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Strategies to Build Resilience in Medical Practice Thurston-Mason County Medical Society Meeting...
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Transcript of Strategies to Build Resilience in Medical Practice Thurston-Mason County Medical Society Meeting...
Strategies to Build Resilience in Medical
PracticeThurston-Mason County Medical Society Meeting
Claudia Finkelstein [email protected]
Learning Objectives:
• Define burnout• Name evidence based strategies to promote resilience• Be aware of existing Resources
In our world: a syndrome characterized by Three Spheres
emotional exhaustion - being emotionally overextended and exhausted by one's work
depersonalization - unfeeling and impersonal response toward recipients of one's service
decreased sense of personal accomplishment – lack of feelings of competence and successful achievement in one's work
Single Item Measure
• I feel emotionally burned out or emotionally depleted from my work
• I have become more callous toward people since I took this job — treating patients and colleagues as objects instead of humans.
Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals. West CP, Dyrbye LN, Sloan JA, Shanafelt TD.J Gen Intern Med. 2009 Dec;24(12):1318-21
Burnout Prevalence
• Students 50 % burnout, 11 % suicidal ideation Dyrbe,LN Ann Intern Med. 2008 Sep
2;149(5):334-41.
• GME varies w specialty 25-75% burnout Ishak WW J Grad Med Educ. 2009 Dec;1(2):236-42
• 1/3 all docs experiencing burnout at any given time Shanafelt,JAMA. 2009 Sep 23;302(12):1338-40
How Can We Make It Better?Examine Causes
Personality traits-idealism, high sense of personal responsibility,
perfectionism
Risk factors for burnout>60,
especially >80 hours/week, young
kids, 2 careers,
career characteristics:
sense of control, appreciation,
meaningful work, fair workload, aligned values
What works: Individual
• Maslow hierarchy• Happiness practices• MBSR• Gratitude Journal• Peer group support• Compassion/empathy/meaning• Spiritual practice
Gratitude Journal
• There is not only one right way (frequency, time of day)• Do it and mean it• Quality more than quantity• Add some details• Savor it• Change it up
Peer group support
• Balint• Finding Meaning in Medicine• Mind Body groups• Faculty meeting time w/o agenda
Compassion/empathy/meaning
• Narrative exercises• Emotional regulation• Perspective taking• Compassion Cultivation training• Medical improve• Connection w meaning/purpose
Peer Support -What is it?
• Option for colleague or self needing support (but not necessarily a psychiatrist/lawyer/etc.)
• Peer to peer service offering- an ear, resources, empathy, confidentiality*
• *unless “duty to report” supersedes
Talking points
• safe way for clinicians impacted by adverse events, medical errors, litigation or other workplace stressors to talk about their experiences and emotions
• does not offer therapy, provides a network of faculty clinicians who offer a listening ear to colleagues experiencing stressful situations. Peer supporters receive training in how to listen and respond as well as information about resources.
Organizational: 2 studies • Quality of Patient Care Drives Physician Satisfaction; Doctors Have
Concerns About Electronic Health Records-• http://www.rand.org/news/press/2013/10/09.html
• In Search of Joy in Practice: A Report of 23 High-Functioning Primary Care Practices
Ann Fam Med. May 2013; 11(3): 272–278.Christine A. Sinsky et al
Rand Study: Primary driver of MD satisfaction?
• The quality of care one can deliver (with an element of control)
Rand Study: Primary driver of MD dissatisfaction?• EHR
• Too much clerical time per task• “death by a thousand clicks”• Poor note quality• Eye contact