Burnout in Your Organization

EPISODE 70: Burnout is a topic that is top of mind for leaders in nearly every industry and at every level. Every organization has a significant amount of impact on level of burnout within their employees. This week's guests Scott Spohn and Dr. Victoria Grady discuss the World Health Organization's new definition and recatagorization of burnout, how to identify burnout and what leaders can do to combat employee burnout.



[00:00:09] JL: Welcome to today’s edition of DHG’s GrowthCast. I’m your host, John Locke, and at DHG, our strength lies in our technical knowledge, our industry intelligence and our future focus. We understand business needs and are laser-focused on company goals. In this ever-changing world, DHG’s GrowthCast provides insights and thought-provoking conversations on topics and trends that address growth opportunities and challenges in the current and future marketplace.

Thanks for joining us as we discuss tomorrow’s need today.

[00:00:42] ANNOUNCER: Views and concepts expressed by today’s panelists are their own and not those of Dixon Hughes Goodman LLP. Always consult the advice of your legal and financial professional before taking any action.


[00:00:58] JL: Welcome to today's episode of GrowthCast, and today's topic is burnout. Our guests are Scott Spohn and Dr. Victoria Grady. Scott is a partner and leads the people and change practice within DHG healthcare and advisory. Victoria is a professor, researcher and thought leader focused on individual behaviors, cultural catalysts, and organizational markers that leaders can use to scientifically approach change in their organizations. Victoria is officially a professor in residence at DHG, while serving as a professor at George Mason University.

Welcome to you both.

[00:01:35] SS: John, great to be here.

[00:01:37] VG: Thanks, John.

[00:01:38] JL: Well, I'm excited to delve into this topic, because this is really a term that gets thrown around a lot in today's era of the pandemic, and now a little bit moving into post-pandemic. But this whole concept of burnout has just taken on a whole new meaning. And when we think about this topic today, why is it such a hot topic?

[00:02:05] SS: John, I'll tell you, we have noticed that exact thing. It is become such a mainstream topic. In the healthcare space, we had been talking about burnout for years and years. But it was pocketed. We talked about it an awful lot when it came to physicians, and extended a bit more into clinicians. But now, that topic has expanded to whether it's administrators inside of the healthcare space, or just about every industry that our practice begins to touch, is that topic is just top of mind. Leaders being worried about where people are from a burnout perspective. So it is on the tip of almost every leader’s tongue that we're chatting with at this point in time.

[00:02:53] VG: I think that's such an important point too to capitalize on that we definitely maybe didn't realize how pervasive burnout actually is among folks both inside healthcare and outside of healthcare and spanning all up and down to different levels within the organization. I think it's really interesting too that we've historically looked at burnout as an individual issue. And what we're seeing is that it is more of an organizational issue, and the organization has a significant amount of impact on the burnout of the employees inside that respective organization.

[00:03:30] SS: And, John, that touches back – Just really quick is this. So Victoria and I just mentioned healthcare, and that's a place that a lot of work has been done. But just this past week, I was on a conversation with a quarry company, so raw material company, and they were talking about how their organization impacts burnout and how the different routines that they have. And so I just think it furthers that point, that it's everything from a healthcare environment, to a quarry, and how they all think about their employees and how they're dealing with the impacts of burnout. So just a reinforcement of what Victoria said and you shared.

[00:04:16] JL: Yeah. Well, I'll tell you what, since this term is used so often, and in so many contexts, let's just take a step back for a quick second and let's define it let. So tell us what really burnout is and, really, what causes it.

[00:04:34] VG: So, john, that's such an interesting question. And I'll tell you, it's changed. The definition is actually – The World Health Organization has given us a brand new definition that will go into effect as of January 20, 2022. I will no longer refer to burnout as a medical condition. But as an occupational syndrome that originates from chronic and persistent workplace stress. The renaming of the word burnout and the reclassification of the definition is an effort by the World Health Organization to raise public awareness of the nature of the condition and that is not related to other illnesses, health condition, or personal weakness, which is often classified as a personal weakness. And it really has nothing to do with that. The new definition really refocuses the nature of the syndrome on its origin, which is, in many cases, the workplace where the individual finds its beginning.

[00:05:36] JL: Well, and I'm sure there's also other contributing factors of stress in and around people's lives in addition to the workplace that are really catapulting this burnout into the mainstream media and the conversations within corporate America and all of this. So all of this together, I guess. And Scott, from the business side, we've got some responsibility here too, right?

[00:06:02] SS: Right. John, I think that's a super important point, is the responsibility that business leaders have around fighting burnout, because many times in the past had been that individual thing. And so was your organizations took a little bit of a hands-off approach to it. The role the organization plays is super, super important. But most importantly, there are steps that you can take. But the costs, as we think about it, is the impact the organization has and why the organization wants to take a proactive approach here is twofold, two things that I’d bring up. One is turnover. And so, again, there is not an organization that I have talked to in the last two to three months that is not very focused on turnover, and frankly, very concerned about its impact because of the cost that's associated with it.

