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Christopher D. Newman, MD
COO/CMO
Mary Washington Healthcare
Fredericksburg, Va.
Q: Tell us about your current position and your primary responsibilities at your organization.
A: I am currently the senior vice president, system COO and CMO for Mary Washington Healthcare in Virginia. I oversee both of our acute care hospitals, Mary Washington Hospital, a 451-bed regional medical and trauma center, and Stafford Hospital, a 100-bed community hospital. I also manage operations for the Mary Washington Medical Group, and I oversee Medical Staff Affairs as well as the Departments of Quality, Patient Safety and Performance Improvement.
Q: How do you ensure the clinical/population health goals work in tandem with the operational/business goals of the organization?
A: Mary Washington Healthcare was an early adopter of population health initiatives. We voluntarily participate in the Bundled Payments for Care Improvement initiative and have had success with our participation in a Next Generation ACO. We have become comfortable taking on risk as we strive to provide the highest quality healthcare at the lowest cost.
Our chief population health officer and a fellow ACHE Member, Travis B. Turner, coordinates many of these efforts through the Mary Washington Health Care Alliance, whose members include our employed physicians as well as many private groups in our region. System CEO and President Michael McDermott, MD, FACHE, is also a physician, so our leadership team really understands the balance between resourcing our clinical demands with preserving a strong operational margin. We walk that fine line every day.
Q: How do you align clinical and administrative leaders?
A: As an operations leader who is also a physician, I understand the natural conflict that can sometimes occur when balancing the operational and financial realities of healthcare with the clinical needs and true resource demands felt by our nurses and providers. I formed a System Operations Council at Mary Washington Healthcare which is comprised of nursing, physician, operational and IT leaders. In this forum, we tackle the large operational challenges that we face in a collaborative, multidisciplinary fashion. All stakeholders have a role in designing our future and reaching our shared vision for success.
Q: When you first transitioned to physician leadership, what are some skills related to the administrative management side of the business you had to develop? How did you go about building those competencies?
A: Critical skills that I had to learn at the early stage of my leadership career included how to manage conflict, how to lead an effective meeting, how to build a high performing team, and how to lead a project. As I have progressed in leadership roles, I’ve focused on broader areas such as effective change management, development of effective organizational culture and leading with an enterprise perspective. I’m also very mindful to keep an eye out for talent and to provide leadership development opportunities for individuals throughout our organization.
I benefited greatly from my MBA program at The University of Virginia’s Darden School of Business. I not only learned important skills such as finance, operations and accounting, but also fundamentals of effective leadership including negotiations and communications skills, how to build organizational culture and how to develop a successful strategy. I also have had significant benefits from executive coaching and have been privileged to have been mentored by a few individuals who took an interest in me early in my career.
Q: What advice can you offer physicians seeking to become physician leaders?
A: As a leader, you need to broaden your perspective. Physician leaders should understand the challenges of various healthcare stakeholders. Decisions must consider community needs, employee concerns, financial constraints, safety concerns, quality and organizational culture. I highly encourage new physician leaders to continuously seek opportunities to learn and to talk to other healthcare leaders in various stages of their career. I also found tremendous benefits from executive coaching and the formal business education of an MBA.
Q: What role has ACHE played in your professional development?
A: When I started my first health system leadership role as CMO at Penn State Health St. Joseph in Pennsylvania, my CEO, John R. Morahan, FACHE, encouraged me to join ACHE. At that early stage in my career, I found the educational programs very helpful as I navigated my new role. Even more beneficial was my ability to network with many healthcare executives across the country and speak to them about how they have approached various challenges at their organizations. I have been able to attend ACHE’s Congress on Healthcare Leadership in Chicago on a few occasions and I have found that event to be an excellent chance to learn, engage and interface with other healthcare leaders.
Mitigating Stress and Preventing Burnout
How physician leaders can recognize burnout within themselves and create a positive example for their team
By Harjot Singh, MD
Professional burnout is an occupational risk in medicine. Repeated chronic stress in a high-stakes profession like medicine, combined with an overload of work, and working with patients and coworkers who are not always agreeable, will put most physicians at risk of burnout.
Burnout is a set of feelings, thoughts and behaviors that arise when there is a mismatch between a person’s capacity and their workload. One of the best evidence-based tools to banish burnout and enhance engagement, created by psychology professors Michael P. Leiter and Christina Maslach, identifies six key areas in the workplace where this mismatch occurs most often: workload, sense of community, fairness, reward, values and control.
Mitigating stress and preventing burnout starts with identifying the signs of overwhelm. The following set of thoughts, feelings and behaviors are common manifestations of burnout:
- Repeated thoughts of personal incompetence. These thoughts make you feel less than who you are and undermine your confidence. They can affect your behavior two ways: by making you feel like you don’t care or leading you to resort to behavior that can come across as controlling, dictatorial or disruptive—which can have an adverse effect on relationships with your patients and your team. Ultimately, this negative shift in behavior can contribute to turnover on your team as well.
