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CEO, president, and founder of the Clinician Burnout Foundation Jodie Green and physician advocate and physical therapist Kim Downey discuss their article “Why wellness programs fail health care.” Jodie and Kim explain why traditional wellness initiatives often add to the burden rather than relieving it for exhausted medical professionals. They introduce the concept of the quicksand effect where meaningful help becomes impossible to grasp amidst systemic failure and advocate for immediate practical support like transportation and child care. The conversation covers alarming statistics regarding physician suicide and nurse safety in the U.S. while addressing the critical difference between burnout and moral injury. Real change happens when we lift the burden from those who care for us to restore their capacity and hope.

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Transcript

Kevin Pho: Hi. Welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome CEO, president, and founder of the Clinician Burnout Foundation, Jodie Green, and physician advocate and physical therapist, Kim Downey. Kim and Jodie, welcome to the show.

Kim Downey: Thanks, Kevin.

Kevin Pho: All right. Kim, I always start with you. How did you find Jodie, and why did you connect?

Kim Downey: She was one of my early connections on LinkedIn about two and a half years ago. We loosely followed each other, but we hadn’t had a conversation. I guess within the past few months, doctors started saying to her: “Oh, you know Kim Downey,” or “You have to connect with Kim Downey. You have to talk to her.”

So she reached out to me and said: “People are saying that I need to talk to you.” So we did, and from our very first conversation, we just started talking about how we could collaborate to amplify our support for doctors and other health care professionals. This is one of the ways we decided to collaborate.

Kevin Pho: Yes. And Jodie, you are the CEO, president, and founder of the Clinician Burnout Foundation. Tell us a little bit about what you do, and then after that, we will jump into your KevinMD article, “Why wellness programs fail health care.”

Jodie Green: I am not a clinician, but this comes from a very personal place. I have been a caregiver for my family since the age of 17. I was still in high school. My father took off. My mother had very severe mental health and anxiety issues, and it was a little bit paralyzing.

My brother is autistic (though back then it was called mental retardation), and they would just warehouse them. This is well before the internet. So finding those clinicians—just an occupational therapist to tie shoelaces or a speech therapist—was not easy. But I had such an attitude of gratitude because they could help them have a quality of life and thrive. That just made me feel so great. Over the years, I never stopped having that appreciation.

I have always needed a large health care team, so I got to know so many different kinds of clinicians. My background is really more marketing. I have worked for global advertising and marketing agencies, always in health care. I did a campaign for the United Nations on psychosocial support. So it is something that has been very near and dear to me to always be able to help in some way as an outsider and still have that great respect as a caregiver to want to care for those who care for us.

Kevin Pho: Both you and Kim wrote the KevinMD article, “Why wellness programs fail health care.” Jodie, for those who didn’t get a chance to read that article yet, tell us what it is about.

Jodie Green: It is about how it was helpful to come from the outside in because health care burnout and moral injury are not single problems. It is very complex. So there are going to be many ways to attack it from the inside out (clinicians like yourself) and from the outside in (non-clinicians like myself). My background enables me to see things a little differently.

I looked at the landscape and saw hundreds or thousands of studies and surveys. I have read tons of them since 2000, when they were really consistent, though some burnout articles appeared in the seventies. I wanted to do something that also felt more inclusive, not just for physicians (which the big focus was on) but for everyone: advanced practitioners, nurses, and the whole workforce. I wanted to do something that was tangible, instant, fast, frictionless, and free because we underwrite it.

What we do is literally give away items, all underwritten by us. Everything from Uber rides—because if you are bleary-eyed from working 87 hours in a day, it probably feels like it. If you are a resident, don’t get behind the wheel. It is probably dangerous for you and others on the road, so we will give you a ride. If you need food on the table, we will provide that. Childcare. Keep your house clean. My early advisory board members were often women physicians who said: “I wish I had had these things.”

So I wanted something for on and off the job. Everyone I spoke to, from med students to residents to longtime practitioners, always said: “I only have two priorities: sleep and food. That’s it.” So I first looked at it from: “Okay, how can I help lift some burden on and off the job? Forget driving, forget food. We will get you the food.” Then I added on so many other things, like a lot of health tech that can slash hours in the EHR with structured data. It is very accurate, not error-filled, but really actionable data.

The reason I wanted to do some of that was things like Uber and food are something everyone could use whether you are a clinician or not. If the custodian doesn’t clean the OR, a surgeon can’t operate. So everyone in the health care system globally could have access to that. For those who practice medicine, they can have that for off the job, and they have on-the-job things. I wanted to do something where we just hand it to you. There is no research. You tell us you have a need, and we will give it to you. Because I didn’t want to be a “me too,” I partner with others who do studies and surveys. My marketing background allows me to help get the word out in an effective way and get a great response rate, but I wanted to complement, not compete with that.