As we come back to the business, and what they think about it, is really thinking about how burnout really drives that turnover number that has a large material financial impact. And then the second piece, and this is some of the things that we've been developing and as we've looked through those changes that haven't been successful, really beginning to see this connection between burnout, and change failure. And so this idea that burnout really does end up being a little bit of the saboteur of changes, because it saps that readiness. It saps that ability to really look change as the opportunity that it may be. So as we think about this, what burnout causes, is it drives this turnover that really is super costly to organizations. But then two, it really is this key sort of contributor to change challenge, if you will, and really drives down an organization's ability to really do what it needs to right now, which has rapidly evolve to a changing environment.

[00:08:03] JL: So that's a new term that I'm not that familiar with, Scott, which is the change saboteur. Could you help our listeners understand kind of – And maybe give us a real life example of a change saboteur situation where it's impacting a business in its ability to move forward?

[00:08:25] SS: Sure. So a perfect example right now, organization is looking at a strategic plan and different pieces of that strategic plan. And as they looked at the readiness of their population, what they saw was a level of burnout, specifically, a level of burnout when it came to efficacy that really challenged people's ability to really move forward with a change. So they were doing lots of good work around communication and connection to strategy and articulating why, etc. All the things that we would say, “Hey, these are great best practices from a change perspective.” But they failed to really connect with the underlying challenge or dimension of burnout that was really sabotaging their efforts, doing all kinds of great things that we think of when we think a classic change management work. But because this burnout was lurking in the background, it was actually sabotaging what they were trying to do.

So, yes, that is a little bit of a new term that we've developed because it feels like it really connects with burnout, this thing that sort of hiding underneath the surface. That ultimately is sabotage and some of the best laid plans, if you will.

[00:09:45] VG: John, I think what Scott said is really important, and he highlighted the role of personal efficacy. And since Scott brought that up, I thought the listeners might be interested in hearing about the other two areas to look out for in terms of maybe even being able to see burnout inside your organization. And burnout in and of itself is characterized by three dimensions. Personal efficacy, as Scott noted, is one of them. But the other two are just exhaustion, feelings of depletion. So you might see that reflected in your employees, and be able to understand the impact of that and get in front of it. The third thing is cynicism or negativism in the workplace. So there're really three dimensions that are important. The personal efficacy, as Scott noted, the exhaustion, or just plain depletion of energy, and then cynicism. And I think if we understand and look inside our organizations at those three different dimensions, it might help give us a new perspective to avoid this concept around being a change saboteur or a scenario that is going to sabotage your change.

[00:11:01] JL: Yeah, what's really fascinating about all of this, Victoria and Scott, is that when you think about the term change fatigue, which is a fairly common term that's been used for years, we associate that traditionally with too much change in a period of time, right? But there is nothing, until I've just heard you talk about it, this giving credit to the other side of the equation. And that is what's going on with that human regardless of the amount of change that’s taking place, right? So it's a different world when you just look at that term change fatigue. And Scott, this is costing really businesses big time right now.

[00:11:49] SS: It is giant. And the macro level numbers that you hear about the cost of burnout. Really, truly, it's tough to wrap your head around. Like it's like $190 billion cost to the economy. And that's tough for anybody that really sort of wrestled to the ground. But as you begin to look at an individual organization, you can begin to take turnover and burnout and really pull them together and see what those true costs are. So of any given organization, and you say to yourself, “Okay. So if I've got turnover at a certain percentage, and then I recognize that, again, very widely known industry benchmarks is roughly half of that turnover is sourced from burnout.” And then, again, you apply the math of, “Okay, so if to replace an employee is anywhere from a half to 75% of their salary, and maybe more depending on the industry. Well, the cost of burnout becomes super material really fast.”

And as Victoria noted, as you look at the dimensions of burnout, as it's now defined, the responses by business are different. John, you bring up a really, really good point, because we've always thought about change fatigue, and there's too much change. And there's things that we wrestle with as business leaders is, “Hey, we've got a lot of things we need to do.” So how do we avoid change fatigue?

Well, as you look underneath at these three dimensions of burnout, the responses to them are all different. If you have an organization that's suffering from really challenges with efficacy or how they're actually getting stuff done, that's when you begin to look at, “Hey, what's that organizational design? What's the support that individuals have for doing that work?” So that has that type of response. If we have exhaustion, depletion, what Victoria was saying, that does map with our sort of historic views of maybe there's too much. Maybe there're too many things going on. And then cynicism gets down to, “Hey, maybe people don't necessarily believe what we're saying.” And it has a whole different response.

