Building community during the COVID-19 pandemic: a system level approach to physician well-being

2021 ◽  
Vol 7 (4) ◽  
pp. 166-170
Author(s):  
Serena Siow ◽  
Carmen Gittens

Before the COVID-19 pandemic, physician burnout was identified as reaching crisis proportions, and the pandemic is expected to worsen the already perilous state of physician wellness. It has affected physicians’ emotional health, not only by increasing workload demands, but also by eroding resilience under increasing pressures. The mental health consequences are expected to persist long after the pandemic subsides. With physician wellness increasingly recognized as a shared responsibility between individual physicians and the health care system, system-level approaches have been identified as important interventions for addressing physician well-being. In this article, we describe two evidence-guided initiatives implemented in our hospitalist network during the current pandemic: a trained peer-support team and facilitated physician online group discussions. These initiatives acknowledge the emotional strain of physicians’ work and challenge the “iron doc” culture of medicine. Our efforts build community and shift culture toward improved physician wellness. We suggest that the pandemic might be an opportunity for our profession to strengthen our support networks and for physician leaders to advance physician wellness in their work environments.

Work ◽  
2021 ◽  
pp. 1-7
Author(s):  
Claudia Finkelstein ◽  
Anne Ordway ◽  
Kurt L. Johnson

BACKGROUND: Burnout is widely regarded as a syndrome resulting from chronic occupational stress. While physician burnout has been the subject of extensive research, physician wellness has been proposed as an alternative framework for understanding physician distress. OBJECTIVE: The purpose of this qualitative study was to understand the organizational context of faculty wellness within an academic health care system. METHODS: Semi-structured interviews were conducted with 24 chairs of clinical and non-clinical departments in a US university school of medicine. RESULTS: Chairs described several system-level factors perceived to interfere with faculty wellness such as a stricter regulatory environment, the loss of professional autonomy, the up or out promotion system, limitless hours, and the rise of shadow work. While all chairs articulated some degree of responsibility for the wellness of their faculty, some said they lacked the skills or knowledge of resources to fully engage in this role. CONCLUSIONS: Findings from this study are consistent with recent research on physician burnout, which has pivoted from describing burnout as an individual responsibility to including the professional, organizational, and societal factors which likely contribute to physician job satisfaction and well-being. As health care organizations, including academic medical centers, move toward systems-based solutions for physician occupational health, it will be incumbent upon organizational leaders to make administrative decisions favoring physician wellness.


2021 ◽  
Vol 7 (2) ◽  
pp. 67-71
Author(s):  
Jason Chaulk

Canadian health care costs are unsustainable and are among the highest in the world. A greater focus on system-level initiatives is needed, and recognizing physician wellness as a quality indicator for health care delivery may be part of the solution. Physicians’ psychosocial health is a significant cause for concern and has been directly tied to patient outcomes. However, suicide rates among physicians are approximately 2.5 times those of the general population and burnout rates are twice those of other workforces. Investing in physician health programs (PHPs), specifically the components dealing with psychosocial issues, is one way to make medicare sustainable. Further, greater provincial government support of national guidelines for the formation of PHPs is needed. This commentary focuses on these background issues and suggests a path toward a more sustainable health care strategy focusing on physician well-being.


2018 ◽  
Vol 4 (3) ◽  
pp. 228-244 ◽  
Author(s):  
Ivan J. Raymond ◽  
Matthew Iasiello ◽  
Aaron Jarden ◽  
David Michael Kelly
Keyword(s):  

2020 ◽  
Vol 8 ◽  
pp. 95-108
Author(s):  
Shanti Prasad Khanal

 The present study aims to examine the multi-level barriers to utilize by the youth-friendly reproductive health services (YFRHS) among the school-going youths of the Surkhet valley of Nepal. This study is based on the sequential explanatory research design under mixed-method research. The quantitative data were collected using the self- administered questionnaire from the 249 youths, aged between the 15-24 years, those selected by using random sampling. The qualitative data were collected using the Focus Group Discussions (FGDs) from the 12 participants who were selected purposively. The study confirmed that school-going youths do not have appropriate utilization of YFHS due to multi-layered barriers. However, the utilization of the service was higher among females, those the older age group, studying in the upper classes, the upper castes, and married youths. The key findings and themes are recognized as multi-layered barriers including personal-level, health system-level, community-level, and policy-level on the entire socio-ecological field. Among them, the existing health system is the foremost barrier. Multi-level interventions are, therefore, required to increase the YFRHS utilization and improve concerns for school-going-youths.  


Obesity Facts ◽  
2021 ◽  
pp. 1-6
Author(s):  
Michele O. Carruba ◽  
Luca Busetto ◽  
Sheree Bryant ◽  
Antonio Caretto ◽  
Nathalie J. Farpour-Lambert ◽  
...  

