Wellness: an Opportunity or an Oxymoron for Medical Educators? APPD LEAD Conference Richard P. Shugerman, MD Rebecca R. Swan, MD
Goal for this session: For leaders in education to recognize the importance of our own wellness and how it relates to our effectiveness as leaders and role models
Burnout Wellness Resilience
PROGRAM Improvement & Management OTHERS Professional Professional Development Development of Team of Team SELF Personal & Professional Development
Considerations No right or wrong answers in this session. As pediatricians, we tell new parents to care for themselves and not just their new baby. As PDs, we tell trainees to care for themselves and not just their patients. As human beings, what do we tell ourselves?
Why Focus on Burnout? 1. We have an imperative to do so: Burnout is highly prevalent among medical providers Burnout affects learning and education Burnout is bad for patient care 2. The public is demanding it 3. Our trainees are demanding it 4. Because we can do something about it
Definition of Burnout 1. The reduction of a fuel or substance to nothing through use or combustion 2. Physical or mental collapse caused by overwork or stress Wikipedia, 2016
Based on the Yerkes-Dodson Human Performance and Stress Curve
Maslach Burnout Inventory
Maslach Burnout Inventory 1. Emotional exhaustion Being emotionally overextended and exhausted by one's work 2. Depersonalization Unfeeling and impersonal response toward recipients of one's service 3. Diminished personal accomplishment Lack of feelings of competence and successful achievement in one's work
Maslach Burnout Inventory Validated 22-item questionnaire Considered criterion standard for measuring burnout High score in either depersonalization or emotional exhaustion qualifies as burned out
Prevalence of Burnout Among Physicians National sample of physicians from AMA Masterfile compared with probability-based sample from US general population First performed in 2011, repeated in 2014 Just about every specialty represented Shanafelt, Mayo Clin Proc 2015
Prevalence of Burnout Among Physicians vs Controls Shanafelt, Mayo Clin Proc 2015
Scoring of the MBI Subscale Low Moderate High Depersonalization/ Cynicism 0-6 7-12 13+ Emotional Exhaustion 0-16 17-26 27+ Personal Accomplishment 39+ 32-38 0-31
Promoting Wellness Wellness is the condition of good physical, mental and emotional health, especially when maintained by an appropriate diet, exercise, and other lifestyle modifications [American Heritage Medical Dictionary]
Program Directors' Challenges Complicated job balance Faculty vs residents/fellows Support systems at work Risk of isolation
Where is the Data? Pediatric PD's General Surgery PD's Anesthesiology PD's Radiation Oncology PD's
So what do we do for self-care? Qualitative study of primary care physicians in Wisconsin completed survey on physician well-being How do you solve dilemmas related to your physical, emotional and spiritual wellbeing?
Wellness-Promotion Practices Relationships Religion or spirituality Work Approaches to Life Self-care
Wellness-Promotion Practices Self-care Consider the data for physicians!! 35% have no regular PCP 66% get recommended colon cancer screening 71% get recommended mammograms 71% get the flu vaccination
Your Own Wellness Wheel Use questions to score yourself Yes, No or Sometimes There are no right answers!
Time To Reflect What does your Wellness Wheel tell you? What are some ways you practice self-care to promote wellness?
Self-Care Activities Exercise Being in Nature Mindfulness Meditation Breathing Music, art Yoga, tai chi Prayer, religious and other rituals Journaling
Wellness-Promotion Practices Relationships Family Friends Colleagues Community
Wellness-Promotion Practices Religion or spirituality Religious beliefs, practices or faith Spirituality or spiritual community
Wellness-Promotion Practices Work Satisfaction from work: meaning from work Choosing a certain type of practice
Wellness-Promotion Practices Approaches to Life Being positive Focusing on success Maintaining balance
Wellness-Promotion Practices Self-Care Good nutrition Avoiding alcohol, drugs Activities Reading Treatment for depression Leaving unhealthy relationships Professional counseling