- Frequently feeling apathetic. Feelings of apathy may make you not want to do your job or do it well. Leaders suffering from burnout may exhibit nihilistic self-talk about their specific job and the medical profession, and may start to feel an overall negative view of life. These thoughts can spread like a contagion on a team and in an organization with devastating effect on the morale. Apathy affects quality of work and is a major risk factor for errors and malpractice. Behaviors such as absenteeism and presenteeism (coming to work sick, injured or incapable of being fully productive) are some of the results of this issue.
- Continuous physical and emotional exhaustion. Exhaustion may seem self-explanatory but, beyond burnout, these feelings can indicate a physical or mental illness too. It’s important to be aware that even though exhaustion can be a sign of burnout, physicians must be careful not to mistake this symptom for burnout, blame workplace stress, and fail to seek medical. Such a mistake can have terrible results.
In addition to work performance and morale issues, burnout is a risk factor for depression, drug/alcohol abuse and suicide, so it must be addressed. Fortunately, there are many things physician leaders can do to mitigate stress, overwhelm and burnout. Leaders can help change the tides, starting by changing their own behaviors to prevent burnout.
Here are a few suggestions for physician leaders who want to mitigate stress and be a positive role model for their team:
- Use the list above to recognize the effects of stress, overwhelm and burnout in yourself. Be aware of the six drivers of burnout (workload, sense of community, fairness, reward, values and control) and whether you are feeling a mismatch in any of those areas.
- Ask for help. It’s easier said than done but asking for help can be reflected in all parts of your life—personal and professional—and will be visible to others on your team. Encourage your team to ask for help, whether that comes in the form of additional training, working with a mentor, or receiving coaching to address specific problems.
- Reset your mindset about addressing burnout. Burnout is a chronic problem. Much like other chronic illnesses, burnout requires long-term management instead of quick solutions that may fail and create more cynicism. Having a long-term mindset will help you have patience and move in a better direction for yourself and your team.
- Overcommunicate with your team. Physicians are not likely to come to you to complain about burnout (though some will). Instead, many clinicians will start by addressing problems they feel more comfortable sharing and that are considered more “acceptable” to discuss at work. Recognize that complaints about feeling overwhelmed, not being treated fairly, not being compensated fairly, complaints about staff and other physicians, or repeated talk about leaving the job may all be signs of burnout. Take the opportunity to listen to the presenting problem, but also consider whether burnout may be the root of the problem.
- Have a balance between ask, show and tell modes of communication. Asking your team members about how they are managing and listening to their responses is crucial. For team members who you suspect are on the verge of (or currently experiencing) burnout, providing personalized feedback and guidance is crucial. Equally as important is demonstrating healthy habits for preventing stress and burnout, to set a positive example. Using all three modes and learning to use them skillfully will go a long way in building trust and engagement with your team.
Editor’s Note: Learn more about this topic from Dr. Singh during, “Professional Burnout in Healthcare: Lead Your Organization to Wellness,” at the Clearwater Beach Cluster, Jan. 27–30, 2019. The session is co-presented by Michael E. Frisina, PhD.
Harjot Singh, MD, is the leadership advisor at HarjotSinghMD.com and a faculty of ACHE. He welcomes your comments at Harjot@HarjotSinghMD.com.
Register for 2020 Congress on Healthcare Leadership
Registration for ACHE's 2020 Congress on Healthcare Leadership is now open. As healthcare’s premier education and networking event, Congress offers unparalleled opportunities to be connected, inspired and empowered. Popular sessions fill quickly, so register early.
At the 2020 Congress, March 23–26 at the Hyatt Regency Chicago, make connections that last a lifetime, discover inspiration from innovative top thought leaders, and gain resources to empower yourself, your organization and your community. Don’t forget to mark your calendars for the Physician Executive Boot Camp on Sunday, March 22, and the Physician Executives Forum Networking Reception on Tuesday, March 24.
Mark your calendars today—more information will be posted on ache.org/Congress as it becomes available. Find what inspires you.
Save 20 Percent During HAP Holiday Sale
Start your holiday shopping or add to your own library with books and resources from Health Administration Press. Order any HAP book or self-study course and receive an additional 20 percent off your already discounted member price when you use the promo code HOLIDAY19 at checkout.
The discount applies to both member and nonmember prices, but excludes any already discounted bundles, Futurescan 15-packs, and the Board of Governors Exam Study Set and Flashcards. Visit ache.org/HAP to start shopping today.
Mentorship
As you progress in your role as a physician leader, consider using a mentor. Learn more about finding a mentor or becoming a mentor yourself as part of the Leadership Mentoring Network.
Connect With Forum Members
Looking to connect with your Forum colleagues? You can locate them at the ACHE Member Directory. Scroll down to the "CEO Circle/Forums" drop-down menu in the directory, select "Physician Executives Forum" and look for the "PE" icon beside their names.
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