Featured Guest: Kandi Wiens, EdD

What she does:  Dr. Wiens is a senior fellow at the University of Pennsylvania, director of the Penn Master’s in Medical Education Program and the Penn Health Professions Education Certificate Program, and academic director of the PennCLO Master’s Program, as well as teaching various graduate-level and executive-format courses.  Dr. Wiens is also co-founder and chief research officer of Big Sky Leadership Labs, where she leads and conducts evidence-based research on executive performance, emotional intelligence, burnout, and resilience. She has designed and delivered over 2,000 leadership development programs focused on helping leaders build and leverage their emotional and social intelligence to amplify their positive impact and protect themselves from burnout.  Her work has been featured in the Harvard Business Review as well as published in her book "Burnout Immunity".  She is also a sought-after international speaker.

On risk: "It's [speaking about burnout] absolutely a risk to individuals.  The effects of burnout aren't just psychological, they're physical as well. They also affect our ability to learn and adapt, and burnout affects our relationships, burnout affects our performance. Take performance, for example, there are studies that clearly show a relationship between burnout and patient experience. Other studies that show relationship between burnout and medical errors. There's a direct correlation between physicians who are burned out and higher medical error risks. And then of course, there are risks to organizations as well, lost productivity or lower productivity, more sickness days, higher turnover, and patient experience scores. You name it. If you look at different metrics that health care organizations are measuring, you can if you look really closely, you can tie those to a physician's well-being, whether it's burned out or they're engaged."

Transcript

Scott Nelson  0:01  
Welcome to The Risky Health Care Business Podcast, where we help you prepare for the future by sharing stories, insights, and skills from expert voices in and around the United States health care world with a mission to inform, educate, and help health care organizations and individuals, ranging from one doctor practices to large integrated systems and organizations throughout the dental, medical, and veterinary health care industry with risk, while hopefully having some fun along the way. I'm your host, Scott Nelson, a guy that grew up in Ohio and has been working all over the United States during my 20 plus year and counting career in the health care industry, with a commitment to accelerating health care performance through creativity, not just productivity. Let's dive in.

Have you ever at work heard or used the phrase "candle burning at both ends" or "fried" when there isn't food involved? Have you ever felt or witnessed sadness or fatigue, frustration or disengagement, distress or anxiety? What about physical experiences or events that involve something like high blood pressure? All of these are symptoms and feelings of burnout.  Burnout is a risk in health care.  It presents itself from all directions and angles, in many forms, and can have negative results for both individuals and organizations. Historically, health care professionals have been among the most common to experience work-related stress and burnout, even before Covid.  During Covid that increased.  And while burnout rates in health care have decreased slightly they are still above pre-Covid levels. Burnout in health care can impact everyone involved:  individuals like staff and patients, as well as organizations.  And burnout is a risk that can threaten patient safety and care quality due to medical errors and jeopardize patient and staff satisfaction leading to low satisfaction scores, decreased patients, and staff losses and shortages.   
In the 2024 Medscape Physician Burnout and Depression Report, 49% of physicians said they are feeling burned out and 20% said they were feeling depressed. The vast majority of doctors - 83% - say their burnout is tied to their jobs.  And burnout isn't just an individual issue, it's also organizational.  The same report noted a finding that 23% of the doctors surveyed said they thought their employees recognized issues with burnout and 48% said employers weren't aware of burnout issues while 29% said they were unsure.  
In this episode I'm speaking with Dr. Kandi Wiens about burnout as a risk in health care.  Dr. Wiens is a senior fellow at the University of Pennsylvania, director of the Penn Master’s in Medical Education Program and the Penn Health Professions Education Certificate Program, and academic director of the PennCLO Master’s Program, as well as teaching various graduate-level and executive-format courses. 

Dr. Wiens is co-founder and chief research officer of Big Sky Leadership Labs, where she leads and conducts evidence-based research on executive performance, emotional intelligence, burnout, and resilience. She has designed and delivered over 2,000 leadership development programs focused on helping leaders build and leverage their emotional and social intelligence to amplify their positive impact and protect themselves from burnout. Her work has been featured in the Harvard Business Review as well as published in her book "Burnout Immunity".  She is also a sought-after international speaker. 

