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2 Ways to Support Physician Wellness

Where to focus solutions?

Physician wellness advocates suggest that about 20% of burnout is impacted by individuals while as much as 80% is impacted by organizational/system factors that also affect the practice environment.

To maximize physician well-being, both individual and organizational/system level strategies are needed (West, Dyrbye, Erwin, & Shanafelt, 2016).

Facility Engagement recommends that MSAs focus physician wellness activities primarily in areas of the local work group-level and organizational-level improvements or in combination with individual level strategies. Below are a few examples of those activities.

SEE MORE: FACILITY ENGAGEMENT AND 80/20

Physician Wellness

Work Group / Organizational Wellness Strategies

Physicians are leveraging collaborative program structures, processes, funding, and health authority relationships through Facility Engagement to address the root causes of burnout and to influence a healthier workplace.

This includes working to improve the effectiveness of care delivery and workplaces, and relationships and communication among physicians, disciplines and between medical staff and hospital and health authority leaders.


TARGETED DEPARTMENT-LEVEL WELLNESS SOLUTIONS - Vancouver Physician Staff Association: Commitment from both medical staff and health authority leadership to wellness through identification of targeted department-level identification of drivers of burnout, with further encouragement and support of manageable improvements within each department (starting in the Emergency Dept.)
 


ENGAGING HEALTH AUTHORITY IN DISCUSSIONS - Providence Health Care Physicians and Surgeons Association: "Pebbles in our Shoe on the Road to Wellness" event – a discussion between medical staff and health authority leaders about trust, transparency and relationships that support wellness.
 


A FORMALIZED ENGAGEMENT PROCESS FOR HEALTH CARE OPERATIONS CHALLENGES - Burnaby Hospital: medical staff have developed a process to engage and align with local and regional administration leads to address health care operations challenges that affect providers and patient care.
 


AN INPATIENT CONGESTION AND FLOW PROJECT - East Kootenay Regional Hospital (EKRH): aims to create realistic recommendations to reduce inpatient congestion (over capacity).
 


PLANNING AMONG RADIATION ONCOLOGISTS TO ADDRESS ANXIETY CAUSING ISSUES - BC Cancer Agency: manpower planning, capital planning, equipment and operational capacity.
 


INTERNAL MEDICINE SPECIALISTS AND FAMILY DOCTORS COLLABORATiON - University Hospital of Northern BC Prince George:  Collaboration to improve communication, expectations between family physicians and internists, while increasing inpatient coverage.
 


ASSESSMENT OF CURRENT OBSTETRIC INTERNAL MEDICINE SERVICE DEMANDS - Children’s and Women’s Hospital Future planning to avoid burnout from escalating referral volumes. 
 


SHARED MATERNITY CLINIC - Creston Valley Hospital: More coordinated, integrated with Public Health, consistent between providers, with a call group that allows for more flexibility. Implementation of weekend ward rounds in the ER with family physicians and nurses streamline the chart review process and save time.
 


EQUITY AND INCLUSION INITIATIVE - Vancouver Physician Staff Association: Creation of the VCH Medical Staff Diversity, Equity and Inclusion (DEI) initiative to improve equity and inclusion in medical leadership.
 


ORGANIZATIONAL ALIGNMENT - Providence Health Care: Alignment of medical staff physician advisory groups with the organization’s strategic priorities, one of which is focused on people and wellness.
 


 

 

Some common themes


INTERDISCIPLINARY SIMULATION DRILLS:  Many simulation programs are serving to improve teamwork and communication, between physicians and health care professionals; increase confidence, role clarity and expectations to reduce stress in emergent situations.
 


SPACE / DEPARTMENT REDESIGN:  Increases efficiency of patient care delivery, creates a health work environment, decreases daily frustration.
 


IMPROVED EMERGENCY ROOM FLOW: physicians and teams at many sites are meeting to discuss and problem solve around flow and patient care and to ensure an effective working environment.
 


MRP IDENTIFICATION AND CLARITY: Several sites working to clarify Most Responsible Provider (MRP) status to improve handovers, reduce confusion, decrease unnecessary documentation, such as between general practice, surgical care and internal medicine.
 


ON CALL SCHEDULE IMPROVEMENTS: Many sites are updating schedules for emergency departments, internal medicine and other services to realistically meet current demand.
 


BC Cancer Medical Staff Engagement Society Survey: BC Cancer medical staff and Canadian Association of Radiation Oncologists (CARO).
 


Children’s And Women’s Hospital Medical & Allied Staff Engagement Society: Wellness Survey developed and disseminated to medial staff that included aspects of burnout, resilience, and leadership.
 


Vancouver Acute/Vancouver Community: Physician Wellness Steering Committee Wellness Survey: assessed Vancouver Physician Staff Association (VPSA) members level of wellness and burnout and causes, and how collaborative solutions can be developed.
 


Powell River General Hospital Facility Engagement and Powell River Division of Family Practice burnout survey: as part of their annual member survey.  A similar survey has been sent out since 2018, which allows for comparisons between years. Response rate has consistently been 85% by reaching out to each physician in person where possible.
 


Survey Options Chart: Some options and considerations for measuring physician well-being, burnout and depression. Download PDF here>
 


 

Supporting Wellness at the Individual Level

*Thinking about developing a peer support program? You are invited to reach out to the Physician Health Program at www.physicianhealth.com for potential training and knowledge sharing opportunities and to enable coordination of peer support initiatives provincially.


