Healthcare professionals dedicate their lives to healing others. But when it comes to their own mental well-being, seeking support can be rife with barriers and challenges.
To get insights into the practical steps healthcare organizations can take to help overcome these challenges, we sat down for an interview with Sarah Webber, MD, one of VITAL WorkLife’s certified physician peer coaches.
In this Q&A, Dr. Webber shares her approach to helping physician peers identify and address a wide range of challenges.
When it comes to clinical burnout, we know structural roadblocks exist. How do we overcome the challenges of these roadblocks?
Dr. Webber: There are many ongoing barriers to clinicians seeking mental health support. Fortunately, we’ve seen efforts to address some of these barriers.
Consider, for example, the 2022 passing of the Dr. Lorna Breen Health Care Provider Protection Act, the nation’s first-ever bill to address mental healthcare options for medical professionals. This legislation and other efforts like it are important—and remind us that, as a healthcare industry, we play a role in how accessible mental health support truly is for clinicians.
- Are we setting our clinicians up to say they can’t have anxiety or depression?
- In what ways does the culture of medicine tell us to be tough and resilient, to push through and not be weak?
These messages can infer that having symptoms of burnout, depression, or anxiety are the result of inherent weakness, creating stigma around diagnosis and help seeking. Clinicians, in general, are trained to be self-reliant problem-solvers, conditioned to push through stress and fatigue. This deeply ingrained mindset can make acknowledging a personal mental health struggle—and acting on that recognition—exceptionally difficult.
As a system, we must ensure that physicians and advanced practice professionals (APPs) are not only aware of available resources but are also supported in a way that helps move them from awareness to action.
What about other, less tangible barriers such as shame and stigma?
Dr. Webber: For clinicians, shame and stigma can be very real. These psychological hurdles often prevent healthcare professionals from taking a first step toward care.
When I experienced burnout eight years ago, I didn’t even realize that my experience had a name. I discovered during a webinar that they were describing what was happening to me as burnout. At first, I didn’t know what to do with it. Fortunately, I had a mentor I could confide in. She said matter-of-factly, “What if you let go of anything that’s not critical and spend some time focusing on yourself.” She gave me permission to admit that I wasn’t doing ok, and to take the time and space I needed to seek support.
Stigma and shame thrive in isolation, but when clinicians engage in discussions with others, they can start to see their experiences as common and human. This is one of the key reasons engaging with others is critical to meeting burnout and mental health symptoms. When the experiences around which we feel shame are seen by someone we trust and who care for us, that connection is therapeutic. This is the first step in overcoming shame and stigma and seeking more formal support like coaching or therapy.
Do you have any examples of how peer coaching and support can help clinicians navigate the unique challenges of working in healthcare?
Dr. Webber: In my role as a peer coach, I once saw a female physician who became a parent after completing training and starting practice in a highly specialized surgical field. She loved her work, but her priorities had shifted. She wanted to spend more time with her child but said her current job didn’t allow for work-life balance. Her conflict and sadness were palpable. She felt stuck. I acknowledged that she felt stuck and asked if that was true. Her demeanor shifted instantly. She realized she had choices. After that session she made a choice to take action that honored her love of medicine and her priority as a parent.
This powerfully demonstrates how being seen and heard by another gives one permission to pause and reframe thinking. This process—acknowledging what is hard and recognizing where we have choices—is critical for folks experiencing burnout or work-life conflict and a theme I see come up again and again in my coaching practice.
Another client came wanting to talk about setting boundaries in clinic. As we worked together, she acknowledged the tension. She had a very direct communication style, and she wasn’t always sure how it landed for others. She valued having a strong team with good relationships, and didn’t want her communication style to interfere with the team dynamics. She also wanted to be authentic. Her stigma was a self-perception: that she cannot be likable unless she’s friendly and chatty.
I validated that this worry was real for her and asked whether there was a way to adapt her communication style without straying too far from her authentic self. This reframing allowed her to come up with ways to be clear and direct with team members, while fostering connection with her team.
What are some approaches to help individuals engage with the well-being resources available to them?
Dr. Webber: Rather than providing a one-size-fits-all approach, healthcare organizations should strive to meet clinicians where they are in their journey by providing multiple access points to well-being-focused programs and services. These can include:
- Concierge services: Sometimes, a hurdle is as small as knowing where to begin. Concierge programs aren’t just service support—they can enhance a clinician’s well-being by alleviating stress and helping with time management, which is essential in creating a positive work-life balance. A call to arrange childcare, home repair services or travel arrangements can go a long way, possibly even freeing up time for peer coaching or counseling. Many physicians who use a concierge or virtual personal assistant share their positive experiences with peers, creating a gateway for others to engage. It can also help people engage with more in-depth and ongoing well-being support, creating opportunities to encourage concierge service users to access more resources.
