What are Hospitals Doing About Physician Burnout?

isolated-1188036_1920Is it just me, or is everyone just starting to realize that physicians are people too?

We’ve all known for a long time that the healthcare paradigm shift of the last ten years means that doctors are overstressed, overwhelmed and overbooked. According to a 2017 Medscape survey reported by the American Medical Association (https://wire.ama-assn.org/life-career/report-reveals-severity-burnout-specialty), physicians from 27 specialties ranked their level of burnout on a scale of one to seven (seven meaning they considered leaving medicine). All but one specialty ranked their burnout at a level four or higher.

A harrowing article in The Washington Post revealed surprising stats about physician suicides in the United States. It was something that I never considered since my doctors have always appeared superhuman. As I think about all that they are expected to do to prepare for the profession, and the physical, emotional and spiritual struggles they witness each day, it should come as no surprise. Compassion fatigue doesn’t begin to describe it.

The impact of burnout on the life of a physician is discouraging enough, but what about the effect on patients? Will they lose a physician due to burnout? Will their physician make an innocent mistake because he/she is overwhelmed?

stressed

I think patients need to question what their hospital is doing to protect its physicians from burnout. I’ve had the opportunity to speak with physicians and executives with AMITA Health in the Chicago area and am impressed about their unique initiatives designed to promote physician well-being–some that have been going on for decades.

Guided by insights from The Coalition for Physician Well-being, some of AMITA Health’s unique interventions include:

  • “Huddles” immediately following traumatic events (not just large scale ones)
  • Free counseling sessions available to physicians with specialists outside of the health system
  • A Medical Arts Program that encourages physicians to share their artwork in exhibitions and within their facilities
  • “Creation Health” physician health and wellness opportunities to help them live life to the fullest
  • International mission trip opportunities (and soon local mission opportunities)
  • Physician Leadership Workshops to empower and engage physicians in highest-level decision-making
  • Mentoring of new physicians by experienced doctors
  • Small groups, Bible studies and more.

     

What are other hospitals doing? Stanford Medicine has implemented an interesting time-banking program for physicians to help avoid burnout. According to a 2014 CHA article, “Hospitals within Adventist Health System [based in Florida] have sponsored a variety of programs designed to foster communication and build relationships, from picnics to art shows, physician concerts, health screenings and prayer breakfasts.”

I’m researching ways that other health systems are looking out for the holistic needs of these folks. If physicians leave their work because the practice of healthcare robs them of their own mental, physical or spiritual health, we all lose.

8 Reasons Why My Dog Hates Running With Me

rosie dry

Rosie is our seven-year old Australian Shepherd.

Like any Australian Shepherd worth its kibble, Rosie loves having a job to do.  That job often includes yours truly, since a lack of sheep in our neighborhood means that someone has to be herded, and I’m the only one in the house willing to comply.

Usually I will succumb to being rounded up, nipped at the ankle and nudged by a wet nose to the back of the knee throughout the day.  But when it’s time for a run, Rosie and I are clearly at odds with one another.  What would seem to be a perfect outing for a herding dog and her master often ends badly.

Why?

She Doesn’t Want to Stop for Me

I began running later in life, and when I was starting out I wanted a mentor who could assure me that you’re never too old to begin running.  It wouldn’t hurt if he/she could also assure me that I wouldn’t die trying.

I found Jeff Galloway and his run-walk interval method, and have loved every minute of working out this way.  Say what you will about “walk” having no place in a real runner’s vocabulary.  I don’t care.  I’m a runner because I run.  It doesn’t matter that I add walk breaks in…often.

However, Rosie has an issue with this.  Just as she gets into a running groove, I slow down for a walk.  So she will keep pushing forward, making me feel like a Biggest Loser to her Jillian Michaels.

To no avail–I’m sticking with Jeff’s program.

I Don’t Want to Stop for Her

Previous scenario, but in reverse.  When I’m trying to do the running portion of an interval, Rosie insists that this is the time to stop and make sure that every canine knows that she lives in their neighborhood.  Each dog we pass, whether inside a house barking or out on the street sniffing, gets a sassy squirt from Rosie.

I’m sure there is some Pavlovian method that I can implement that will train her to only pee when my interval timer beeps when it is time for me to walk.  It’s worth a try.

The Harness

I tried a standard leash.  I tried a retractable leash.  I tried various collars.  Nothing kept Rosie from choking herself and yanking my arm out of its socket.  That is, until we started using a harness.  Works like a charm.  Because it goes around her chest, it seems to distribute the force of her pull so that it’s not jarring to either one of us.

The only problem is that she hates it (see photo above).  She literally rolls her eyes every time I pull it out.  The shame of being shackled when your job is to run around being in charge of everything!

Her Herding Instinct is Squelchedrosie wet

Rosie does get to run free at the dog park and pond!!

Rosie knows she was made to run after mammals twice her size and keep them in line, not to drag me up and down the street.  She tries to make up for her frustration by chasing after the myriad of squirrels, rabbits and other critters in our neighborhood.  Once again, the harness saves both of us from ruin, but leaves Rosie wanting more.

