Physician Wellness – From Burnout to Wellness

By Dr. Grace Mucci, CHOC Children’s Physician Wellness Subcommittee

One year ago, a group of CHOC Children’s physicians gathered to begin the process of defining and building a meaningful wellness program throughout the health system.

As many know, physician burnout has become of great concern, and we are only beginning to appreciate the scope of this phenomenon, including the impact of burnout on ourselves, our patients and our colleagues, in addition to the complexity of issues involved.  More importantly, we struggle with identifying the signs and symptoms leading to burnout, and how best to address them.

A recent survey of more than 15,000 physicians found that 44 percent of physicians reported symptoms of burnout, 11 percent reported subclinical depression, and 4 percent reported clinical depression. The gender disparity is notable, with 39 percent of males compared to 50 percent of female physicians experiencing burnout. The factors that lead to burnout are complex, and range from bureaucratic tasks and long work hours, to the challenges of electronic medical record keeping and loss of control/autonomy.

In a recent survey of physicians, 44 percent of reported symptoms of burnout, 11 percent reported subclinical depression, and 4 percent reported clinical depression.

Coping strategies vary and include a number of activities, including exercise, talking with close friends and family, and ensuring adequate diet and sleep. But sometimes these approaches aren’t enough.

Depressive symptoms can begin to emerge, leading to more serious functional impairment. If left unchecked, clinical depression can result. Unfortunately, many physicians contemplate suicide. It is estimated that one doctor a day dies by suicide in the United States, the highest rate of any profession1. Even more concerning is that of those physicians who report suicide ideation, 42 percent do not tell anyone or get professional help2. Obviously, this needs to be addressed, and it needs to be addressed now.

CHOC’s Physician Wellness Subcommittee is comprised of a group of physicians dedicated to help CHOC continue to be proactive and supportive of physicians. Our mission, “To promote physician wellness to benefit ourselves and others,” captures our focus. We have been meeting since January 2018 and have established several key goals with the Stanford Medicine Model of Wellness, below, as a guide3.

Using the key areas as a guide, we have determined the following short-term goals to address each area below:

  • Personal Resilience: A “Wall of Gratitude” displayed in the physician dining room (PDR) will give physicians a platform to recognize colleagues in an informal format posting words of appreciation and encouragement to one another.
  • Efficiency of Practice: Improvements to the computer work station in the PDR will ease charting while also gaining needed nourishment. Results of an EMR survey, conducted with the ARCH Collaborative, will provide us with specific and targeted data that will allow us to address common EMR frustrations and issues to help increase our efficiency.
  • Culture of Wellness: We are in the beginning phases of planning a “refresh room” where physicians can go to recharge, meditate and decompress. We’ve also made some improvements to the coffee machine in the PDR.

Additional long-term goals include:

  • Peer-to-peer mentorship training
  • Optimizing EMR practices
  • Gathering Information from physicians willing to help to improve our culture of wellness

Another noteworthy CHOC-supported activity that helps to meet our Personal Resilience and Culture of Wellness goals includes restoring the joy of practice through the Communication in Healthcare seminar that we’ve deployed. Approximately 60 physicians and additional allied health providers have completed the patient communication program. Participants have reported extremely positive feedback and state the training has increased their sense of fulfillment, communication efficiency, and overall resulted in more meaningful relationships with their patients.

While there is much work to be done, we are grateful for the support we have received from CHOC, and are confident, with our collective effort, that a culture of wellness is achievable.

If you would like to help in our efforts, reach me at 714-509-8225.

Physician Wellness Subcommittee:
Co-Chairs:  Drs. Felice Adler, Anjalee Galion and Grace Mucci

Members:  Drs. Richard Chang, Ashish Chogle, Susan Gage, Charles Golden, Jen Ho, Himala Kashmiri, Jessica McMichael, Shoba NarayanAshley Plant, Christina Reh, Andrew Shulman and Anita Shah

1Anderson P. Doctors’ suicide rate highest of any profession. WebMD. May 18, 2018. Source Accessed February 28, 2019.

2Pappas S. Suicide: Statistics, warning signs and prevention. LiveScience. August 10, 2017. Source Accessed February 28, 2019.

