Psychotherapy with a soul.
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It is possible to improve the health of employees by changing the organization of work towards a situation with reasonable psychological work demands, improved skill discretion and improved decision latitude. Improvements should also be directed towards increased social support to colleagues and superiors. Improvements in work organization can reduce not only musculoskeletal, gastrointestinal, and sleep problems, but also sick leave and staff turnover. Occupational health physicians should have a crucial role in the implementation of these findings.
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After more than 20 years in health care, including at least a decade in leadership, this day was perhaps my darkest on the job. Since becoming chief operating officer of this Catholic hospital, I, with the help of my management team, had struggled to find answers to apparently overwhelming financial and operational challenges. I had been forced to make tough decisions in the pursuit of financial stability. In round-the-clock meetings, my team and I (with the assistance of a consulting firm whose specialty was turnarounds) had dissected every aspect of the operation. I had compared the performance of the hospital to industry benchmarks, never wanting to be unfair in expecting more from my staff than others had accomplished. In fact, in every decision I made I tried to be fair, weighing the different interests at stake before choosing a course of action--all the while knowing that, no matter what, I would make someone angry. Those around me, instead of recognizing my efforts to be fair, seemed to feel they had been betrayed. The whole organization was dispirited. My medical staff support was eroding as physicians refocused their practices at other facilities not faced with the challenges I had to address. Local leaders roundly criticized me for what they saw as abandoning the community's needs in the interest of serving the hospital and its bottom line. Then came the most hurtful news of all. My employees had filed a petition for representation by a union. It was not that I had a problem with organized labor. But how could an organization that I led have come to a place where the staff felt so abandoned by my leadership that they needed someone else to represent and protect their interest? Hadn't I tried hard to educate the staff about the changes in health care reimbursement? Hadn't I told them that the very existence of the hospital was at stake? Didn't they see how hard I worked, how much I cared? What was I to do now?
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