Sasha Shillcutt, MD, MS, FASE, co-hosted another installment of our #PWChat series, on May 9, which focused on physician wellbeing and handling burnout.

Topics discussed included whether messages of awareness & calls to action regarding physician suicide should be welcome in organized medicine, what can be done to change the culture of “work harder and longer” in medicine, which is largely accepted as largely contributing to physician burnout and, in turn, mental illness and suicide, what impact(s) should be expected from the moves of some organizations, such as Stanford Medicine, to appoint physician leaders to lead teams that address micro and macro level burnout, and much more!

Below are the highlights from the chat. You can read the full transcript here, by scrolling down to the corresponding responses.

Click here for a look at our #PWChat schedule and recaps.

 

 

Question 1

Q1: Should—as @PamelaWibleMD—states, messages of awareness & calls to action regarding physician suicide be welcome in organized medicine? #PWChat

— Physician’s Weekly (@physicianswkly) May 9, 2018

Absolutely. Recently I was lecturing on this topic, and my colleague also lecturing polled the audience of anesthesiologists, and 60% knew someone directly in medicine who had taken their own life. Organizations – and we, as part of a living org, must address. #PWChat

— Brave Enough MD (@RUBraveEnough) May 9, 2018

Q1 Ask a room of physicians how many have been personally impacted by physician suicide and most, if not all, hands usually go up. It permeates medical culture and has to be openly discussed. #PWChat

— Sara Taylor, M.D. 🇨🇦 (@SaraTMD) May 9, 2018

A1: Agree 100%. And we must make it intentional to discuss, the why, and what, and how can we recognize and prevent. #PWChat

— Brave Enough MD (@RUBraveEnough) May 9, 2018

A1. I used to wonder whether Physician suicides are happening “more often” now and realized I am only aware of them because we are talking about it and these deaths are being called out for what they are. If we don’t welcome discussion no one will know it’s a problem! #PWChat

— Jasmine R Marcelin, MD (@DrJRMarcelin) May 9, 2018

 

Question 2

Q2: It’s largely accepted that the culture of “work harder and longer” in medicine largely contributes to #PhysicianBurnout and, in turn, mental illness and suicide. What can be done to change this culture?#PWChat

— Physician’s Weekly (@physicianswkly) May 9, 2018

A2: I like to encourage colleagues who are burned out this: it is ok to withdraw from paper and projects; it is never ok to withdraw from close colleages aka your “people”. If you find yourself withdrawing, you may be burned out. #PWChat

— Brave Enough MD (@RUBraveEnough) May 9, 2018

A2. Great advice – social disconnection is often a sign of burnout but is the very thing that is needed. Physicians who are experiencing burnout need to feel supported and that they aren’t going it alone. #PWChat

— Sara Taylor, M.D. 🇨🇦 (@SaraTMD) May 9, 2018

A2: I think @nishamehtamd ‘s article describes #burnout well. We physicians have always worked harder & longer for our patients. It’s the meaningless unnecessary system imposed tasks that bring us down! #PWchat https://t.co/zHvn3LDakX

— ChristinaDeweyMD (@PedsMamaDoc) May 9, 2018

A2. Defining burnout as @RUBraveEnough and others have is important. Perhaps asking a trainee if they are burned out will not help because they don’t recognize this. What can be done to change the culture? 1/

— Jasmine R Marcelin, MD (@DrJRMarcelin) May 9, 2018

 

Question 3

Q3: Some organizations, like @StanfordMed, are appointing physician leaders to lead teams that address micro & macro level burnout. What impact(s) should be expected from these moves?#PWChat

— Physician’s Weekly (@physicianswkly) May 9, 2018

A3: Wellbeing should be the foundation of our culture – as it is has vast reach into patient outcomes, patient safety, physician safety, etc. Which means it should be part of strategic planning and be present in the C Suite of every dynamic organization. IMO MDs can lead #PWChat

— Brave Enough MD (@RUBraveEnough) May 9, 2018

A3: I enthusiastically agree with you @RUBraveEnough. We can’t abdicate our leadership and hope that someone else will fix this. #PWChat