3Bohman, B., Dyrbye, L., Sinsky, C., Linzer, M., Olson, K., Babbott, S., & Trockel, M. (2017). Physician well-being: the reciprocity of practice efficiency, culture of wellness, and personal resilience. NEJM Catalyst.

2015 CHOC Children’s – UC Irvine Child Health Research Awards

We are pleased to announce that we just completed another round of the CHOC Children’s – UC Irvine Child Health Research Awards, our annual call for proposals that enhance research collaborations between CHOC and UC Irvine and further the Mission, Vision and strategic aims of the CHOC-UCI Child Health Research Strategic Plan. Intended to support research and collaboration in targeted areas of research excellence that align research strengths for focused growth and maximal translational impact, our call this year specifically solicited applications for two funding mechanisms, Pilot Collaborative Research Awards and Clinician Investigator Awards.

Child Health Research Award - UC Irvine Infographic

Pilot Collaborative Research Awards are intended to provide funds for collaborative projects in need of initial start-up funding to enable procurement of other independent support. These awards are designed to promote novel, translational research efforts that coalesce talented clinicians and researchers from CHOC and UC Irvine. Projects bring investigators from multiple disciplines from CHOC and UC Irvine together to identify targets for improved diagnosis, prevention, or treatment of a pediatric health problem relevant to the goals of the CHOC-UCI Child Health Research Strategic Plan.

Clinician Investigator Awards are intended to provide funds for clinician-investigator initiated projects in need of funding to advance study into a clinically relevant and important topic that has a high likelihood of impacting clinical practice and the positive experience of pediatric/ adolescent patients and their families. Priorities are given to proposals that are closely aligned with the research themes identified in the CHOC – UCI Child Health Research Strategic Plan. Projects identify targets for improved diagnosis, prevention, or treatment of a pediatric health problem relevant to the goals of the CHOC-UCI Child Health Research Strategic Plan. Collaborations between CHOC and UCI faculty are strongly encouraged, but not required.

This year we received 18 proposals, an increase of 13% over last year, covering a wide range of topics and specialties. After external academic peer reviews and committee discussions, we decided to fund 6 projects, 3 Pilot Collaborative Research Awards and 3 Clinician Investigator Awards.

Congratulations to the well-deserving recipients of the 2015 awards! They are listed below, in order of award type and Principle Investigator’s last name.

 

Pilot Collaborative Research Awards.

Principal Investigator: Dr. Gurpreet Ahuja

Collaborators: Drs. Nguyen PhamKevin Huoh, Naveen Bhandarkar, Carolyn Coughlan, Joon You

Project Title: NIR Imaging of Pediatric Sinuses

 

Principal Investigator: Dr. Tami John

Collaborators: Drs. Lilibeth Torno, Daniela Bota, Grace Mucci, Mary Zupanc, Jack Lin

Project Title: Cognitive Training to Promote Neuroplasticity and Neural Re-circuitry in Chemotherapy

Associated Cognitive Impairment

 

Principal Investigator: Dr. Calvin Li

Collaborators: Drs. John Weiss, Hong Yin, William Loudon

Project Title: A Tunable Engineered Tissue Graft Model for Repair of Traumatic Brain Injury

 

Clinician Investigator Awards

Principal Investigator: Dr. Antonio Arrieta

Collaborators: Drs. Katrine Whiteson, David Michalik

Project Title: Addressing the Fear Factor in Neonatal Serious Bacterial Infections: Distinguishing E Coli From Bacteremia, Urinary Tract Infection, and Bacteremic Urinary Tract Infection in Infants <28 Days vs. >28 Days to 90 Days Old by Pairing E. Coli Genome Analysis with Clinical Data

 

Principal Investigator: Dr. Joanne Starr

Collaborators: Drs. Richard Gates, Sharief Taraman, Mary Zupanc, Paul Yost, Michele Domico, Juliette Hunt, Tammy Yoon, Kimberley Lakes

Project Title: Seizures and Neurodevelopmental Outcomes in Mild Hypothermic Cardiopulmonary Bypass

 

Principal Investigators: Dr. Sharief Taraman and Ruth McCarty

Collaborators: Drs. William Loudon, Frank Hsu

Project Title: The Use of Traditional Chinese Medicine (TCM) as a Complementary Treatment of Pediatric and Young Adults with Post-Concussive Syndrome