Let's talk with Dr. Wiens about burnout and risk in health care.

Dr. Wiens, welcome to the show. 

Dr. Kandi Wiens  3:19  
Thanks, Scott. Happy to be here. 

Scott Nelson  3:21  
Before we begin our conversation about burnout as a risk in health care. I'd like to take a moment to talk about your background and work. What is your work with burnout? And how did you get into it? 

Dr. Kandi Wiens  3:29  
It's a good question. Because I often wonder myself like why did I want to become a burnout expert? It's not something that a lot of little girls grow up thinking that they want to be. So I spent 22 years as a management consultant, primarily in the health care industry, working on the operations side, a little bit on the clinical side, but mostly operational consulting. And I was observing a lot of burnout and hearing a lot about it from many of our clients. And I was quite eager to learn more about it. And so I and at the same time that I was learning about it and reading about it on my own, and starting to explore it while I was in my doctoral program, I was also starting to experience burnout to the point where I had a hypertensive emergency. I went into my doctor one afternoon just for a regular routine checkup, I felt like my stress level was normal because that's I was working at a pretty amped up level all the time, as most consultants do, we're in it for for our clients, and anyway, my my blood pressure reading came back at a 200 over 110, which is a hypertensive emergency, and when my doctor ordered me to bed rest for five days, I thought to myself well, while I'm here I might as well like really take a hard close look at what my experience has been with work and what my relationship with work has been like. So very long story short, that sent me on a journey to understand more about stress and the coping process and what burnout was doing to many people and leaving so many people psychologically and physically sick and many, many of them losing their careers over it, I wanted to understand it more. So I decided to study it during my doctoral studies at the University of Pennsylvania. And my first study was with a group of chief medical officers, I studied 35 of them. And what I was looking at, Scott, was I wanted to study specifically people who told me that their stress level was at that time severe, very severe, or worst possible for a six month period or more. So not just acute stress, not just one bad day, but over a long period of time, very high levels of stress, yet they were not burned out. And I measured that measure their level of burnout using an instrument called the Maslach Burnout Inventory. So my research, beginning with that CMO study started to find that there are people who would I call have burnout immunity, people who have the capacity and the ability to work in very high stress, long term chronic stress environments. Yet, not burnout doesn't necessarily mean that they go to work happy and engaged every single day, it doesn't mean that they're not experiencing or feeling stress. But it does mean that they're able to deal with it and cope with it in an effective manner. So that's, that's really how I got into the research. And then over the past 11 years, it's just progressed, and I've studied, I've done other studies in health care, I've done a lot of studies with law enforcement and with educators, and with corporate leaders as well. So it goes, what I'm finding, by the way, is really translatable and transferable across industries and professions, the skills that I'm learning about, and then I'm teaching people about it, regardless of the type of role or profession or where the stage of your career, all of the stuff that I write about in "Burnout Immunity" is applicable. 

Scott Nelson  6:45  
There's a lot covered about burnout in all industries, like you mentioned, including health care. Let's start with defining burnout. So what is burnout?