So the cost is really large. So you have the macro level cost that lots of us see, and Harvard Business Review, etc., of $190 billion. So you see that. But then when you bring that down, and you connect burnout and turnover together, the costs are really large in an individual organization. And when you get under the cover of burnout and begin to think about what's really driving it, and this gets back to what the Victoria was sharing, those dimensions. Your response is unique each time and with each people group inside your organization. And some being able to do that and really fine tuning that, because there are pockets of your organization that may be a little bit tougher to identify with burnout than others, but they're very important to get to.

[00:14:42] JL: And Victoria, what are some of those other under the covers kind of issues and things that are really impacting that people in these organizations that often really are not either identified or just recognized at any level?

[00:14:58] VG: That's such an interesting question, John. I would say that a couple of the things that we have really identified that have a significant impact are morale and motivation. So I would say that, definitely, we see organizations struggling internally with both morale and motivation as a result of burnout. We also see a significant – So morale motivation are oftentimes predictors of things that are more significant to come. And when I say more significant, I'm talking about things like absenteeism, right? And absenteeism isn't just being physically absent, but it's also being mentally, emotionally checked-out, right? And that has a significant cost.

And then, of course, the excessive amount of absenteeism ultimately has the ability to result in increased turnover, which we all know is going to be very expensive from a bottom line dollar amount, but it's also going to be expensive to the culture of the organization. It's going to be expensive to the evolution of the organization, because as people leave and new people come, I believe that culture is the sum of its parts. And so as we lose people and as we struggle with bringing new folks in, that culture is going to shift and change and ebb and flow in addition to the other aspects of change that are contributing to that idea of burnout.

[00:16:28] JL: Another term that I've started hearing, especially in the pandemic era, is this term silent burnout. Help us understand what that's about and what's it what it's referring to.

[00:16:43] VG: That's so interesting, John, that you bring that up. This is, I’m going to say, recently new bit of information or research that I become aware of, and it's related to a study that a group of folks did at Yale. And it was actually in 2018. So it was pre-pandemic, yeah, and they were looking at high-performers, and engagement, and burnout kind of in collaboration with each other and how one impacted the other.

And interestingly, what they found was that the high-performers were very highly engaged, but they were also highly burned out. 20% of the workforce was experiencing a significant level of burnout. And those 20% were the high-performers in those organizations. They were also typing out as significantly engaged. Wow! That's a big percentage in your organization. That is your high-performers, so driving productivity and performance inside the organization, burned out, and you can't tell because they're highly engaged, and you're using engagement as a barometer. And unfortunately, that's not giving you what you need in terms of understanding where the challenges are. Scott, I think you had some thoughts on that?

[00:18:03] SS: Well, it’s because we've run into this a number of times. We'll chat with clients, and they'll say, “Well, hey, we sort of track to the opposite of burnout. We do our engagement surveys, and we get a really good pulse on where we have those pockets of burnouts.” And I can remember sharing with a client of ours is like, “Do you know, if you had five of your engaged people sitting right in front of you, one of those people is burned out.” That's what that research would tell you. So those people that you think are the superstars, the rock stars of your organization, they're engaged in what you're doing, they're excited about what they're doing. You think they're excited about what they're doing. And they may be, and they may show up as super engaged. But they're also burned out one out of five. And those are the people that – And I think every manager, if you've been doing it very long, you've had the situation where someone resigns from the organization and somebody comes to you and is like, “What happened? Did you not see this coming? Did you miss something? What happened?” And you find yourself fumbling with this, “I don't know.” And the reason why you didn't know is because I showed all the classic signs of engagement. But we were missing these new and emerging signs of burnout.

And so it's something that as leaders, as we think about, really trying to retain our highest and best talent and really making sure that we try to manage turnover to its lowest level, lowest possible level. That phrase, understanding what that silent burnout might be inside your organization is very, very important. And it is interesting when you share that with leaders how that shocks them when you say, “Hey, one in five of those of those engaged employees are burned out.”

And then you tell that story, John, that we’re just sharing of, “Have you had somebody that's left?” That you're like, “I can't believe that.” And everybody has, and it drives the point home, but it does require you to take another look beyond engagement really to get at burnout.

[00:20:12] JL: And I know that we have just probably caught the ear of some leaders who are listening to this podcast right now. And they're going, “Okay, now that I'm a little paranoid. And I can't rely on my engagement surveys and just general feedback.” Victoria, what should they be asking? What do they need to be looking for to help somewhat keep these folks a little bit more in alignment with moving forward as opposed to suffering some level of burnout? What do they do?

[00:20:48] VG: John, I think that's so good. And one of the things that Scott and I were on a meeting earlier today talking about is the concept of awareness. So hopefully, we are bringing a little bit of awareness that maybe didn't exist before about this really interesting space, this concept of silent burnout in those folks that we really want to make sure are taken care of inside of our organization.