Kevin Pho: Kim, in the article you guys talk about traditional wellness programs. That is why Jodie needs to do all these supplemental things because it is assumed that these traditional wellness programs aren’t really doing the job when it comes to preventing burnout and moral injury. Kim, why do you think that is? Why do traditional wellness programs often fail health care?

Kim Downey: Some of it is lack of leadership buy-in. If they just offer the historical yoga and pizza parties, sometimes it is not exactly what the clinicians really need. Or if they aren’t given time on the job to access those resources, once they get home, they are too busy and tired to do it.

I would say a really key factor is leadership buy-in. It starts with systems and leaders understanding that they have a critical responsibility to take care of their teams and offering the time and resources to show that they really do care. They need to give them time to do it and also to model it. The leaders themselves need to focus on their own well-being.

Jodie Green: If I may jump in, part of what I did was establish the Clinician Burnout Foundation. We are literally and figuratively a foundation. I looked at all the great efforts made to address burnout and moral injury, but they sit on quicksand. I call it the “quicksand effect” because they don’t tend to scale, or some of them fail because of a lot of what Kim said. We are not going to yoga our way out of this. You have already worked a long day. The last thing you want to do is now tack on a yoga class.

So what we are doing by giving things away is lifting from the bottom. If someone is literally drowning or being pulled down by quicksand, they can’t even take it in. Any practitioner not well is overwhelmed or paralyzed. The last thing you could do is even accept an offer, even if it is a great thing that is being offered to help us. So by lifting the bottom, we are restoring well-being. We are bringing up the emotional, mental, physical, and financial status. By lifting those burdens, we are creating stability. Therefore, our partners and others can build on that. This will support everyone. This literally is a foundation because now everyone in health care who we can help will feel like: “Oh, that is a great idea. I can now take that in.”

Kevin Pho: Tell us, Jodie, an example or story just so we can really have that illustrated where your foundation really helped a specific clinician.

Jodie Green: I think what we have really done early on was with health tech. It was a very transformative, kind of Apple-like user interface and a NASA algorithm. That was just an overlay to Epic and Cerner with some AI in it. It was instant, instantly usable like how we use a phone, all structured data because NASA has no margin of error in outer space. We applied that same idea, and that has helped to slash hours and ensure accurate billing so it wasn’t being kicked back for fixing. So that was early on.

Also Uber rides. I have done that with a group of some residents. Just being able to do that allowed them to sleep on the way home or the way in. They felt like: “Okay, tack on a half hour here, 45 minutes there of feeling more rested, not stressed to get there through traffic.” Even that made a difference.

Kevin Pho: For the Uber rides, how would you find programs to partner with?

Jodie Green: Uber is a partner.

Kevin Pho: And so how do people get these things?

Jodie Green: Thank you for mentioning that. They come to the Clinician Burnout Foundation website and there is a sign-up right there. You sign up for what you want. As we have funds, which we raise through grants, sponsorships, and individual donors (we also have donor-advised funds and trusts), we will contact that person and say: “Here is your menu. What would you like?” And then we will pay for that.

Kevin Pho: Other than Uber rides, what are some other examples of resources that you provide to these burned-out clinicians?

Jodie Green: As I said, it could be childcare or housekeeping. We are talking to companies like Merry Maids or others internationally, but also those that are regional and local. We are international. So with Uber, we are talking to Lyft because they are international, right? Because we are serving those who are global. Uber is just a good example because everybody gets what an Uber is.

Kevin Pho: Kim, I think one of the points that Jodie made was that you wanted to extend support not only to clinicians but also to the ancillary health care staff as well. Tell us why that is so important.

Kim Downey: Because none of us can do this alone. I do love it when sometimes on LinkedIn doctors spotlight their team and they say: “It would be hard to make it through the day without my medical assistant.” Well, as Jodie said, what if the medical assistant doesn’t make much money? What if their car is in the shop and they can’t get to work? That affects the doctor. It is just so we can all support each other because we are all part of a health care team.

I am a physical therapist. A doctor can do the orthopedic surgery, but then they send them to a physical therapist. The outcomes wouldn’t be as good if a doctor does a knee replacement and the patients don’t have access to physical therapy. So we are important members of the team too. Even though my personal focus is on physicians, I fully understand as another health care worker that we are part of the team, so I understand the importance of supporting all members of the team.

