Faculty wellness in academic medicine: Addressing stressors in the workplace

Work ◽  
2021 ◽  
pp. 1-7
Author(s):  
Claudia Finkelstein ◽  
Anne Ordway ◽  
Kurt L. Johnson
Keyword(s):  
Health Care ◽  
Organizational Context ◽  
Well Being ◽  
Professional Autonomy ◽  
Individual Responsibility ◽  
System Level ◽  
Physician Burnout ◽  
Structured Interviews ◽  
Physician Wellness ◽  
Promotion System

BACKGROUND: Burnout is widely regarded as a syndrome resulting from chronic occupational stress. While physician burnout has been the subject of extensive research, physician wellness has been proposed as an alternative framework for understanding physician distress. OBJECTIVE: The purpose of this qualitative study was to understand the organizational context of faculty wellness within an academic health care system. METHODS: Semi-structured interviews were conducted with 24 chairs of clinical and non-clinical departments in a US university school of medicine. RESULTS: Chairs described several system-level factors perceived to interfere with faculty wellness such as a stricter regulatory environment, the loss of professional autonomy, the up or out promotion system, limitless hours, and the rise of shadow work. While all chairs articulated some degree of responsibility for the wellness of their faculty, some said they lacked the skills or knowledge of resources to fully engage in this role. CONCLUSIONS: Findings from this study are consistent with recent research on physician burnout, which has pivoted from describing burnout as an individual responsibility to including the professional, organizational, and societal factors which likely contribute to physician job satisfaction and well-being. As health care organizations, including academic medical centers, move toward systems-based solutions for physician occupational health, it will be incumbent upon organizational leaders to make administrative decisions favoring physician wellness.

PERSPECTIVE: No person left behind: improving physician wellness in Canada

2021 ◽  
Vol 7 (2) ◽  
pp. 67-71
Author(s):  
Jason Chaulk
Keyword(s):  
Health Care ◽  
Care Delivery ◽  
Well Being ◽  
Psychosocial Health ◽  
Provincial Government ◽  
Government Support ◽  
System Level ◽  
National Guidelines ◽  
Physician Wellness ◽  
Canadian Health

Canadian health care costs are unsustainable and are among the highest in the world. A greater focus on system-level initiatives is needed, and recognizing physician wellness as a quality indicator for health care delivery may be part of the solution. Physicians’ psychosocial health is a significant cause for concern and has been directly tied to patient outcomes. However, suicide rates among physicians are approximately 2.5 times those of the general population and burnout rates are twice those of other workforces. Investing in physician health programs (PHPs), specifically the components dealing with psychosocial issues, is one way to make medicare sustainable. Further, greater provincial government support of national guidelines for the formation of PHPs is needed. This commentary focuses on these background issues and suggests a path toward a more sustainable health care strategy focusing on physician well-being.

Building community during the COVID-19 pandemic: a system level approach to physician well-being

2021 ◽  
Vol 7 (4) ◽  
pp. 166-170
Author(s):  
Serena Siow ◽  
Carmen Gittens
Keyword(s):  
Emotional Health ◽  
Well Being ◽  
Shared Responsibility ◽  
System Level ◽  
Group Discussions ◽  
Physician Wellness ◽  
Physician Leaders ◽  
Building Community ◽  
Support Team ◽  
Emotional Strain

Before the COVID-19 pandemic, physician burnout was identified as reaching crisis proportions, and the pandemic is expected to worsen the already perilous state of physician wellness. It has affected physicians’ emotional health, not only by increasing workload demands, but also by eroding resilience under increasing pressures. The mental health consequences are expected to persist long after the pandemic subsides. With physician wellness increasingly recognized as a shared responsibility between individual physicians and the health care system, system-level approaches have been identified as important interventions for addressing physician well-being. In this article, we describe two evidence-guided initiatives implemented in our hospitalist network during the current pandemic: a trained peer-support team and facilitated physician online group discussions. These initiatives acknowledge the emotional strain of physicians’ work and challenge the “iron doc” culture of medicine. Our efforts build community and shift culture toward improved physician wellness. We suggest that the pandemic might be an opportunity for our profession to strengthen our support networks and for physician leaders to advance physician wellness in their work environments.