Dr. Kandi Wiens  6:53  
Burnout is, it's considered a psychological syndrome, that occurs when people experience chronic stress at work. So let me break that down a little bit. Psychological syndrome, meaning that, syndrome, meaning that we can experience it to some degrees, lower, moderate, or high levels of it, and we can also recover from it so it can come and go. Chronic stress, meaning that it's a long, not just a one bad day, but people who experience a lot of stress for a long period of time. And it's primarily studied in the context of work. So a lot of burnout researchers have looked at burnout as only the stress that people experience because of their work environment. But I and other current researchers are really redefining that and broadening that definition to include all life stressors, because we know that when we experience a lot of stress outside of work that limits or depletes our capacity to deal with stress at work, and vice versa. So it is it's a psychological syndrome. It's characterized by three common symptoms or feelings that people have. The first one is considered or called emotional exhaustion. That's that feeling where if you've ever woken up to get ready to go to work in the morning and you just have that feeling of I can't imagine giving another ounce of energy to anyone today, like I'm just so emotionally depleted I can't imagine going to work today. The second symptom that people experience is cynicism or sometimes also called depersonalization. That's how people feel about other people in the work environment. Not just coworkers or colleagues but it that also includes patients or if you're an educator includes your students. So that cynicism shows up in the form of our attitude, how we perceive our experiences with other people at work, whether we enjoy working with them or not. So that's the second dimension and symptom. The third symptom of burnout is feeling a lot less effective than you normally do in your job. It's that feeling of I'm going to work every day, I'm putting in a lot of hours, I'm seeing a lot of patients, I'm doing everything I should be doing but it doesn't feel like I'm making a difference the way that I used to feel. So I'm feeling just less effective in my job than I normally do. So those are the three common symptoms of this psychological syndrome.

Scott Nelson  9:11  
Is burnout an individual, a team, or an organizational issue? Who does it affect? Is it personal that it would affect me as the person that's going to my job and doing my work? Does it also affect an organization from kind of a higher abstract kind of thinking process?

Dr. Kandi Wiens  9:30  
So it's interesting there, there's a little bit of research on this thing called burnout contagion, meaning that in a in a work setting, in a, let's say, a small practice, where you have just like a handful of people working within it. If one or two of those individuals is experiencing a high degree of burnout, and they're, they're really expressive about how they feel and they are very negative and cynical, and their attitudes are really showing those emotions can get transferred and start to rub off on other people. So it can, it can spread, just like just like our emotions can spread across the team. So we often find that when we studied burnout, and at a systemic level that where we see a small group of people burned out, that's not necessarily a concern, if it's a small percentage of people, but if it's a larger percentage of people, we know that that's typically caused by not just stuff going on in the work environment, but also because it's potentially spreading amongst coworkers.

Scott Nelson  10:33  
Who are the people that are typically involved in burnout? When you mentioned from the educational perspective, that you have the workers but then you also have the students who are involved in this as well, thinking from a health care perspective, if you have doctors and then staff, anybody within these health care organizations, but then there's also patients involved. So I would think that the patients could take the position of the of the students in that. Who are the people that are typically involved on, and are they involved on both sides of, of experiencing and receiving but also potentially receiving the the other end of of a burnout situation? 

Dr. Kandi Wiens  11:07  
The people who are affected by physician burnout most directly are their coworkers, so that the nurses and the administrative staff that they work with but certainly patients too. And remember, I mentioned that the second symptom or dimension of of burnout is this thing called depersonalization. That, in health care, it's been characterized as physicians who, who used to be able to have, who used to really feel and express empathy for their patients, but when they're burned out that their level of empathy and their their level of patience with their patients is wearing thin, that shows up and that is obvious oftentimes to patients. So and it shows up in in observable ways. Meaning that if you were to interview a group of patients who were being seen by a physician who was burned out, you would likely hear them say things like, well, my doctor, you know, we used to have a conversation, you would ask he or she would ask me how I'm doing or how my family is doing. Now, when I go into the go in for my annual checkup, he barely looks me in the eyes, or she barely talks to me or asks me questions about my family. So it absolutely can wear off on patients and affect the patient experience. And of course colleague and coworker experience too. 

Scott Nelson  12:20  
Burnout rates among physicians and nurses are declining slightly in health care but remain above pre-pandemic levels. Generally, how does burnout happen? Was burnout happening before Covid and Covid brought it to light? Or is burnout a result of Covid or similar crisis situations? Or is it is it just always a possibility that's there? 

