Could leadership training for doctors and nurses fight burnout? This new venture is betting on it

By Beth Kutscher, Senior Managing Editor at LinkedIn News

There’s a sentiment that comes up quite a bit among clinicians, whether they’re responding to Amazon buying One Medical or cuts to Medicare reimbursement.

And that’s a fear that autonomy is being taken away from them. 

The people who are calling the shots in healthcare often aren’t frontline doctors and nurses, but they’re making clinical decisions like how long a patient visit should last and which drugs and treatments will get insurance coverage. 

For some healthcare professionals, the past two and a half years have been a reckoning, prompting many to quit and do something else entirely. 

But a new startup believes it can empower doctors and nurses in another way: with knowledge and leadership training.

Russell Holman MD, MHM is a physician who’s spent his career on the business side of healthcare, most recently as chief medical officer of Lifepoint Health, the private equity-backed hospital operator based in Brentwood, Tenn. Now he’s undertaking his own venture, 1821Health, that will focus on providing short, digestible training courses – seven to 14 minutes in length – on topics like conflict resolution and how to build respect. Think MasterClass, but for healthcare.

“It dawned on me that leadership development is exclusive by nature and it’s exclusive to those people with that title or rank,” Holman said. “And yet those at the frontline arguably not only need it the most but are the most valuable people in any organization.”

Holman, you might recall, has a lot of thoughts about burnout in the profession – or what he prefers to call “structural violence.” Those institutional failings can’t be solved with a meditation app or other wellness initiatives, he says, offering the analogy of a nuclear power plant.

“If there is a radiation leak from the reactor, we can tell people to just throw on a couple of extra suits,” Holman said, “or we can actually go try and fix the leak. 1821 health is really focused on trying to repair that leak.”

An edited transcript of our conversation is below. 

And tell me: What will it take to restore that sense of autonomy for healthcare professionals? To what extent would leadership training empower clinicians in their workplaces?

LinkedIn News: What are you trying to achieve with 1821 Health?

Holman: Everyone in healthcare is well trained in their narrow particular focus. But no one has had five minutes of training in terms of how to resolve conflict, how to build respect in the workplace, how to build trust, how to build culture, how to be part of a change initiative – none of those things are ever taught.

And it’s that knowledge that is within the hands of the few that have leadership roles and titles, but it’s the people at the frontline that need it the most.

When we look at healthcare and who gets appointed into leadership and management roles, it’s often a nurse who was a really good bedside nurse who’s tapped to be the nurse manager. Or it’s a good doctor, and we say, Okay, you’re going to be the next medical director. But there is no training and no preparation and they’re often thrust into roles that they were not prepared for.

LinkedIn News: How does this training help people who will stay in their clinical roles?

Holman: In my career, I have heard a number of CEOs stand up in a town hall format and make a pronouncement that everyone here is a leader. Those words sound really strong and they sound really motivational. The challenge is that when you walk away from the town hall, and you get back into your workplace, you wonder, Okay, how is this actually going to work? Because empowerment means that you have new skills or new abilities to be able to apply in your workplace. 

What it looks like at a frontline level is if you are imparted with these skills and you build these skills, then you are better equipped to be able to make decisions and improve the broken processes and the undesirable parts of the culture that you’re working within. Without it, you are left powerless and you have this growing sense of lack of ability to impact your environment which, of course, leads to burnout and stress and feeling helpless within the workplace.

It’s a noble desire to want to empower people. but it has to be followed up with concrete action. And if we’re not developing those skills, then we’re simply saying the words without being able to fulfill them. 

LinkedIn News: What happened to training budgets during covid?

Holman: Training and training budgets absolutely went out the window. If there was training, then it was trying to catch up on emergency preparedness procedures on things like the use of protective equipment and isolation procedures. It was singularly focused on how do we get through this; we are so unprepared.

LinkedIn News: If budgets are being cut, where is the financial incentive to invest in this program?

Holman: When you look at organizations of all types, there is always some budget allocation for leadership development and leadership training. But it tends to be very expensive.

And when I say expensive, it’s not only in terms of the dollars, but in terms of the time commitment required for those select few that have been pulled out. They are actually removed from the workplace, so they are not able to be productive during that period of time.

The learning that takes place when people are pulled out of their environment is often falling short of its promise, because you are not in a real situation. We learn best when we are learning something and applying it in real time.

LinkedIn News: How does leadership training address burnout?

Holman: Burnout is a very deep and emotional topic for me, and there’s a way of thinking about burnout that I don’t see talked about very much at all. That term is called structural violence, which means that the violence or the harm that comes to people is actually emanating from the environment in which they work.

The interventions that are being done regarding burnout are all about individual wellness. I’m not saying all those things are wrong. But I am saying that you can do all those things, and if every day, when you walk through the door to work you’re immersed in a harmful environment, then all of these things over here are going to have relatively little impact so i’m all about resilience building.

I’m far more interested in helping fix the broken systems and culture from the inside out.