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Saturday, May 26, 2018

On Well-being

Physician burnout and mental health have been on my mind lately. Considering the many articles I’ve read recently on these topics, I’m sure it’s been on your mind too. I’m part of an initiative at my organization to address physician burnout and improve wellness among staff, both at the individual and systemic levels. I find this recent article on Kevin MD an interesting idea. Given all the metrics we tailor our system to based on patient care, safety and satisfaction, it’s an innovative twist to ask that our wellness, or lack thereof, be a goal marker as well.

Ultimately, our well-being affects how well we care for our patients and even their outcomes. The cynical part of me thinks the only way we can really get our healthcare system to change and address the epidemic of physician burnout is to tie those levels to dollar signs. There is a strong argument for the financial benefits of physician wellness and many organizations seem to be acknowledging that reality and investing more in this issue.

As mothers and physicians we’re used to putting others’ needs before our own. But I’ve realized over the years that I’m a better caregiver - to my children and to my patients - when I’m practicing good self-care. In the world of healthcare though, systems need to be in place to support that ability.

What are your thoughts? What has been successful or not so successful at your organization? Has your workplace found ways to encourage not only personal resilience but also support an organizational culture of wellness?

6 comments:

  1. I think our residency program has made some important strides with this. We are now able to get relieved from our ORs for a couple of hours to attend doctors appointments and meetings, which was previously impossible, and now permitted to take the few personal days we have. The GME office has also stated that it will require programs to give residents 4 weeks of vacation per year rather than three, and the number of personal days residents can take recently increased by one per year. The program is also more attuned to the idea that residents have families and lives. Overall I think the changes have been positive.

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    1. That’s great to hear. I didn’t have kids when I was in residency but I can imagine there would be unique challenges for residents with families. I think a cultural shift is needed to address this issue for physicians-in-training and those out in practice. It sounds like the GME is making a start.

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  2. My program has a new wellness committee and they've been able to get us a few social workers so we spend less time on sw. They are trying to set up emergency child care as well but unlikely that it'll happen his year. We now have wellness days as well which is nice for going to apppointments for self and kids. We also have free passes to a nearby gym, discounts on theatre tickets and select sporting events

    They've done other stuff like free lunches and ice cream socials which I think is a load of BS in terms of addressing actual wellness.

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    1. The wellness days sound great but do you feel like leadership at your organization is invested? I think there needs to be concrete cultural and leadership investment for front line staff to feel like there’s real buy-in to wellness.

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  3. I used to think finding some brand of "part time" was the key to eventual balance; now that I'm about to start a[n academic] job, I learned that while something that is truly "part time" is possible, it sounded like a lot of work and difficulty. But there are things that are essentially what I am going for (basically, being able to scale the work load to what I want, even if it means going a bit slower and taking a bit less pay, provided it is proportional) that are still considered "full time" and get full time benefits. Part time might mean getting a full friday totally off every week, but may come with issues of finding someone to cover you (forever... who's going to do that??) vs full time means technically you have to be available Friday but no one here's micromanaging provided you get your work done. I guess later you can negotiate your RVU goals, but I'm not at that point. IDK, knowing me I'll still fill everything up but it's a nice idea.

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  4. It's a balancing act... there is no true work-life balance. There is work and there is life. Sometimes life requires more of you. Sometimes work requires more of you. Coming to terms that you are human and can only do so much is probably the first step, or at least it has been for me.

    I've chronically been the Yes person. Just this year, I started saying No and guess what? The world didn't crumble and they found someone else to do the thing. I have also learned that when you give someone a no, if you can recommend someone else for the task, it doesn't feel like a No.

    Part of the reason I love my academic job is much like Spiffystuff mentions above in that my academic time is my own, not being micromanaged. If I want to spend the afternoon with my kiddo running around the park, the compromise is that I work on work after bedtime.

    Burnout is real and contributes to depression, anxiety, relationship stress, work stress and unfortunately lost careers and lost lives. Without institutional support and organizational change, the global climate for wellness is unlikely to change, IMHO. We do have some control over ourselves and how we react to those systems, however. You will never get what you don't ask for. Furthermore, if you're not getting what you need to keep you sane, you'll have to identify your tipping point and sort out when to transition if that's what it comes to.

    All the support and virtual hugs!

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