Dr. Kandi Wiens  12:40  
Burnout has always been there. So the whole construct of burnout started to be researched, academically researched, back in the 1980s by a woman named Christina Maslach actually coined the term burnout in the context of how people experience have a psychological experience with their work environment. So she primarily in her group, they were studying burnout in health care, and primarily with physicians back in the 80s and 90s, so it's always been there. We just haven't been hearing about it as much until Covid hit and then and it's really taken on a life of its own. The word itself has taken on a life of its own. And I'll be honest, I think it's one of those words that's really started to lose its meaning a bit because I hear very frequently, really on a on a daily basis, of groups of people who say that they're burned out. But yet, when we measure whether they're burned out or not, they're not burned out. They might be overextended or overwhelmed or feel ineffective in their jobs, but they don't have the other all three classic symptoms of burnout. So it has been there, it's just that we're hearing a whole lot more about it because it's been raised in the popular media and people are talking about it more. I think the other thing I'm seeing too is that I work with a lot of physicians who are in medical education so they work with residents and fellows and med students. And they tell me that they're seeing that some of these younger med students, residents, and fellows are advocating for themselves like they've never seen before. They're speaking up and talking about their mental health more so than we then residents and fellows were 5, 10, 15 years ago. So yeah, we're absolutely hearing more about it but it's always been there. It's just coming more to light. 

Scott Nelson  14:25  
And I know we'll get into coping mechanisms and other tools and resources but for now is burnout something that will never be solved and only managed or is it something that is a continuous work in process or can it actually be resolved and be solved? 

Dr. Kandi Wiens  14:40  
I believe that can be solved and resolved especially at the individual level, which is what my book is all about. It's all about for individuals who are really care about their own well-being and have made attempts and have really tried to change things in the work environment, yet the work environment isn't changing. And so their experience is one that's causing and creating this feeling of burnout. Those individuals can absolutely develop different types of coping skills to continue to work in that environment if they choose to or can develop plans to move into something else if that's what's right for them and for their longer term well-being. So "Burnout Immunity" is based on research with people who have either had burnout, and they've recovered from it, or people who work in these high stress jobs and have learned how to protect themselves from burnout. So we can solve it. We just it takes work at the individual level.

Scott Nelson  14:42  
Shifting to risk, with your work and your research and your experiences in burnout, how do you view and think about burnout as a risk?

Dr. Kandi Wiens  14:52  
It's absolutely a risk to individuals, like in my case where I had a hypertensive emergency. So the the effects of burnout aren't just psychological, they're obviously physical as well. But they also affect our ability to learn and adapt, and burnout affects our relationships, burnout affects our performance. So all of those if you take each one of those individually those present risk. Take performance, for example, there are studies that clearly show a relationship between burnout and patient experience. Other studies that show relationship between burnout and medical errors. So I mean, talk about a risk that I would think all physicians want to avoid is medical error risk. And so there's a direct correlation between physicians who are burned out and higher medical error risks. And then of course, there are risks to organizations as well. Lost productivity or lower productivity, more sickness days, higher turnover, and patient experience scores. You name it on you know, if you look at different metrics that organization health care organizations are measuring, you can if you look really closely, you can somehow tie those to a physician's well-being whether it's burned out or they're engaged. 

Scott Nelson  16:57  
The American Hospital Association published a piece titled "What Physicians and Nurses Want Execs to Do about the Burnout Problem," and cited findings from a report that collected data from 20,000 physicians and more than 32,000 nurses between January 2022 and August 2023. Top factors contributing to burnout were listed as staffing shortages, noted by 56% of physicians and 65% of nurses, too many bureaucratic tasks cited by 54% of physicians and 29% of nurses, the chaotic work environment, noted by 28% of physicians and 39% of nurses, and no control over workload, reported by 39% of physicians and 18% of nurses. Viewing burnout as agnostic, so in health care it isn't just impacting physicians and nurses in medical care, but it's also in dental care and veterinary care. How is burnout identified? What are some burnout characteristics that individuals and organizations should be looking for?