Prevalence and Workplace Drivers of Burnout in Cancer Care Physicians in Ontario, Canada

2021 ◽  
pp. OP.21.00170
Author(s):  
Simron Singh ◽  
Ashley Farrelly ◽  
Catherine Chan ◽  
Brett Nicholls ◽  
Narges Nazeri-Rad ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Care ◽  
Gynecologic Oncology ◽  
Maslach Burnout Inventory ◽  
Well Being ◽  
System Level ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Questionnaire Response ◽  
Mental Health Patient

PURPOSE: Provider well-being has become the fourth pillar of the quadruple aim for providing quality care. Exacerbated by the global COVID-19 pandemic, provider well-being has become a critical issue for health care systems worldwide. We describe the prevalence and key system-level drivers of burnout in oncologists in Ontario, Canada. METHODS: This is a cross-sectional survey study conducted in November-December 2019 of practicing cancer care physicians (surgical, medical, radiation, gynecologic oncology, and hematology) in Ontario, Canada. Ontario is Canada's largest province (with a population of 14.5 million), and has a single-payer publicly funded cancer system. The primary outcome was burnout experience assessed through the Maslach Burnout Inventory. RESULTS: A total of 418 physicians completed the questionnaire (response rate was 44% among confirmed oncologists). Seventy-three percent (n = 264 of 362) of oncologists had symptoms of burnout (high emotional exhaustion and/or depersonalization scores). Significant drivers of burnout identified in multivariable regression modeling included working in a hectic or chaotic atmosphere (odds ratio [OR] = 15.5; 95% CI, 3.4 to 71.5; P < .001), feeling unappreciated on the job (OR = 7.9; 95% CI, 2.9 to 21.3; P < .001), reporting poor or marginal control over workload (OR = 7.9; 95% CI, 2.9 to 21.3; P < .001), and not being comfortable talking to peers about workplace stress (OR = 3.0; 95% CI, 1.1 to 7.9; P < .001). Older age (≥ 56 years) was associated with lower odds of burnout (OR = 0.16; 95% CI, 0.1 to 0.4; P < .001). CONCLUSION: Nearly three quarters of participants met predefined standardized criteria for burnout. This number is striking, given the known impact of burnout on provider mental health, patient safety, and quality of care, and suggests Oncologists in Ontario may be a vulnerable group that warrants attention. Health care changes being driven by the COVID-19 pandemic provide an opportunity to rebuild new systems that address drivers of burnout. Creating richer peer-to-peer and leadership engagement opportunities among early- to mid-career individuals may be a worthwhile organizational strategy.

scholarly journals Improving community health networks for people with severe mental illness: a case study investigation

2015 ◽  
Vol 3 (5) ◽  
pp. 1-234 ◽  
Author(s):  
Vanessa Pinfold ◽  
Daryl Sweet ◽  
Ian Porter ◽  
Cath Quinn ◽  
Richard Byng ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Community Health ◽  
Well Being ◽  
Personal Networks ◽  
System Level ◽  
Network Type ◽  
Care System

IntroductionPolicy drivers in mental health to address personal recovery, stigma and poor physical health indicate that new service solutions are required. This study aimed to understand how connections to people, places and activities were utilised by individuals with severe mental illness (SMI) to benefit health and wellbeing.MethodsA five-module mixed-methods design was undertaken in two study sites. Data were collected from 150 network-mapping interviews and 41 in-depth follow-up interviews with people with SMI; in-depth interviews with 30 organisation stakeholders and 12 organisation leaders; and 44 telephone interviews with practitioners. We undertook a three-stage synthesis process including independent lived experience feedback, and a patient and public involvement team participated in tool design, data collection, analysis and write-up.ResultsThree personal network types were found in our study using the community health network approach: diverse and active; family and stable; formal and sparse. Controlled for other factors we found only four variables significantly associated with which network type a participant had: living alone or not; housing status; formal education; long-term sickness or disability. Diagnosis was not a factor. These variables are challenging to address but they do point to potential for network change. The qualitative interviews with people with SMI provided further understanding of connection-building and resource utilisation. We explored individual agency across each network type, and identified recognition of the importance and value of social support and active connection management alongside the risks of isolation, even for those most affected by mental illness. We identified tensions in personal networks, be that relationships with practitioners or families, dealing with the impact of stigma, or frustrations of not being in employment, which all impact on network resources and well-being. The value of connectedness within personal networks of people, place and activity for supporting recovery was evident in shaping identity, providing meaning to life and sense of belonging, gaining access to new resources, structuring routines and helping individuals ‘move on’ in their recovery journey.Health-care practitioners recognised that social factors were important in recovery but reported system-level barriers (workload, administrative bureaucracy, limited contact time with clients) in addressing these issues fully. Even practitioners working in third-sector services whose remit involved increasing clients’ social connection faced restrictions due to being evaluated by outcome criteria that limited holistic recovery-focused practices. Service providers were keen to promote recovery-focused approaches. We found contrasts between recovery ideology within mental health policy and recovery practice on the ground. In particular, the social aspects of supporting people with SMI are often underprioritised in the health-care system. In a demanding and changing context, strategic multiagency working was seen as crucial but we found few examples of embedded multisector organisation partnerships.ConclusionWhile our exploratory study has limitations, findings suggest potential for people with SMI to be supported to become more active managers of their personal networks to support well-being regardless of current network type. The health and social care system does not currently deliver multiagency integrated solutions to support SMI and social recovery.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Mothers’ Perceived Barriers to and Recommendations for Health Care Appointment Keeping for Children Who Have Cerebral Palsy

