Caring Leadership Prevents Burnout and Improves Healthcare Outcomes
TL;DR
- Prioritizing "taking care of your people" as a leader, mirroring military strategy, prevents mission failure by ensuring the healthcare team's well-being, which directly impacts patient care quality.
- Investing in leadership development for healthcare professionals, rather than assuming technical competence equates to leadership skill, mitigates costly turnover and improves organizational performance.
- Implementing "caring" leadership behaviors, beyond mere compliance, fosters employee commitment and reduces turnover, offering a significant return on investment compared to replacing staff.
- Healthcare systems often leverage provider altruism to avoid fixing systemic issues, leading to burnout and potential shortages, underscoring the need for proactive culture change.
- Leaders who empower their teams by fostering psychological safety and balancing challenge with support create environments where both staff well-being and patient care outcomes improve.
- The high cost of replacing physicians ($500k-$1M) necessitates investing in support staff and better nurse-to-patient ratios, which enhance care safety and reduce financial strain.
- Empowering healthcare professionals with agency and the permission to say "no" to non-essential tasks can combat burnout and improve focus on core responsibilities.
Deep Dive
Caring leadership, particularly in high-pressure fields like healthcare, is not merely a soft skill but a strategic imperative that directly impacts outcomes and prevents costly burnout. The core argument is that leaders who prioritize the well-being and development of their teams foster environments where individuals are motivated to excel, ultimately leading to better mission accomplishment and reduced turnover. This approach, rooted in military principles of soldier care and extended to civilian professions, offers a powerful antidote to pervasive burnout and a pathway to sustained high performance.
The effectiveness of caring leadership stems from its ability to cultivate commitment over mere compliance. When leaders actively invest in their people through genuine support, mentorship, and development, they foster a sense of psychological safety and belonging. This, in turn, allows individuals to perform at their best, as demonstrated by the military's emphasis on checking soldiers' feet for blisters to ensure they can complete a march, or ensuring soldiers eat before leaders do. These seemingly small acts signal a deep commitment to the team's welfare, a principle directly transferable to healthcare. In this context, prioritizing team well-being--whether by reducing nurse-to-patient ratios or providing adequate support staff for physicians--is not just ethically sound but economically prudent. The cost of replacing a physician can range from $500,000 to $1 million, making proactive investment in retention through supportive leadership a clear financial advantage.
Furthermore, the absence of effective leadership training contributes significantly to burnout and suboptimal performance. Many individuals are promoted to leadership roles based on technical expertise rather than managerial aptitude, leading to a leadership vacuum. This gap is particularly evident in healthcare, where providers often feel compelled to work excessive hours or take on tasks out of perceived obligation, rather than through conscious choice. By encouraging leaders to challenge assumptions, pilot new approaches, and empower their teams with agency, organizations can move beyond a reactive, compliance-driven model to one that fosters proactive prevention of burnout. This shift is crucial, as burnt-out providers deliver less safe care, leading to poorer patient outcomes and decreased patient satisfaction.
Ultimately, the most significant implication is the potential to avert a critical shortage of healthcare professionals. As experienced providers, particularly those in mid-to-late career, leave or reduce their hours due to unsustainable work environments, the system faces increased strain. Embracing a culture of caring leadership offers a tangible solution, not only by improving the well-being of current staff but also by making these professions more attractive and sustainable for future generations. The consistent application of caring principles, from daily interactions to strategic organizational change, can create a ripple effect that enhances both individual fulfillment and collective success.
Action Items
- Create leadership development framework: Define 3 core competencies (feedback, conflict resolution, time management) for all new managers.
- Audit team support structures: Assess 5 key processes (e.g., onboarding, performance reviews) for potential burnout contributors.
- Implement "care for your people" initiative: Establish 2 regular touchpoints (e.g., weekly check-ins, monthly team retrospectives) to foster psychological safety.
- Develop primary prevention strategy: Identify 3 systemic issues in current workflows that lead to employee burnout.
