
Whether your institution is just starting to address the
burnout crisis, or already has a broader solution in place…
• You might be already addressing workflow, IT systems, or hiring
support staff. Consider EBM to increase your staff’s stress resilience.
• In addition to any mindfulness training solutions you may have in place
(e.g., Headspace/MBSR), you could optimize your burnout prevention
strategy by offering EBM as an alternative or complementary stress
management training option for your staff.
8
Security and Privacy
The EBM system is fully HIPAA compliant.
• We do not transmit PHI (Personal Health Information) to our servers.
• Individual progress is stored on each user’s smartphone or PC/Mac
• Simple recovery of user’s progress via easy-to-remember codes
Our staff is available for Security and Privacy audits on short notice
EBM is ready to sign your BAA (Business Associate Agreement)
9
Design - Usability
Our program was designed to be practical:
• The EBM course is structured so that each lesson builds on the last
one, and flows seamlessly into the next one.
• Our 14 twenty-minute integrated lessons provide for optimal
learning of stress resiliency skills.
10
Demo Screenshots – Ask Us for Demo Access
11
User Perspective - Usability
“The program was easy to access. I think the mobile platform was a
smart choice and designed beautifully.”
“I liked the instructor’s relaxed and calm voice. I liked the fact that it
took only a few minutes in my day to relax and touch base with my
body and emotions.”
“I liked the clear instructions given, and the examples showed me how
to apply the course training in my daily life.”
12
How to make EBM available to your staff
Share your institution’s EBM page and simple access code with
your members. E.g., your-institution.ebmforhealthcare.com
Works on iPhone, Android, PC/Mac. Direct access – no need to
go through app stores.
Contact us to get started
13
14
Contact Info
Uwe Heiss
uwe@ebmforstress.com
LinkedIn
ebmforstress.com
Analysis done by Stanford University Medical Center: Economic
Cost of Physician Turnover Attributable to Burnout 3
This study of Stanford physicians suggests that over the next two years, the
departure of 58 physicians will be attributable to burnout. The estimated
recruitment cost per physician is $268,000 - $957,000. This means that without any
intervention the estimated two-year economic loss due to physician departure
attributable to burnout will be between $15,544,000 and $55,506,000 at this
academic medical center (AMC).
“Our results suggest that, compared with those who are not experiencing burnout,
physicians experiencing burnout are more than twice as likely to leave their AMC
within two years. This results in significant recruitment costs. Therefore, investing
in interventions and strategies that reduce the prevalence of physician burnout
may be an economic priority for academic medical centers.”3
15
Sources: references on last slide
References/Notes
1. Shanafelt et al., Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working
Population Between 2011 and 2014. Mayo Clin Proc. 2015 Dec;90(12):1600-13
2. Dyrbye et al., Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to
Safe, High-Quality Care. Discussion Paper - National Academy of Medicine. July 5, 2017.
3. Hamidi M., Boyman B., Sandborg C., et al., “The Economic Cost of Physician Turnover Attributable to Burnout,”
presentation at 2017 American Conference on Physician Health, San Francisco, Oct. 12-13, 2017.
4. The efficacy of five hours of EBM app training (i.e., monitor + accept) was demonstrated in: Creswell et al., Acceptance
lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial. Psychoneuroendocrinology 87
(2018) 63–73.
Also, mindfulness intervention RCTs suggest that certain benefits of training last through to follow-up even without
continued formal practice (e.g., Creswell et al., 2016, Biological Psychiatry, 80(1), 53–61), perhaps due to integration of mindfulness skills
into daily life via recursive processes (Cohen & Sherman, 2014, Annual Review of Psychology, 65(1), 333–371; Walton, 2014, Psychological Science, 23(1),
73–82).