2019 ◽  
Vol 6 ◽  
pp. 233339361986897 ◽  
Author(s):  
Marilyn Ballantyne ◽  
Laurie Liscumb ◽  
Erin Brandon ◽  
Janice Jaffar ◽  
Andrea Macdonald ◽  
...  
Keyword(s):  
Health Care ◽  
Cerebral Palsy ◽  
Well Being ◽  
Rehabilitation Services ◽  
Structured Interviews ◽  
Care Needs ◽  
Care Services ◽  
Care Appointment ◽  
Appointment Keeping ◽  
Competing Priorities

Children with cerebral palsy (CP) require ongoing rehabilitation services to address complex health care needs. Attendance at appointments ensures continuity of care and improves health and well-being. The study’s aim was to gain insight into mothers’ perspectives of the factors associated with nonattendance. A qualitative descriptive design was conducted to identify barriers and recommendations for appointment keeping. Semi-structured interviews were conducted with 15 mothers of children with CP. Data underwent inductive qualitative analysis. Mothers provided rich context regarding barriers confronted for appointment keeping—transportation and travel, competing priorities for the child and family, and health services. Mothers’ recommendations for improving the experience of attending appointments included virtual care services, transportation support, multimethod scheduling and appointment reminders, extended service hours, and increased awareness among staff of family barriers to attendance. The results inform services/policy strategies to facilitate appointment keeping, thereby promoting access to ongoing rehabilitation services for children with CP.

Physician Wellness Is an Ethical and Public Health Issue

2018 ◽  
Vol 158 (6) ◽  
pp. 970-971 ◽  
Author(s):  
Rosandra Walker ◽  
Harold Pine
Keyword(s):  
Public Health ◽  
Well Being ◽  
Public Health Issue ◽  
Health And Wellness ◽  
Physician Burnout ◽  
Sustainable Change ◽  
Ethical Implications ◽  
Physician Wellness ◽  
Hospital Systems ◽  
The Impact

Attention to physician well-being has traditionally focused on substance abuse, usually with disciplinary implications. But, in recent years, greater notice has been granted toward physician burnout and overall wellness. Burnout and its sequelae not only affect physicians and physicians-in-training as individuals, but the impact then multiplies as it affects these physicians’ patients, colleagues, and hospital systems. In addition, the American Medical Association Code of Medical Ethics charges physicians with a responsibility to maintain their own health and wellness as well as promote that of their colleagues. Therefore, the question of physician wellness has both public health and ethical implications. The causes of burnout are multifactorial, and the solutions to sustainable change are multitiered.

The Personal and Professional Consequences of Physician Burnout: A Systematic Review of the Literature

2019 ◽  
Vol 77 (5) ◽  
pp. 371-386 ◽  
Author(s):  
Eric S. Williams ◽  
Cheryl Rathert ◽  
Sandra C. Buttigieg
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Well Being ◽  
Empirical Literature ◽  
Future Research ◽  
Conservation Of Resources ◽  
Physician Burnout ◽  
Health Physician ◽  
Reducing Costs ◽  
Dynamic Loss

The well-being of the health care workforce has emerged as both a major concern and as a component of the “quadruple aim” to enable the “triple aim” of improving patient experiences, reducing costs, and improving population health. Physician burnout is problematic given its effects on physicians, patients, health care organizations, and society. Using conservation of resources theory as a frame, we conducted a systematic review of the empirical literature on the relationship of physician burnout with physician personal and professional outcomes that includes 43 articles. Nine outcomes were organized into three categories illustrating burnout as a dynamic loss spiral rather than a static end-state. Findings show that emotional exhaustion had the greatest impact with the outcomes explored, while depersonalization and lack of professional accomplishment manifested fewer associations. The results suggest that burnout is a complex, dynamic phenomenon, which unfolds over time. Future research and implications of these results are discussed.

