How do we promote physician well-being under the current conditions of medical practice which are stressful and for many, increasingly demoralizing?
One key is providing professional resources—including peer coaching and therapeutic support.
Such programs with even the best intentions, may come too late in the game if they are conceived simply as responses to problems after they occur. Waiting until someone is suffering, until someone complains and does or doesn’t seek help, or worse a tragedy occurs, can be too little, too late. By the time a physician expresses their pain or decides to address their demoralization, they may have already left the organization—or medicine, altogether.
A Work Culture of Well-Being
I want to incorporate into the idea of well-being, something all physicians understand—the power of prevention. I’m calling for proactive measures to support physician well-being before stressors become unmanageable. The most basic, big-picture way for an organization to be proactive is creating a culture of well-being.
Writing in a 2022 issue of Anesthesiology Clinics, Jina L Sinskey, MD and colleagues argue that “moving the needle on improving well-being in medicine necessitates a cultural overhaul of the medical system, understanding that the well-being of health care providers is essential for a safe, efficient, and effective healthcare system. ‘Checking the well-being box’ without changing the system is as useful as rearranging deck chairs on the Titanic… Physician well-being experts have known the secret for years: the answer is not group yoga or mandatory resilience training; the answer is the arduous work of culture change.”
Three years before that article—and just a few months before the pandemic drew a bright line beneath the many stressors under which physicians work—a team led by veteran well-being advocate Tait Shanafelt, MD wrote: “Although physician distress and some of the contributing factors are now widely recognized, we believe that many of these problems are symptoms of more insidious issues affecting the culture of our profession as well as the culture of our health care organizations and the health care delivery system. Culture refers to the shared and fundamental beliefs, normative values and related social practices of a group that are so widely accepted that they are implicit and no longer scrutinized.”
An Ecosystem
In defining the change, I’m advocating for the creation of a work culture that rejects the persona of the physician as a superhero without challenges and struggles of their own; or conversely, a mere employee whose main job is to carry out organizational directives—I am relating culture to another resonant concept, ecology.
The ecosystem of the medical workplace has levels that run from the individual to his or her closest colleagues, to their work unit, then all the way up through the organization, including multiple people, policies and procedures. How can concern for the well-being of physicians become an essential element in our thinking and practice and be woven through each and every level in the ecosystem?”
Learn how I answered this powerful question by clicking here.