- Measure leadership impact on turnover: Track retention rates across 5-10 teams with varying leadership styles over 6 months.
Key Quotes
"The primary thing that I took from the military training is that our job as leaders or in my case an officer in the military was to take care of my soldiers and when I was working in a joint environment take care of my soldiers sailors and airmen and it was really that emphasis that look you can't accomplish the mission if you're not taking care of your people at the end of the day generals admirals don't win wars they create great strategy and great plans but if there aren't soldiers sailors airmen and marines to carry out those missions it's not going to be effective."
Dr. Hartzell explains that a core lesson from his military leadership experience is the paramount importance of taking care of one's team. He emphasizes that mission success is contingent upon the well-being and capability of the personnel executing the plans, highlighting that strategic brilliance alone is insufficient without the people to carry it out. This principle, he suggests, is directly transferable to other high-stakes environments like healthcare.
"The same for healthcare you really need to have leaders who understand that if we don't take care of the healthcare team and the healthcare team is large right physicians nurses physical therapists pharmacists front desk techs the people who sterilize our equipment all of these folks are part of our healthcare team and if we don't do a good job taking care of all of them then we're potentially jeopardizing the ability to provide the best patient care that we possibly can and that lesson was a direct carryover from many of the things I learned in the military."
Dr. Hartzell draws a direct parallel between military and healthcare leadership, asserting that leaders in healthcare must recognize the critical role of their entire team. He lists various roles within a healthcare setting, underscoring that the collective well-being of all these individuals is essential for delivering optimal patient care. This perspective, he notes, is a direct application of the lessons learned in his military career.
"My biggest fear or concern is that if we don't really embrace culture change we're going to have significant shortages of healthcare providers as we have an increasingly aging population which is really a recipe for disaster with those two things happening at the same time."
Dr. Hartzell expresses significant concern about the future of healthcare if systemic issues are not addressed through cultural change. He predicts that a failure to improve work conditions and culture will exacerbate existing shortages of healthcare providers, which, when combined with a growing elderly population, creates a potentially disastrous scenario. This indicates a worry about the long-term sustainability and quality of care.
"The only thing I would say Dex I think just this is going to air on Christmas which is awesome that's exciting for me the thing I've really been thinking about is twofold one is on a daily basis we interact with a certain number of people and that may be a few people it may be a lot of people but every one of those interactions is really an opportunity for us to think about how can I positively impact this person's life and it could be as simple as a smile right it could be as simple as holding the door for somebody who's walking out of the grocery store carrying their groceries and looks like they are going to struggle it could be having a mentoring conversation with somebody but this idea that all of these interactions are opportunities for us to positively impact that person's life which in and of itself is worthwhile and important and we should feel good about i feel good about these interactions but then recognizing that each one of those interactions that person then goes and interacts with somebody else so these positive interactions can have this ripple effect throughout your team your organization your family your community so really as we think about going into 2026 like why don't we try to make this the year where all of us with what we can control are trying to positively impact the lives of those closest to us that would make 2026 a banner year in my mind."
Dr. Hartzell shares a reflective thought about the power of daily interactions, suggesting that each encounter is a chance to positively influence another person's life. He illustrates this with simple examples like smiling or assisting someone, emphasizing that these small acts can create a ripple effect. Dr. Hartzell proposes that focusing on these positive impacts within our control can lead to significant improvements across our communities and advocates for making this a conscious effort.
"The only thing I would say Dex I think just this is going to air on Christmas which is awesome that's exciting for me the thing I've really been thinking about is twofold one is on a daily basis we interact with a certain number of people and that may be a few people it may be a lot of people but every one of those interactions is really an opportunity for us to think about how can I positively impact this person's life and it could be as simple as a smile right it could be as simple as holding the door for somebody who's walking out of the grocery store carrying their groceries and looks like they are going to struggle it could be having a mentoring conversation with somebody but this idea that all of these interactions are opportunities for us to positively impact that person's life which in and of itself is worthwhile and important and we should feel good about i feel good about these interactions but then recognizing that each one of those interactions that person then goes and interacts with somebody else so these positive interactions can have this ripple effect throughout your team your organization your family your community so really as we think about going into 2026 like why don't we try to make this the year where all of us with what we can control are trying to positively impact the lives of those closest to us that would make 2026 a banner year in my mind."