- Peer coaching: Many physicians and APPs feel more comfortable speaking with a fellow clinician who understands their unique pressures rather than a counselor or therapist. Peer coaching offers a confidential and nonjudgmental space where clinicians can partner with professionally trained peers to explore challenges, navigate choices, feel empowered, and move toward thriving.
- Confidential counseling: While some clinicians recognize they need structured mental health support; others arrive at this realization during peer coaching. For most, it’s about being at the right time and place. Counseling is sometimes made available proactively, during traumatic crises, for example. Immediate support is given, and doors may be open to additional counseling. This model has served my organization well in the immediate aftermath of a school shooting in our community. Some physicians want privacy related to their own therapy and seek therapists outside their home institution or network. Offering both in- and out-of-network therapists is really important to overcoming worries about stigma.
You discussed the importance of peer coaching? Why might a clinician opt for this over counseling?
Dr. Webber: There are many paths to a physician seeking peer coaching. Some physicians come saying, “I’m at a point in my career where I just feel ‘Meh.’” Others identify shifts in personal priorities or values and want to explore what this means for them. Some physicians come to coaching at a breaking point of burnout, knowing something needs to change but unsure what that change is. Coaching gives people the opportunity to be heard, to be assured that it’s okay to speak their truth, and to explore their needs with someone who “gets it."
Reasons for tapping into peer coaching might seem straightforward to most but are not top-of-mind for specific individuals. I recently helped a highly esteemed colleague who couldn’t pinpoint why he wasn’t getting the same fulfillment from his job as he used to. Through our discussions, he realized that his role had shifted over the past few years, and he was no longer leading projects he was passionate about. Knowing this helped him begin to articulate and explore what would be most meaningful to him, and he applied and got a new leadership role that allowed him to do what he loved.
Some clinicians relate better to the label of “peer coaching” rather than “counseling” or “therapy.” It seems to be more palatable perhaps because it’s perceived as career-focused and performance-oriented rather than mental health-centric. This distinction is a myth, emotions and challenges can be incorporated into a coaching relationship as long as the coaching process is generally future oriented. It’s not uncommon for physicians to have both a coach and a therapist at the same time, using the unique approach and skillset of each to support well-being, processing the past, and moving forward.
In the end, labels can matter. I find myself telling people that whatever help they seek, they should focus on finding someone who listens to you and works to help you move forward by addressing things that are important to you.
In our work with healthcare organizations, we often discuss the importance of creating a culture of support. What variables should be considered when moving to this model?
Dr. Webber: It’s critical that we explore how healthcare leaders play a role in reducing barriers and changing culture to lessen stigma and shame. This can be accomplished by ensuring that support services are:
- Easily accessible: Removing logistical challenges such as scheduling difficulties and long wait times. I recently heard about a peer coach in an institutional setting who provides established office hours.
- Confidential: Guaranteeing privacy and reassurance that seeking help will not negatively impact one’s career.
- Integrated into the organizational culture: Embedding well-being conversations into leadership discussions, training, and peer interactions. Aligning a team of ambassadors to support well-being awareness and engagement. Both formal and informal leaders can share their own stories of personal challenge and how they sought help. This can normalize help-seeking as something we all do at times.
- Supported based on needs: Different units and departments have differing needs. I was pleased to learn about a hospital that recently enacted a policy to let managers grant time off based on the unique demands and needs of their teams.
Any last thoughts on how healthcare organizations can navigate barriers and stigma?
Dr. Webber: Ultimately, our goal should be to create an environment where seeking help for one’s mental well-being is as encouraged as seeking a mentor or professional development coaching. By offering multiple pathways to connect with support and matching the right support to individual needs, organizations can help clinicians overcome barriers and engage in the well-being focus they deserve.
My own journey from burnout to being an advocate for clinician well-being led me to partner with VITAL WorkLife. Their commitment to breaking down barriers and creating accessible support systems aligned perfectly with my vision for transforming healthcare culture. Now, as a peer coach, I can help others navigate the same challenges I once faced.
Sarah Webber, MD, is an associate professor in the Division of Hospital Medicine and Complex Care at the University of Wisconsin School of Medicine and Public Health. Dr. Webber has also served as the Director of Well-Being for the Department of Pediatrics since 2018. As a VITAL WorkLife Peer Coach, she’s helped dozens of clinicians identify and address a wide range of challenges.
