I’m (MK) joined by several experts, Dr. Daven Morrison (DM), Dr. Greg Couser (GC), and Dr. Andrew Brown (AB), all of whom are psychiatrists and published authors on burnout, to explore the crucial problem of physician burnout and how we can begin to address it.

MK: In your work, you talked a lot about ESG. Can you define that term and talk a bit about why it matters to this conversation on burnout?

DM: ESG is an acronym for environment, social and governance. Essentially, the environment is what are you doing to ensure that the planet is a healthy planet to live on. Are you actively looking to reduce your carbon footprint or doing something else along those lines to keep, basically, planet Earth healthy? The “S,” social, is more along the lines of race, gender, and issues related to DEI [diversity, equity, and inclusion]. How systematic, how thoughtful, how comprehensive is the organization around addressing that? And finally, G is for governance. How carefully, how thoughtfully, how comprehensively are you governing or managing your organization? The broader term that ESG is used interchangeably with is sustainability.

ESG was really motivated by the millennials in a lot of ways, asking questions about endowments, asking questions about, is there something more than shareholder value? Asking questions about, look at the boards of these companies, look at the makeup of who’s governing these organizations our university is invested in, look at what you say you’re about, look at what you’re actually about. There were several fairly progressive or forward-looking organizations that really targeted ESG in terms of their investments. And there’s a larger community of investors in ESG whose investments are fairly significant now … as much as $53 trillion.

And that brought me to the idea of H in between all three of them, the E, the S, and the G, is, “How are we thinking about the human being?” There are mistakes that are made because of burnout that harm patients. If there’s this energy, there’s investment in the scale of $53 trillion, could we introduce a dialogue between management and the physicians about monitoring and measuring burnout?

MK: How do we incorporate ESG into emergency medicine?

DM: I think that’s the natural next step of a dialogue like this. How do you build the case that it does make a difference to the proverbial numbers-crunchers, with the green-eyeshade-wearing CPAs. How do we build a case ahead of time before we’re at the desperate moment, and the hospital’s about to close, or they have to shut down different services?