When Amy Sullivan, PsyD, ABPP, participated in a two-year leadership program in Cleveland Clinic’s Neurological Institute in 2016, she studied employee engagement, beginning with a review of related Press Ganey survey scores. She discovered that female professional staff in the institute and across the organization were the least engaged of all categories included in the survey, which included male and female professional staff, nurses and other employees. That led to further investigation and a correlational analysis of the topic.
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“What we are finding is not just at Cleveland Clinic. It is similar at healthcare institutions across the U.S.,” says Dr. Sullivan, Director of Engagement and Wellbeing in the Neurological Institute and Director of Behavioral Medicine in Cleveland Clinic’s Mellen Center for Multiple Sclerosis. “Women have reached parity in graduation rates from medical school, but they haven’t come close to parity in leadership development.”
Dr. Sullivan is the lead author of a recent article in the Journal of Health Service Psychology examining lower engagement, leadership inequity and burnout of women in medicine. The paper presents several evidence-based efforts that psychologists can lead to address these ongoing issues.
There is a clear relationship between low engagement and burnout, which can negatively impact patient care and clinicians’ health and well-being, as well as contribute to high rates of physician turnover, says Dr. Sullivan.
“One of the major contributing factors is a higher stress level at home for women, who often serve as the hub of the household,” she says. “Many women never really turn that off. Then they come to work — where they are highly committed to their careers — and experience additional stress.”
In addition, women in medicine may not feel as valued as their male counterparts. “There is still this marginalized status and discrimination, which comes in all different forms, such as not having a seat at the leadership table, inequity in pay, harassment, microaggressions,” Dr. Sullivan says. “There is so much women in healthcare have to overcome.”
Dr. Sullivan posits that psychologists are well positioned to lead efforts to combat burnout and increase engagement because of their training in and skill with communication, empathetic listening, programmatic development and organizational systems. She offers three tips for colleagues who want to tackle the issues:
Dr. Sullivan says burnout and engagement interventions should focus on four levels — national, organizational, unit/team and individual — and that actions can trickle down from one level to another. “It’s multidimensional,” she explains. “We can’t just look at issues from the individual perspective.”
Cleveland Clinic’s Neurological Institute has put in place several programs based on its needs, which are constantly evolving. They include:
Dr. Sullivan believes this commitment to engagement, in combination with multifaceted programming, is making an impact. “By putting programming in place at the Neurological Institute, we’ve seen our women physicians become more engaged,” she says. “It’s not a competition, because we want our men to be just as engaged. But it’s something we are keeping a close eye on.”