— Dan Diamond, MD (@DanDiamondMD) May 9, 2018

A3 this may be an effective approach as it puts some of the control back to physicians – one of the well-known contributors of burnout is a feeling of lack of control. Physicians knowing they can be a part of the change and impact the system is a step forward. #PWChat

— Sara Taylor, M.D. 🇨🇦 (@SaraTMD) May 9, 2018

 

 

Question 4

Q4: #MentalHealth is often neglected among physicians, as @KGoldMD writes (https://t.co/gbEzhjpheV), due to stigma & perhaps questions on state med licensing boards. How do we encourage clinicians w/ mental health issues to seek care?#PWChat

— Physician’s Weekly (@physicianswkly) May 9, 2018

A4: a simple start is to look at PTO/vacation days. Are institutions/orgs allowing their employees &physicians to utilize? why or why not do they not utilize? Several industries have shown a positive relationship between work productity/employ engagement and utilized PTO #PWChat

— Brave Enough MD (@RUBraveEnough) May 9, 2018

A4 These are real concerns and barriers for physicians. Hoping conversations such as these continue and chip away at the stigma that exists. Small confidential support groups have shown some promise, esp when it comes to things such as adverse events. #PWChat

— Sara Taylor, M.D. 🇨🇦 (@SaraTMD) May 9, 2018

A4. People are often skeptical of how confidential the employee assistance programs are, how can institutions be more transparent about this so that employees utilize the services more? #PWChat

— Jasmine R Marcelin, MD (@DrJRMarcelin) May 9, 2018

 

 

Question 5

Q5: Work compression in medicine largely contributes to burnout, as you write (https://t.co/SpsGxnzXXT). How do HCPs reassess work versus recovery in medicine?#PWChat

— Physician’s Weekly (@physicianswkly) May 9, 2018

A5 We need to let go of days where overworking physician was on a pedestal. Work compression is real w our current tech advances; we must allow & encourage phys recovery. Think – highest burnout areas: armed forces, fire fighters, police etc. they mandate recovery days..#PWchat

— Brave Enough MD (@RUBraveEnough) May 9, 2018

A5. I like the idea of having a tribe for accountability. Check in with each other, assess each other’s work/recovery cycle? I struggle with being accountable for my accountability though! #PWChat

— Jasmine R Marcelin, MD (@DrJRMarcelin) May 9, 2018

 

 

Question 6

Q6: What signs of burnout can/should clinicians look for in their colleagues & what advice would you give on how to help that individual?#PWChat

— Physician’s Weekly (@physicianswkly) May 9, 2018

A6: Lack of empathy, cynicism, disengagement, blunted responses, loss of joy, social withdrawl, all point to signs of burnout. Often we can see it in our collegaues before ourselves. reach out – I set coffee dates or show up w coffee…and insist on chatting #PWChat

— Brave Enough MD (@RUBraveEnough) May 9, 2018

A6. When I feel like I’m getting there, I feel cranky, tired, unfulfilled, stressed. I like socialization so I will try to reach out to my friends for coffee or lunch dates and just talking, taking my mind out of my office helps. Reaching out is the best first step #PWChat

— Jasmine R Marcelin, MD (@DrJRMarcelin) May 9, 2018

 

 

Question 7

Running short on time, so going forward with Q7…

Q7: What day-to-day advice would you give to clinicians to help maintain some semblance of work-life balance?#PWChat

— Physician’s Weekly (@physicianswkly) May 9, 2018

A7: Take a few days – yes, days, – to remind yourself why you went into medicine, and what makes you find JOY there. Then do ALL you can do DO that thing for 20% of your work week; set boundaries; practice daily self care. There is power in self care &JOY. connect #PWChat

— Brave Enough MD (@RUBraveEnough) May 9, 2018

A7. I like the thought of daily gratitude. My mom shared about her reading a book by @AmitSoodMD and being grateful for little things each day. I also try to schedule my tasks so that I feel like I made many mini-accomplishments rather than failed at one big task #PWChat

— Jasmine R Marcelin, MD (@DrJRMarcelin) May 9, 2018

A7. I completely agree with the benefits and power of a daily gratitude practice. What has stuck for me is thinking of 3 things (no matter how small) from the day I am grateful for before going to sleep. #PWChat

— Sara Taylor, M.D. 🇨🇦 (@SaraTMD) May 10, 2018