16

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EBM for Physician Burnout

  • 2. More than half of US physicians are experiencing substantial symptoms of burnout.1 Alleviating this crisis leads to: lower staff turnover,fewer medical errors, better communication, lower liability cost, and improved patient outcomes.2 1 Sources: references on last slide
  • 3. Imagine you discovered that there is an evidence-based intervention for physician burnout available. How valuable would that be to your institution? 2
  • 4. EBM offers the only smartphone and computer based training course demonstrated by clinical trial to lower objective bio-markers of stress, as well as boosting positive emotions in daily life. 3
  • 5. Clinical Evidence – Stress Reduction (I) 4 The EBM App (Monitor + Accept) reduced cortisol reactivity during a stressful event. Source: Psychoneuroendocrinology 87 (2018) 63–73 Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial
  • 6. Clinical Evidence – Stress Reduction (II) 5 Source: Psychoneuroendocrinology 87 (2018) 63–73 Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial A. Systolic blood pressure responses during the post intervention assessment as a function of study condition. B. Diastolic blood pressure responses during the post- intervention assessment as a function of study condition. The EBM App is (Monitor + Accept) The EBM App is (Monitor + Accept)
  • 7. Clinical Evidence – Positive Emotions EBM reduces practical barriers associated with more intensive group-based mindfulness interventions (MBSR) while delivering similar benefits for positive emotions. • A study accepted by a peer-reviewed journal provides well-controlled experimental evidence that EBM boosts positive emotion in daily life. • Parallel trial of EBM and MBSR showed 2 weeks of EBM app training had similar medium-to-large effect sizes on positive emotions as 8 weeks of in-person, group based, MBSR training with a live instructor. 6 MBSR – Mindfulness Based Stress Reduction
  • 8. Good Fit for Time-pressed Clinicians • Instructor led group training workshops can be very effective, but they are also very time consuming. • It takes only 5 hours to complete our course of training, but it provides proven results that are equivalent to much longer mindfulness training courses.4 • Apps with smaller time commitments are likely too short for effective stress resilience training. In fact, there is no strong direct evidence that they work. 7
  • 9. Whether your institution is just starting to address the burnout crisis, or already has a broader solution in place… • You might be already addressing workflow, IT systems, or hiring support staff. Consider EBM to increase your staff’s stress resilience. • In addition to any mindfulness training solutions you may have in place (e.g., Headspace/MBSR), you could optimize your burnout prevention strategy by offering EBM as an alternative or complementary stress management training option for your staff. 8
  • 10. Security and Privacy The EBM system is fully HIPAA compliant. • We do not transmit PHI (Personal Health Information) to our servers. • Individual progress is stored on each user’s smartphone or PC/Mac • Simple recovery of user’s progress via easy-to-remember codes Our staff is available for Security and Privacy audits on short notice EBM is ready to sign your BAA (Business Associate Agreement) 9
  • 11. Design - Usability Our program was designed to be practical: • The EBM course is structured so that each lesson builds on the last one, and flows seamlessly into the next one. • Our 14 twenty-minute integrated lessons provide for optimal learning of stress resiliency skills. 10
  • 12. Demo Screenshots – Ask Us for Demo Access 11
  • 13. User Perspective - Usability “The program was easy to access. I think the mobile platform was a smart choice and designed beautifully.” “I liked the instructor’s relaxed and calm voice. I liked the fact that it took only a few minutes in my day to relax and touch base with my body and emotions.” “I liked the clear instructions given, and the examples showed me how to apply the course training in my daily life.” 12
  • 14. How to make EBM available to your staff Share your institution’s EBM page and simple access code with your members. E.g., your-institution.ebmforhealthcare.com Works on iPhone, Android, PC/Mac. Direct access – no need to go through app stores. Contact us to get started 13
  • 16. Analysis done by Stanford University Medical Center: Economic Cost of Physician Turnover Attributable to Burnout 3 This study of Stanford physicians suggests that over the next two years, the departure of 58 physicians will be attributable to burnout. The estimated recruitment cost per physician is $268,000 - $957,000. This means that without any intervention the estimated two-year economic loss due to physician departure attributable to burnout will be between $15,544,000 and $55,506,000 at this academic medical center (AMC). “Our results suggest that, compared with those who are not experiencing burnout, physicians experiencing burnout are more than twice as likely to leave their AMC within two years. This results in significant recruitment costs. Therefore, investing in interventions and strategies that reduce the prevalence of physician burnout may be an economic priority for academic medical centers.”3 15 Sources: references on last slide
  • 17. References/Notes 1. Shanafelt et al., Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. Mayo Clin Proc. 2015 Dec;90(12):1600-13 2. Dyrbye et al., Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care. Discussion Paper - National Academy of Medicine. July 5, 2017. 3. Hamidi M., Boyman B., Sandborg C., et al., “The Economic Cost of Physician Turnover Attributable to Burnout,” presentation at 2017 American Conference on Physician Health, San Francisco, Oct. 12-13, 2017. 4. The efficacy of five hours of EBM app training (i.e., monitor + accept) was demonstrated in: Creswell et al., Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial. Psychoneuroendocrinology 87 (2018) 63–73. Also, mindfulness intervention RCTs suggest that certain benefits of training last through to follow-up even without continued formal practice (e.g., Creswell et al., 2016, Biological Psychiatry, 80(1), 53–61), perhaps due to integration of mindfulness skills into daily life via recursive processes (Cohen & Sherman, 2014, Annual Review of Psychology, 65(1), 333–371; Walton, 2014, Psychological Science, 23(1), 73–82). 16