Absence of Fairness – An Overlooked Driver of Healthcare Burnout

There are six key drivers of burnout described in Maslach and Leiter’s classic book The Truth about Burnout. The fifth of these is Absence of Fairness. 

A workplace is perceived to be fair when three key elements are present: trust, openness, and respect.  This makes intuitive sense.  When we trust the people we work with, we can be more open about our feelings and our performance. This openness with each other is not possible without mutual respect.

Absence of fairness takes place at a macro and micro level.

At a macro-level, the job that doctors and nurses thought they were signing up for early in their careers bears little resemblance to the job they are doing now. Between increasing time and financial pressures, and increasing impact of technology on patient care delivery, it feels like there has been a “bait and switch”.

Particularly with societal changes and breakdown in civility, there are challenges with trust, openness, and respect from patients. Clinicians feel these challenges deeply and are questioning whether they would make the same career choice today that they did when they were younger. Many are seriously considering ending their clinical careers years, or decades, earlier than their original plan.

On a micro-level, absence of fairness happens in situations where people are treated, usually by the leader of their work unit, not based upon their contribution to the team, but based on issues they have no control over, such as their gender, race, country of origin, or sexual orientation. This has a direct impact on self-esteem.

Ensure Fairness on all Healthcare Team Members

It’s easy to see how such discriminatory treatment violates the trust, openness, and respect and have a significant negative impact on team effectiveness.

As a leader, no matter if you lead a team as small as 2-3 people, or as large as an organization with 20-30,000 employees, ensuring fairness for all team members provides a solid foundation for improving your organization’s culture and performance.

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