Kevin Pho: Jodie, since you’ve been around clinician burnout with your foundation, what would you say are the main drivers that are leading to worsening burnout rates?

Jodie Green: I think it has been around for many, many years. At least 15 years before the Affordable Care Act and moving from paper to electronic health records. That probably started more often when it became a medical-industrial complex in the eighties. That is when it started. Over time, it has been profits over people, as you know. It has been greed and neglect. As I say, health care is a system, and there are weak links. When the weak links fail, the links are everyone who is within the ecosystem globally.

So when there is neglect, burnout, and devaluation with moral injury, we are left cutting costs. Look, nurses today are said to have the most violent job in America. It is not just nurses, though; it is absolutely terrifying. I think what happened is COVID-19 ripped off the curtain. It pulled it back. You couldn’t hide it anymore. Now you can’t hide malpractice suits or whatever else was trying to hush it up. It is out in the open.

I still see the statistic that has been used for years: 300 to 400 physicians die by suicide every year. Frankly, that has been used forever. I am sure that it is many more now post-COVID-19, but one suicide is one too many. So our goal is to definitely help not lose a life. As a non-clinician, that would be amazing to me, but also to definitely address burnout. We can eliminate it if we work towards that.

Kevin Pho: Jodie, what does it say about the system that it requires outside organizations like yours to really help address the burnout rather than organizations themselves addressing and fixing the problem?

Jodie Green: I think it is because, as I said, I am an outside-in, so I bring a different perspective. We are all living it. We are all patients. Obviously, every clinician is a human being and patients themselves, but I think it is going to take many different types of attempts to fix things. I think the great awareness groups are wonderful, but so many are still just raising awareness. I am right there. Obviously, we need to raise awareness about our own foundation and the issues, but we need to do things actively and quickly. There is a lot of echo chamber that is still going on. I think it is great to be discussing it, but I have been to conferences too, and people leave saying: “Yeah, I feel that way. Now what?” So that is why I wanted to do something that was strategic, but really tactical. Like, here is the tactic and we are doing it.

Kevin Pho: We are talking to Jodie Green. She is the CEO, president, and founder of the Clinician Burnout Foundation, and physician advocate and physical therapist, Kim Downey. Today’s KevinMD article is “Why wellness programs fail health care.” Now, we are going to end by asking each of you just to share some take-home messages to the KevinMD audience. Jodie, we will start with you, and always we will end with Kim. Jodie.

Jodie Green: Okay. I think the take-home message is: Help us out there. We are going to get to the point where it is not going to take 40, 50, or 60 years to end it. It has been since the eighties. I think now there is a galvanizing force. There is enough attention. There are strikes. There are equity investors and owners shutting things down. I think once the people who make these decisions that harm clinicians and all others need care themselves, it may not be there for them. Sometimes it takes until it happens to you.

But we are galvanizing for political will and public attention to shift policy and really bring a chorus of voices now to create change. I think we are all gaining ground together, and it will take a big alliance of those of us to work on it. The last thing I just want to add is where I come from. I think why I am more of a hands-on action person is there is a wonderful quote from Hillel: “If not me, who? If not now, when?” So that is how I approach things.

Kevin Pho: And Kim, we will end with you. Your take-home messages.

Kim Downey: I love that, Jodie. To kind of dovetail on that, the first thing I say as I end each episode of my podcast is: To move the needle in health care, we all need to raise our voices and we all need to care about each other. So to systems and leaders: Take responsibility for the well-being of your teams. To boards: Hold your systems and leaders accountable. And to individuals (and that includes leaders): Make yourself aware of resources now. So if there is a time you find yourself struggling, you will already know where you can turn.

Resources such as the Clinician Burnout Foundation and the Dr. Lorna Breen Heroes Foundation are very good places to start. Jodie has shared today about the Clinician Burnout Foundation, so people can go to that website now and find out how they could access resources when they need them. Also, on the Dr. Lorna Breen Heroes Foundation website, you can click on the tab that says “Take action” and then the highlighted line that says “For health care workforce” or “For physicians.” So then you know when you are struggling where you can go. You would already know: “Okay, these are the resources that I can access.” And of course, you can always reach out to me and follow Stand Up for Doctors. I will help you out as well.

We end our article in part by saying: No single entity can solve it all. By working together, we can synergistically make headway by sharing expertise, augmenting resources, and more. Together we can ignite a real, lasting, lifesaving chain reaction of change. So let’s do it.

Kevin Pho: Kim and Jodie, thank you so much for sharing your perspective and insight. Thanks again for coming on the show.

Kim Downey: Thank you.