She’s Ashamed of Me

I love to run at night.  Because it’s often dark by the time I get outside, I wear a headlight (best Christmas gift ever from my husband!).  It’s not the most fashionable thing, so it doesn’t work if you’re very self conscious.  Rosie runs to hide as soon as she sees me strap it on.  Funny–it has the same effect on my 22-year old daughter.

She Never Knows the Schedule

Because I adore running, I never want to miss a workout.  So I fit it in whenever I can.  At 6:00 a.m., over my lunch hour or at 8:00 at night.  Rosie never knows when she needs to be ready.  As a result, she spends the day in a state of constant anticipation, and sometimes wears herself out before we even get going.  I think it’s starting to wear on her.

She Gets Gypped on Long Run Days

I’m preparing for a half-marathon, the Galloway way, so I do long runs on the weekend.  As much as she likes to run, Rosie is done after about 30 minutes of my shenanigans.  So on my longer days, she goes for a walk with Dad.  He doesn’t run at all, so Rosie is quick to express her displeasure to me as I try to sneak back in the house hiding my post-run glow.

She Has to Carry Her Own Poop

Just kidding on this one.  I can’t do it.  I’ve seen the bags that can be attached to the leash and the backpacks that some dogs wear,  but I can’t bring myself to do it to her.  I don’t know why, since this is the same dog who once came home from doggie day care with a remnant of every other dog on her coat.  It’s not like she has cleanliness standards.

But we still keep running together.  That is until she throws in the towel, or I start marathoning.  Then my husband gets to be the sheep.

To Live is to Laugh

“You can always tell an Irishman…but you can’t tell him much.”

I’m 67% Irish.

If my father’s family had anything to say about it, I’d be 100 percent. But somehow my mother snuck in under the radar as a German Swede (and a Protestant at that).

She married my dad before the McGlynns were any the wiser. Our Irish relatives never let her live down her lack of Celtic and Catholic pedigree, talking and snickering behind her back at every family gathering.

Perhaps it was because she’s never been funny, and the Irish place a premium on funny. I don’t mean to overgeneralize, but Germans, at least the ones in my family, were not what you would call humorous.

And the Swedes? Well let’s just say my Swedish relatives were all work and no play. Maybe they were cutting jokes while they were cutting meat at the my great grandfather’s butcher shop, but I never heard any. At least not any REAL yucks.

Come forth, Lazarus! And he came fifth and lost the job. From Ulysses by James Joyce

But my dad’s relatives? It was an adventure every time we saw them. There are no better storytellers than the Irish, and every tale of family intrigue was hysterical. Not because the story was that interesting–in fact it could have been about a tree that fell in someone’s yard. Yet somehow the way it was told, it would leave everyone doubled over and trying to remember every word to share it with the next person. It’s a badge of honor in our family if you weave a yarn that leaves them laughing.

Dad army photo

Laugh to Keep from…Everything

For as long as I can remember, my dad has handled both the good and the bad of life with jokes and laughter. To be serious was to consider that life is difficult and that problems may be overwhelming. Being silly was a happy form of denial that made him feel less helpless and more in control over things that couldn’t be controlled. He truly had never learned any other way to communicate.

The instinct to be hysterical would most certainly kick in when any of my father’s seven children was sick.

In fact, when I had my gall bladder removed at age 17 and almost died, my Dad was the one who spent the most time with me in the hospital in the days following the surgery. Whether sitting next to me, or walking down the halls with me (IV cart in tow), he would tell me funny stories.

Envision busting a gut–LITERALLY. I was laughing so hard it was pulling at my sutures and making me cry in pain. But I wouldn’t have traded it for anything in the world. I knew that my dad loved me and was truly concerned because he was trying to make me laugh.

My Dad would be the one to incite a giggling wave throughout our family’s pew at a funeral. My Dad would be the one talking about how the tornado headed towards our house would do a great and desperately needed remodeling job. And my Dad would be the one to joke with the doctor when a prognosis was dismal, causing both doctor and patient to forget that anything was wrong.

Keep ‘Em Laughing…Whatever it Takes

Last month, we had to have my Dad join my Mom in a local nursing home as a resident. Though he’s dealing with several health issues and a wee bit of dementia, he is still trying to be as funny as ever, and using his humor to help him cope. He will call me on the phone and give me the weather report, in the style of George Carlin’s “Hippie Dippie Weatherman” skit. He will make faces as other residents go by to produce giggles. He will pull old family stories out of the shrinking storehouse in his brain to help us both feel a connection to a better time and a funnier place.

He gets frustrated that he is not as quick-witted as he once was. Besides being able to go home, nothing would make my dad happier than being able to be more humorous. So we throw easy joke bait to him and let him take a bite on a fabulous punch line of his own creation.

I’m sure that our combined sense of humor will keep us both going, since making merry is in our blood (or at least 67% of mine). But as his brain slips further away, we will have to resort to finding some new way to giggle, even if it’s simply sticking our tongues out at each other. To see that Irish twinkle in his eyes will be enough for me. Because as long as we’re laughing, we are living life to the full.