MEMA Seeks to Identify the Signs, Contributing Factors and Provider Perceptions


Everyone knows that working as a clinician in the emergency department is an intense endeavor– but how can you identify when there’s a problem and address it before it comes at a significant cost? According to the Agency for Healthcare Research and Quality, clinicians who are burned out are more likely to leave the practice. In addition, burnout has been linked to problems with patient safety and quality since it can impact clinician’s ability to practice.


That’s why the Mid-Atlantic Emergency Associates (MEMA) decided to conduct a comprehensive evaluation of job-related burnout throughout their practice. Founded in 1976, MEMA is a physician-owned team of more than 75 emergency and acute medical care clinicians that serves the greater Charlotte and Piedmont areas of North Carolina, and the team that staffs Novant’s Charlotte-area emergency departments.


Tim Lietz, CEO MEMA (Center) and members of NCPHP

For this project, MEMA engaged the North Carolina Physicians Health Program (NCPHP) to learn more about job-related burnout and to conduct a survey that would benchmark their clinicians’ perceptions related to burnout. The NCPHP is a non-profit organization designed to support the well-being and recovery of clinicians who may be struggling with conditions (such as burnout) that could impair their ability to safely provide care and services to their patients.  After decades of supporting physicians, NCPHP has significant expertise in burnout and the costs that come with it.


Facts on Provider Burnout (According to NCPHP)

  • Provider burnout is progressive in nature and can only be alleviated when the underlying causes are identified and addressed.
  • The three hallmark signs of burnout include: emotional exhaustion; depersonalization (cynicism); and a lack of personal accomplishment, or inefficacy.
  • Five major contributors to toxic work environments within medicine include: the mandated utilization of electronic health records; increased regulations; the Affordable Care Act; the increase in physician group acquisition by hospitals (loss of independence); and pay-for-performance compensation models.
  • The cost of replacing one physician ranges from $250,000 to $1.2M. The cost to replace a physician assistant or nurse practitioner ranges from 1.5 to 3 times their annual salary.


The survey, administered to clinicians in October 2018 was conducted to help MEMA identify the causes and effects of burnout in the emergency department – as well as to benchmark how MEMA clinicians are faring when compared to similar physician groups.


“As physicians, we know burnout is a hazard that comes with incredible costs – the most important being the mental health of our team,” explains Tim Lietz, MD FACEP, President and CEO of MEMA “At MEMA, we’re striving to better understand the underlying causes and early symptoms of burnout so we can protect our providers, our patients and the communities we serve,” says Dr. Lietz.


The survey included 45 questions – all designed to gauge MEMA providers’ perceptions across six key areas that correlate to provider burnout, including: workload, control, reward (compensation), community, fairness, and values. The NCPHP explains that “mismatches” in these areas significantly contribute to burnout. For example, a clinician who feels overworked, a lack of control, under-compensated, lack of community or conflicting values (from their employer) are more likely to experience burnout.


“When NCPHP came to present the survey findings to us, we were anxious to hear the results,” explains Dr. Lietz. “We were thrilled to see that the overall feedback was very positive when compared to the broader physician population. While we did identify some areas of opportunity, we learned that our clinicians feel supported by leadership and appreciate a sense of community, fairness, and reward – all of which are key factors in avoiding burnout.


The NCPHP encouraged MEMA to continue implementing strategies to foster engagement, while continuing to monitor and evaluate the six potential mismatches that can lead to burnout. Research suggests that organizations that take steps to mitigate burnout may avoid problems in patient safety and quality, as well as costly turnover.


Dr. Lietz concluded, “MEMA is committed to our exceptional clinicians and most importantly to our patients, so we recognize that maintaining a focus on preventing burnout and fostering a healthy work environment will be a key factor in providing high-quality emergency care to our patients.