scholarly journals Connection Failure: Systemic Disadvantages Facing the LGBTQ+ Community in Therapy and how to Address them

2019 ◽  
Vol 2 (1) ◽  
pp. 63-76
Author(s):  
Erin Roach
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Pilot Study ◽  
Literature Review ◽  
Health Outcomes ◽  
Empirical Studies ◽  
Well Being ◽  
Small Sample ◽  
Structured Interviews ◽  
Therapist Knowledge

This paper examines the experiences of members of the LGBTQ+ community in accessing mental health care in Ottawa, Canada, both positive and negative, and what might be done to improve outcomes. The paper includes a literature review of empirical studies and theoretical works about conducting therapy with LGBTQ+ clients, as well as the results of a pilot study conducted by the researcher to examine in depth the experience of a small sample of LGBTQ+ clients in Ottawa (N=4). Through semi-structured interviews, the researcher found that three out of four participants had experienced some dissatisfaction with how their identity was addressed in therapy, and as a result their overall well-being had suffered. This implies that therapists could be doing more to connect with their LGBTQ+ clients, potentially through better educating themselves on the issues affecting the community, as recommended by the participants. Increasing therapist knowledge would likely improve mental health outcomes for LGBTQ+ clients.

scholarly journals The hospital designed by hospitalized children and adolescents

2020 ◽  
Vol 73 (suppl 4) ◽  
Author(s):  
Larissa Karoline Dias da Silva Cassemiro ◽  
Aline Cristiane Cavicchioli Okido ◽  
Maria Cândida de Carvalho Furtado ◽  
Regina Aparecida Garcia de Lima
Keyword(s):  
Health Care ◽  
Children And Adolescents ◽  
Physical Environment ◽  
Qualitative Data ◽  
Well Being ◽  
Hospitalized Children ◽  
Structured Interviews ◽  
Material Resources ◽  
Environmental Theory ◽  
Inductive Thematic Analysis

ABSTRACT Objective: to identify, through the contributions of hospitalized children and adolescents, the characteristics they consider necessary for a hospital that promotes well-being and development. Method: descriptive and exploratory study, with qualitative data analysis, carried out with a total of 30 hospitalized children and adolescents. Data were collected through semi-structured interviews, mediated by drawing, and analyzed by inductive thematic analysis, supported by the theoretical framework of the humanization of health care and the Florence Nightingale’s Environmental Theory. Results: the designed hospital takes up the principles of Florence Nightingale’s Environmental Theory, as well as one of the guidelines of the National Humanization Policy, the environment, from two perspectives: elements and material resources from the physical environment; elements of comfort and well-being environment. Final considerations: hospitals such as the projected institution corroborate what is recommended in public policies, as they qualify health care.

scholarly journals “A prison with extra flavours”: experiences of immigrants in Swedish immigration detention centres

2015 ◽  
Vol 11 (2) ◽  
pp. 73-85 ◽  
Author(s):  
Soorej Jose Puthoopparambil ◽  
Beth Maina Ahlberg ◽  
Magdalena Bjerneld
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Well Being ◽  
Structured Interviews ◽  
Immigration Detention ◽  
Content Type ◽  
Care Services ◽  
Lack Of Control ◽  
Health And Well Being

Purpose – The immigration detention environment largely influences the health and well-being of detainees by either aggravating medical conditions or contributing to new illness. There is limited research on how detainees experience and try to cope with this environment. The purpose of this paper is to describe experiences of detainees in Swedish immigration detention centres. Design/methodology/approach – Semi-structured interviews were conducted in three detention centres with a total of 21 detainees who had been detained for at least two weeks. Interview transcripts were analysed using thematic analysis. Findings – The detainees likened immigration detention to imprisonment. They experienced lack of control over their life situation mainly through arbitrary restrictions and lack of proper response from authorities making it appear futile to seek help. This perceived lack of control forced them into passivity. Differences in amenities provided in the centres were observed and some of these were reported to assist in making detention more bearable. Research limitations/implications – This study provides only one stakeholder perspective. The perspectives of other stakeholders, such as detention staff, health care professionals and volunteers must be explored to improve understanding and mitigate the effects of detention. Originality/value – Irrespective of the better standards of detention in Sweden, the detainees considered detention as imprisonment affecting their health and well-being. If states deem detention to be necessary, improved staff-detainee interaction should be ensured through proper staff training, arbitrary restrictions within detention should be avoided and health care services should be improved.

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