So a couple of things that we're suggesting is to prioritize self-care, right? Be able to step away and take a space away from the workplace when you need to and get a little bit more concentrated on what makes sense for you. For some folks, that's going to look like yoga classes, or it might look like some other health and well-being. But some folks don't need that at all. Because to add a yoga class, just as one more thing you've got to do. So that's not necessarily helpful for everybody. So I think it's really important to prioritize what works for you and for our leaders to tell us that we have that ability to do what we need to do for ourselves. To shift to perspective, and then to really let your employees shift their perspective in a way that meets their needs. Again, I think it comes back to the organization. Understanding what the individuals that are collectively what make up the organization, what they need, and how they need to experience it.

[00:22:19] SS: Well, I'm just trying to get the thought of me taking a yoga class out of my mind outside of that. In addition to the individual things, which I think are important for people to keep in mind, I think it's important for leaders to keep that in mind both for themselves and the people inside of their organization. I'd give the advice that we give our clients. And it's really, there're sort of three steps, if you will, to try to wrestle to the ground some of the burnout issues that people are really concerned about and how that burnout turns into turnover. And that said, the first thing that I'd say to anybody is you need to get a full picture of where your organization really is. And I just stressed that engagement surveys aren't enough. I think we talked about that topic enough, is that you need to go a bit deeper than that.

And so our clarity analytics platform is meant to help clients do just that is really to begin to look at readiness, burnout and optimism, and the catalysts that really will help you as an organization move forward and beyond those challenges. So I think the first thing is to get that full picture. That's beyond traditional engagement scores.

I think the second thing is, and we touched on it, is to recognize what a role organizations play, and be clear not just in the elements of our health plan. Those things are really important. So all kidding aside, when we begin to think about those mental health benefits, when we begin to think about those wellness benefits, those things are very important and an important part of the picture. But that's just one side. What's your organizational design? What's your thought process on leverage? What's your thought process on workload? What are those things that you can do inside your organization to make it more resilient, but also help organizations as they're moving through? What is a profound time for all of us? So that's sort of number two.

And then number three, and this is a connection to that last one, is move upstream. Victoria mentioned this just a little bit ago, is lots of times organizations spend hundreds of thousands, millions of dollars as their hand-wringing over engagement surveys and turnover statistics, etc., etc., is that's too late. Where organizations need to do is really upstream. Begin to think about those things as you're looking at morale, as you're looking at motivation. What are the things you can do before people depart? Make those changes inside the organization before you suffer the consequences, so that ultimately you can begin to move the organization forward.

So just those three steps, is getting that clear picture, really begin to understand and appreciate the influence you as an employer have when it comes to burnout. And then finally, move upstream. Get to those things that really are the cause of burnout and turnover, and really make them a priority as you look into the New Year. So that's what I'd say. That's what we share with our clients. And that's what I'd share with the audience, is just those three simple steps, if you will, to try to get at this problem.

[00:25:38] JL: Yeah, simple, yet profound, and something that we all as leaders need to take very seriously moving forward. Because this is kind of a new era in human engagement and employee retention and employee satisfaction, right? So let's all pay attention to this right?

[00:25:56] SS: Gosh! Victoria and I talked about that quite a bit, John. That could not be more spot-on. We are in a new and different world. And, really, having that flexibility as leaders to understand and interpret and be flexible themselves as they approach this environment is really, really important. So spot-on comment there.

[00:26:15] JL: Yeah. Well, Victoria, Scott, thank you so much for being with us today and sharing your insights, the work that you're doing, I'm sure with organizations around the country is incredibly valuable. And it just piqued, I think, so many interest levels today as you shared your insights. So thank you for being with us today.

[00:26:36] SS: John, our pleasure.

[00:26:37] VG: Thanks, John.

End of Interview

[00:26:40] JL: Thank you for joining us today on GrowthCast with our guests, Scott Spohn, partner and leader of DHGs healthcare and advisory people and change practice. And Victoria Grady, DHGs professor in residence, researcher and thought leader on human behavior. I'm your host, John Locke, and I look forward to reconnecting with you soon on another episode of DHG GrowthCast. Until then, be sure to rate, review and subscribe to DHG GrowthCast on Apple Podcast, Spotify, or Podbean.

End of Episode
About DHG's GrowthCast

At DHG, our strength lies in our technical knowledge, our industry intelligence and our future focus. We understand business needs and are laser focused on company goals. In this ever-changing world, DHG’s Growthcast, provides insights and thought -provoking conversations on topics and trends that address growth opportunities and challenges in the current and future marketplace. Join us in discussing tomorrow’s needs today.

Disclaimer: The views and concepts expressed by today’s guests are their own and not those of Dixon Hughes Goodman LLP. Always consult with your legal and financial professional before taking any action.


Scott Spohn
Partner, DHG Healthcare

Dr. Victoria Grady
Professor-in-Residence, DHG Healthcare

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