Dr. Kandi Wiens  17:51  
In my book I actually offer, there's a whole section in there about how to how to identify whether you might be at risk of burnout, and so you might watch for some keywords that people are saying, and there's a whole list of keywords in there. Sometimes people won't use the word burnout but they'll say things like depleted, exhausted, overwhelmed, anxious, you know, a whole list of things that people will describe their experience, but when you dig deeper, it's often related to burnout. But really the, this is something that I wanted to solve so I actually created an instrument called the Burnout Risk Assessment. We are working on validating that instrument so that we can use it for research purposes. But for now I'm using it in my workshops and with my coaching clients. It is it's available on my website but that Burnout Risk Assessment, basically what what that measures is, it assesses the degree of risk that someone might be exposed to in terms of how much their how much stress could potentially cause them to eventually burnout. And so the results of that that instrument or that quiz will come back as either I'm at low risk of burnout, moderate, or high risk of burnout. And then I offer a number of suggestions based on the severity of the risk.

Scott Nelson  19:05  
So there are degree variations or a scale or a continuum of burnout when you'd mentioned earlier, overwhelmed, ineffective feelings or comments made to you by people that have have had issues within a certain environment. But then you also just mentioned depleted and exhausted. There is a continuum that people can be rated on or ranged on, correct?

Dr. Kandi Wiens  19:26  
That's right, some people will who technically have burnout might experience burnout just a couple of times a year, for the most part, they might feel engaged most of the year but then have periods of burnout based on like patient volumes or something going on, like Covid, for example. And that was you know, if there was a big wave in your city for a short period of time, you might have noticed that burnout rates were ticking up at that point. But then there are people who experience burnout on a daily basis. Like literally four or five times a week, where every single day they're feeling these these, having these experiences that I mentioned with exhaustion and feeling cynical and feeling less effective. So it's definitely a continuum. Same thing with the risk assessment too. I measure that as either low, moderate, or high risk.

Scott Nelson  20:19  
Medscape's 2024 Physician Burnout and Depression Report noted that physicians were most likely to report deploying the following coping mechanisms to deal with burnout, things like exercise, talking to family and friends, getting more sleep, spending time alone, or playing and listening to music. How should individuals manage themselves? And how should organizations manage the organization and it's team and individuals?

Dr. Kandi Wiens  20:43  
There are two chapters in my book that touch on this. One is all about meaningful connections. And that gets at helping people understand and really get clear on the types of experiences in their life that bring meaning to them, whether those are meaningful experiences and having a connection through meaningful work, or it may be meaningful relationships, or it may be a connection to your values. But these meaningful connections include things like exercise, spending time in nature, doing things outside of work that you absolutely love to do. But it's what really what we're trying to get at with meaningful connections is help people identify ways in which they can connect to meaningful things and people that help them feel their authentic selves and bring joy in their lives so that it can offset some of the negative feelings that they might be experiencing at work that might be causing burnout. And then there's another chapter in the book that I call the 3Rx prescription for people who are burned out and are trying to heal from burnout. And the three Rs are for recover, reconnect, and reimagine. So in the Recover section I talk about and I present a number of recommendations for people to engage in and practice daily micro recovery. And then bigger things like for people who can take a longer vacation, and then people who have opportunities to take sabbaticals and so forth. But recovery is is absolutely critical for people who work in high stress environments. It's really no different than a professional athlete who is training and has, who's putting a lot of stress on their bodies. It's the same thing, if you work in an environment where you're putting a lot of stress on your psyche, you also need to recover just like an athlete would need to recover physically. So the second R in that in that chapter is about reconnecting, so reconnecting to those meaningful connections and people and values and relationships. And then reimagining is all about when when you have experienced burnout, and you have healed really recovering from it, how you can imagine a more healthy relationship with work, where you have the level of balance that you want, where your activities outside of work, are really the kinds of activities that work for you in terms of refueling your energy levels, and giving you more capacity to deal with the stress at work.

Scott Nelson  23:07  
That same Medscape report also shared workplace measures by physicians that the physicians say would be most helpful to alleviate burnout, including things like increased compensation, adding support staff, more flexible work schedules. Is burnout mental or physical or is it both? Thinking about those responses, how does a compensation increase compared to a workload decrease as a solution to helping or resolving burnout?