DOCS FOR DOCS WORKSHOP - Sechelt Hospital: A dialogue on physician mental health and work environment to create a supportive workplace where physicians can receive and provide the care for each other that they give so diligently to their patients.
 


FACILITATED DINNER GROUPS - Vancouver Physician Staff Association:  Physicians from across specialties come together to discuss common issues such as work-life integration and build peer-to-peer support in a facilitated environment. 
 


PEER SUPPORT AND PERSONAL RESILIENCY WORKSHOPS - Burnaby Hospital Medical Staff Physician Society: Wellness Subcommittee education sessions on peer support communication skills and managing personal energy, in order to promote collegiality, peer support, and personal self care.
 


CONFIDENTIAL PEER SUPPORT - Royal Columbian Hospital: a confidential conduit for individual physicians to contact an emotional first aid counsellor at Fraser Health. Each department identifies a trusted physician liaison that cn be contacted in confidence to discuss acute emotional stress and be connected further with a counsellor.
 


MEDICAL STAFF PEER-TO-PEER SUPPORT PROGRAM - BC Children's and Women's Hospital: accessible in-house peer support to promote a psychologically healthy Workplace and training and opportunities for medical staff to engage with peers to provide support.
 


YOUNG FACULTY INITIATIVE - BC Children's and Women's Hospital:  provides support for a group mentorship for newer faculty members through regular structured meetings  for members to discuss a variety of topics relevant to professional, academic and personal endeavors. Each session is moderated by a senior physician with experience in the area, or by an external speaker.
 


EMPOWERING PHYSICIAN SELF-EFFICACY: A BALINT GROUP - BC Children’s Hospital: aims to improve physician psychological self-efficacy and physician wellness, improve physician relational skills, including awareness of transference, to improve patient care.
 


NARRATIVE MEDICINE WORKSHOP AND WRITING GROUP - South Island MSA and South Island/ Victoria Divisions of Family Practice:  A physician group that shares the desire to practice their narrative medicine writing skills with a group of like-minded peers in a supportive and facilitated way.
 


LEADERSHIP FOR MEDICAL WOMEN COURSE - Burnaby Hospital Medical Staff Physician Society: Learning together as colleagues to identify what influences leadership and specific strategies to become more effective as a medical woman leader, and identify opportunities to drive and support female physician leadership in a complex health care system.
 


“US CARE” - CIVILITY MATTERS PROJECT - Vernon Jubilee Hospital Physician Society: Hospital staff including physicians are introduced to the profound downstream impact that rudeness can have on both the recipient of uncivil behaviour and even witnesses to the event.  Cognitive distraction, reduced work performance, and absenteeism as a consequence, detract from joy in teams and deny patients optimal heath care. Link: www.civilitysaveslives.com.


CRUCIAL CONVERSATIONS - Royal Columbian Hospital:  Clear, consistent, and respectful communication between a wide variety of providers can help identify opportunities for improved quality of care, and workplace environment.
 


MENTAL HEALTH & RESILIENCY WORKSHOPS - Kootenay Lake Hospital: A series of mental health/resiliency focused and facilitated virtual workshop sessions.
 


PHYSICIANS STAYING HUMANE IN THE ER - Vancouver General Hospital: Explores the causes of stress and burnout and aims to create civility, collegiality, humanity and restore joy and compassion in the ER.
 


THRIVE RESILIENCE & WELL BEING COACHING PROGRAM FOR DOCS: Tools and strategies to manage both the everyday hassles and big challenges. 
 


BURNOUT PROOF LIVE WORKSHOP FOR PHYSICIANS: Training to recognize burnout, and how to deal with it on a personal and organizational level.
 


SKY – COVID ONLINE STRESS REDUCTION PROGRAM FOR FRONTLINE CARE PROVIDERS: Develop, implement, evaluate and disseminate an on-line accredited continuing medical education program centering on the neurobiology and health impacts of stress.
 


LINDA EDGECOMBE: KINDNESS AND HUMILITY IN CRAZY TIMES: Linda Edgecombe is a funny motivational speaker with an expertise in resiliency training. An evening with colleagues reminding everyone to tap into their sense of humour and find ways to recover their sense of balance. www.lindaedgecombe.com
 


COMPASSION TRAINING (CCT) - Kootenay Boundary /Cowichan Valey Division of FP: Two series of this Stanford University-developed training offered to physicians and other care providers (including Midwifes and Nurse Practitioners) with outstanding feedback.  Link>
 


RESILIENCY Rx SESSIONS - Kootenay Boundary Division of FP: Partnered with the Kootenay Boundary Family Residency Program to invite Residents and Staff to participate in short sessions about Resiliency, facilitated by a local psychologist, and included a series of text-based check-ins to loop back on key learnings.
 


2021 SPIRIT AWARDS - Campbell River Medical Staff Engagement Initiative Society / Campbell River Division of Family Practice collaboration:  These awards honour and celebrate local physicians and individuals/agencies who bring excellence to our community. This spirit-boosting social event recognizes the dedication, passion, talent and tireless efforts of those working to provide significant contributions to meaningful healthcare initiatives locally. The event is to be live streamed on Thursday March 10th, 2022. We look forward to seeing everyone virtually.
 


COVID-19 ABOVE & BEYOND AWARDS  -  Royal Columbian & Eagle Ridge Hospitals Medical Staff Society: Peers acknowledge physicians who have gone above and beyond during the COVID-19 pandemic, built collegiality and support, and strengthened relationships with health authority leadership.