Based on an American Medical Association news article published May 17, 2019 and Sara Berg's interview with Amber Hastings-Truelove, PhD, research associate in the Faculty of Health Sciences at Queen's University, Ontario, Canada.
Learn how a multi-disciplinary task force crafted a well-being program that reaches physicians across the career continuum.
The medical community is aware that burnout remains high, and is seen in medical students, residents and practicing physicians, as well as other members of the health care team. However, to begin making an impact, it is important to look at how well-being is being approached in medical school and in the clinic. To do that you need to create an effective physician wellness program.
Developing the Intervention
“Physician wellness matters. It matters to the physicians who are going through this and it matters to the patients who are on the receiving end of this care,” said Amber Hastings-Truelove, PhD, a research associate in the Faculty of Health Sciences at Queen's University in Ontario.
The Royal College of Physicians and Surgeons of Canada established a physician wellness strategy task force to influence doctor education across the career continuum. The task force was created by the Royal College and is chaired by Leslie Flynn, MD, vice dean of Education Faculty Health Sciences at Queen's University. The task force members represent a variety of organizations and have diverse backgrounds. Other members of the task force include:
Sarah Ann Smith, MD, a resident at the University of Toronto.
Caroline Gerin-Lajoie, MD, vice-president of physician health and wellness at Canadian Medical Association, and a psychiatrist and associate professor at the University of Ottawa.
Erica Dance, MD, an emergency physician and assistant dean of Resident & Fellow Affairs at the University of Alberta.
Mithu Sen, MD, acting vice dean of faculty affairs and assistant dean of faculty equity and wellness at Western University.
Christopher Simon, PhD, senior advisor at Canadian Medical Association.
“We've compiled recommendations from experts in the field and we've compared them with the results of the scoping literature review to create a matrix of change to identify the most effective evidence-based interventions,” said Hastings-Truelove. “To allow us to think through how to create a change in medical culture, we created a template that loosely allowed us to follow four steps and bridge a matrix of change.”
There are 4 steps that Dr Hastings-Truelove and colleagues recommend taking when creating an effective physician well-being program in your organization or school.
Figure 1. Four Features to Cover When Creating a Well-Being Program
Identify existing goals and processes
This first step is divided into 2 parts. In part A it is important for teams to identify existing goals and processes. “For us that was doing an environmental scan of the Canadian medical schools—what's already been offered over there?” said Hastings-Truelove. “So, what does our starting point look like?”
And the second part of this step involves identifying target processes and goals. This is where experts compile their “wish list of what standard physician wellness would look like—where do we want to get to?” she said.
Look at system interaction
“We started thinking about the different levels involved in physician wellness, so the individual, the organization and the culture,” said Hastings-Truelove. “So, what are the interactions between these three levels?” Understanding that will help organizations figure out where to begin.
Discover transition interactions
Part of this is identifying the difficulty in making this change for an organization. “There's lots of evidence that's available,” she said. “Lots of people are doing different things with physician wellness, but it hasn't really been compiled into one place.” With so many pilot programs, part of this is bringing together the wealth of evidence. While people and organizations are working on improving physician burnout through well-being initiatives, what works?
Survey the stakeholders
Hearing from experts in the field is an important step. For example, Hastings-Truelove's team scheduled a workshop and invited key stakeholders to join them and contribute their voice to recommendations.
“Our target goal is to create a culture where each level reinforces the next. So, the individual has a responsibility to know what resources are available to make personal choices that contribute to wellness,” said Hastings-Truelove. “The organization has a responsibility to measure wellness and provide clear policies around support and accommodations that include flexibility.