Dr. Kandi Wiens  23:32  
That's interesting, right. So I would characterize like, if someone's primary cause of burnout is from insufficient compensation, they perceive that they're not compensated fairly or adequately, that would most likely result in more of a psychological, it would manifest in psychological feelings of burnout. Whereas if it's workload a physician who's working in the emergency room, or is on their feet a lot or has a lot of physical activity associated with their clinical care, then they might experience you know, some degree of psychological distress, but more so physical symptoms that they that that come along with that job. I interviewed a surgeon one time who said that he absolutely he was born to be a surgeon, he loved practicing as a surgeon, but he eventually could no longer practice surgery because his back, you know, bending over and that just the posture that he was in when he was in surgery. So different people will experience that differently, depending on both the stressor and the type of clinical work that they have.

Scott Nelson  24:35  
What data and resources can be helpful to address and manage burnout from either the individual perspective or the organization?

Dr. Kandi Wiens  24:42  
So data that's available, I mean, all you need to do is go to Google or Google Scholar, and you can find all kinds of data if you want to look for studies that show correlations between say, let's say for example, you were interested in learning more about burnout and the relationship with medical errors you can easily find studies on that. So lots of studies out there to help you get into the data if you want to explore it more. And then as far as resources to help you, there are a number of lot of resources out there that are free, actually, not just my stuff but I've seen Psychology Today puts out a lot of great stuff, Harvard Business Review, I've written now I think it's 11 articles for Harvard Business Review, those are free resources that you can get on my website. I'm going to start writing a monthly column for Psychology Today. I think that will start next week. And then there's a free resource from Fast Company that came out last week. So a number of free resources, just if you can't find what you're looking for, I'd encourage people to shoot me an email at kandi@kandiwiens.com and I can try to find something for you or point you in the right direction. 

Scott Nelson  25:45  
You mentioned burnout immunity, where you have learned from individuals that may be working in high stress environments, like an emergency department I'm thinking, that actually are working in that situation in that environment that are able to to manage a high stress environment. It seems that burnout potential is inherent in some groups more than others, such as the emergency department. Are there lessons learned from those individuals that can then be taken and applied as a lesson learned to other groups and individuals to help them through that process? 

Dr. Kandi Wiens  26:16  
One of the one of the things I've learned through my own studies as well as other studies, and this likely won't come as any big surprise, but there are certain personalities and people with certain types of temperament, and just personality characteristics and temperament, that align better with certain clinical specialties. And so I hear this often from the people that we bring into teach in the Medical Education Master's Program at Penn, who do a lot of work with residents and physicians, and they can see a clear linkage between you know, someone who loves working in a really fast paced, high intensity, high stress environment. Those are the kinds of people that tend to really thrive and enjoy working in emergency medicine or trauma versus there are some personalities that are just better suited to perhaps pediatric care, pediatric primary care. And so that's really interesting, if you look at people who are burned out by specialty, and then if you were to interview those people who are burned out by specialty, you would find oftentimes that there's some correlation between what the type of work environment that they prefer to work in versus what they're actually experiencing in their work environment. 

Scott Nelson  27:34  
If I'm an individual working my day to day job, or my role within an organization, or I'm the leader of a group that is managing people, how should the individual and the leader, how could those people be proactive to try to help those situations from turning into something bigger? And then if there are situations where you have individuals or teams within an organization that are experiencing these situations how should they be responding? 

Dr. Kandi Wiens  28:03  
I am very grateful that you asked that question because one of the things I want to accomplish with my book and with the Burnout Risk Assessment that I created is to give people resources and tools to have conversations with each other. To be able to feel more comfortable and expressing vulnerability, opening up about what they might be feeling or experiencing. And if that's burnout, to be able to feel not threatened by that if they were to have a conversation with someone in their work environment. And as we know, there's there's been a lot of stigma in the health care industry and primarily in medical education around stress. And I talk to older physicians who tell me that, I mean, they don't say this explicitly, but the takeaway that I hear often is that, well, we this is how that's the type of residency training or fellowship training that I went through and so the residents these days can't handle the stress like we did. But then you hear residents who were younger, advocating more for their mental health and well-being, you know, they might feel just as stressed  as an older physician may have been, but they have, they're having different conversations about it now, because it's a different time, and different expectations around what people want and need from their work environment. And so what I hope will happen is that people will just start to talk about it a little bit more openly, and with empathy, meaning that we listen to each other. We may not always understand each other, especially when there are generational differences about people's experiences with stress and burnout. But if we at least listen to each other and share our own experiences we can begin to destigmatize something that has historically just been not not a big topic in health care. 