Dr. Hartzell shares a reflective thought about the power of daily interactions, suggesting that each encounter is a chance to positively influence another person's life. He illustrates this with simple examples like smiling or assisting someone, emphasizing that these small acts can create a ripple effect. Dr. Hartzell proposes that focusing on these positive impacts within our control can lead to significant improvements across our communities and advocates for making this a conscious effort.
"To me it's simple it's take care of your people they will take care of the mission you know this idea that as leaders it's part of our job to help take care of others and i think as humans it's part of our job or should be part of our job to take care of others so just that idea that if you take care of others it's going to lead to good things in your organization."
Dr. Hartzell distills his core leadership philosophy into a concise statement: "take care of your people, they will take care of the mission." He posits that caring for others is not only a leader's responsibility but a fundamental human duty, and that prioritizing the well-being of one's team will ultimately lead to positive organizational outcomes. This principle serves as the central takeaway message from his perspective on effective leadership.
Resources
External Resources
Books
- "A Prescription for Caring in Healthcare Leadership" by Dr Joshua Hartzell - Mentioned as the author's recently written book on building a culture of compassion and excellence in healthcare leadership.
- "Dichotomy of Leadership" by Jocko Willink - Mentioned for a quote about leaders needing to train their people hard to ensure they can return home safely from conflict.
- "Essentialism" by Greg McKeown - Mentioned as a life-changing book that emphasizes the idea that individuals have choices and can prioritize what is truly important.
People
- Dr Joshua Hartzell - Guest, retired US Army Colonel, physician, author, speaker, coach, and teacher on leadership development.
- Dex Randall - Host of the Burnout Recovery podcast, author, and coach.
- Greg McKeown - Author of "Essentialism."
- Jocko Willink - Author and speaker known for his views on military leadership and caring.
Organizations & Institutions
- US Army - Mentioned for its emphasis on leadership training and taking care of soldiers.
- Uniformed Services University - Mentioned as the United States' military medical school.
- Walter Reed National Military Medical Center - Mentioned as the location where Dr. Hartzell served as program director for the internal medicine residency program.
Websites & Online Resources
- LinkedIn - Mentioned as the platform where Dex Randall discovered Dr. Hartzell's posts.
- dexrandall.com - Mentioned as the website where listeners can book a consultation with Dex Randall.
Other Resources
- Burnout Recovery podcast - Mentioned as the podcast hosted by Dex Randall, focused on helping professionals recover from burnout.
- Military medicine - Discussed as Dr. Hartzell's area of expertise and career focus.
- Leadership development - A central theme discussed throughout the episode, focusing on effective and humane leadership practices.
- Healthcare leadership - Discussed in comparison to military leadership, with an emphasis on caring and people-focused approaches.
- Performance plans - Mentioned in the context of HR involvement and employee management in healthcare.
- Compliance vs. Commitment - A concept discussed in relation to HR practices and employee engagement.
- Primary prevention - Discussed as a strategy to prevent burnout and employee turnover in healthcare.
- Nurse turnover - Mentioned as a significant cost to healthcare organizations.
- Physician shortage - A concern raised regarding the potential impact of poor work conditions and culture in healthcare.
- Interpersonal skills - Identified as a key area where physician leaders seek training, including conflict resolution and feedback.
- Time management - Another key area where physician leaders seek training to prevent burnout.
- Psychological safety - Discussed as a crucial element for healthcare teams to thrive.
- Physician altruism - Mentioned as a factor that some healthcare systems may exploit by not fixing systemic problems.