Scott Nelson  29:47  
Considering something like stigma as a barrier to overcoming burnout. And then on the flip side empathy as a way of overcoming burnout. What are challenges that individuals and organizations are facing today related to burnout and what could or should they be doing to address and overcome those obstacles?

Dr. Kandi Wiens  30:02  
Well, I think one of the biggest barriers is that if you look at what people are incentivized for, it's often not for well-being metrics. They're often incentivized for financial or operational metrics. And so those are often in conflict with an individual's well-being. And depending on the type of practice that a physician is working in, or an administrator is working in, whether it's a very small practice or a large health care system, really looking at what are the metrics that are driving behaviors at the highest leadership levels and that are cascaded down throughout the organization. And are those metrics the kind of things that incentivize people for behaviors that are opposite of employee well-being. 

Scott Nelson  30:46  
Looking backward in time, what was expected versus unexpected in burnout and what could have been done differently? 

Dr. Kandi Wiens  30:51  
So looking back at just let's just take Covid, for example, and some of the some of the interventions that were developed and deployed during or after Covid. Most of us have seen like a lot of well-being workshops being introduced, employee incentives to join gyms and exercise, and just a lot of things that organizations were doing to offer well-being opportunities to employees. But often times employees, physicians, administrators, were not taking advantage of those. Because what really needs to be fixed are some of the are the drivers of burnout, not necessarily giving people more resources to help them just work on their own self care, which is a lot of what those interventions were aimed at is just helping people practice better self care. It actually backfired for I've seen a number of organizations where that's backfired, because the employees are somewhat offended that the organization is taking that approach, rather than looking inside and and really looking at what the drivers and the causes of burnout are. 

Scott Nelson  31:57  
Looking forward, what do you see as trends or potential burnout issues that individuals and organizations could or should be anticipating and prepare for? 

Dr. Kandi Wiens  32:06  
I think one of the big things we'll hear more about, and I hope anyway, that we'll hear more about is what are the metrics that that are driving behaviors and driving well-being. And again, like I said, in my one of my other answers to is like, if there's a disconnect, or major misalignment between what's being measured and the desired behaviors, or the desired levels of well-being, that we need to either change the metrics, or fix the things that are driving the well-being metrics to be lower than what you would want them to be. 

Scott Nelson  32:40  
That's a great point to conclude our conversation. Dr. Wiens, thank you very much for your time and sharing your thoughts and experiences today. How can people learn more about your work? 

Dr. Kandi Wiens  32:48  
Well, first Scott, thanks for having me on, it's really nice to talk to you again. I appreciate the opportunity to speak with your audience. If you want to hear more about my work, go to kandiwiens.com, that's K-A-N-D-I-W-I-E-N-S. And you'll find a number of free resources there, including all of my Harvard Business Review articles and some other pieces that I've written. And you'll be able to take the Burnout Risk Assessment there and of course, you can learn a whole lot more about the book and you can even order the book right there. The book, by the way, comes out next Tuesday. 

Scott Nelson  33:20  
That's great. Thank you so much. I appreciate it again. Thank you very much. 

Dr. Kandi Wiens  33:24  
Thanks, Scott.

Scott Nelson  33:28  
Thank you for listening to The Risky Health Care Business Podcast. You can listen to all episodes from the resource center page of the SpringParker website, springparker.com, or click the Listen link in the show notes to listen and subscribe for free on your platform of choice. And remember, accelerating health care performance is achieved through creativity, not just productivity.