The Milan Charter on Urban Obesity highlights the challenges of urban environments as a battleground for human health, as cities are often organized to subvert public health goals, and promote rather than prevent the development of obesity and consequent non-communicable diseases. The Charter articulates ten principles which detail actions and strategies through which general practitioners, diverse medical specialists, related healthcare professionals, administrators and healthcare practice managers, policy actors – within health systems and at a national level – along with experts across disciplines, and citizens, can work in cooperation to meet this challenge and improve public health. The Charter urges the adoption of decisions that deliver the following: (i) policies which enable our cities to become healthier and less obesogenic, more supportive of well-being and less health-disruptive in general, and (ii) policies that fully support primary prevention strategies, that address social stigma, and that ensure fair access to treatment for people living with obesity. The Milan Charter on Urban Obesity aims to raise awareness of our shared responsibility for the health of all citizens, and focuses on addressing the health of people living with obesity – not only as a challenge in its own right, but a gateway to other major non-communicable diseases, including cardiovascular diseases, type 2 diabetes, and some cancers.


2021 ◽  
Vol 11 ◽  
pp. 204512532098663
Author(s):  
David M. O’Shaughnessy ◽  
Ilana Berlowitz ◽  
Robin Rodd ◽  
Zoltán Sarnyai ◽  
Frances Quirk

Aims: The therapeutic use of psychedelics is regaining scientific momentum, but similarly psychoactive ethnobotanical substances have a long history of medical (and other) uses in indigenous contexts. Here we aimed to evaluate patient outcomes in a residential addiction treatment center that employs a novel combination of Western and traditional Amazonian methods. Methods: The study was observational, with repeated measures applied throughout treatment. All tests were administered in the center, which is located in Tarapoto, Peru. Data were collected between 2014 and 2015, and the study sample consisted of 36 male inpatients who were motivated to seek treatment and who entered into treatment voluntarily. Around 58% of the sample was from South America, 28% from Europe, and the remaining 14% from North America. We primarily employed repeated measures on a psychological test battery administered throughout treatment, measuring perceived stress, craving frequency, mental illness symptoms, spiritual well-being, and physical and emotional health. Addiction severity was measured on intake, and neuropsychological performance was assessed in a subsample from intake to at least 2 months into treatment. Results: Statistically significant and clinically positive changes were found across all repeated measures. These changes appeared early in the treatment and were maintained over time. Significant improvements were also found for neuropsychological functioning. Conclusion: These results provide evidence for treatment safety in a highly novel addiction treatment setting, while also suggesting positive therapeutic effects.


2021 ◽  
Vol 13 (7) ◽  
pp. 3924
Author(s):  
Wendy M. Purcell ◽  
Brian S. Feldman ◽  
Molly Finn ◽  
John D. Spengler

The Culture of Health framework includes four pillars of societal health and well-being influenced by business, namely: consumers; employees and workers in the supply chain; the community, and the environment. The Auto industry was an ideal crucible in which to explore the interface of public health with business given the confluence of the different domains in this sector. The substantial benefits of mobility, especially for the under-resourced, sit alongside negative impacts from emissions, accidents, products and services. Through interviews with 65 senior executives from seven major automakers, corporate actions reflecting health as a strategic agenda were mapped to the Culture of Health model. While most of the companies did not use the language of health explicitly in their strategy, key examples were present across all four pillars. Given the future of mobility relies on the interface of human experience with technology, it is a population-level challenge demanding system-level changes. Ostensibly, a framework for sustainability, the Culture of Health model could help the Auto industry navigate the disruption caused by the global megatrends and changing societal expectations of business in society and transition successfully to a new mobility economy.


Author(s):  
Camilla Ihlebæk ◽  
Camilla Castellan ◽  
Jenny Flobak ◽  
Jo Ese

Schools may play an essential role as an arena for co-creating community activities that enhance well-being, equity, and citizenship. Still, there is limited knowledge about physical and non-physical factors that contribute to well-being within such approaches. The aim of this study was to identify important factors for well-being as perceived by pupils, school employees, and parents in a community school in Norway. The participatory method photovoice was used, and seven pupils, six employees, and four parents participated by taking photos used as the basis for six focus group discussions. Transcripts of the discussions were analyzed using Systematic Text Condensation. The analysis showed that the participants experienced that the school’s built and natural environment, the activities happening there, and the human resources and organization at the school facilitated perceptions of safety, inclusion, and cohesion, which in turn contributed to well-being. Furthermore, the results showed that co-creating schools as a community arena could be an innovative way of ensuring participation, equity, and well-being in the community. Such an approach might be especially important in deprived areas or in multi-ethnic communities. An important prerequisite to succeed is the openness of the school’s staff to engage in co-creation with other stakeholders in the community.


BMJ Leader ◽  
2020 ◽  
pp. leader-2020-000344
Author(s):  
Taylor C. Standiford ◽  
Kavya Davuluri ◽  
Nicole Trupiano ◽  
David Portney ◽  
Larry Gruppen ◽  
...  

BackgroundThe COVID-19 pandemic impacted many aspects of normal operations in academic medicine. While effective leadership is always important, the intensity and urgency of COVID-19 challenged academic medicine leaders to find new ways to lead their institutions and manage their own experiences of the pandemic.MethodsSixteen physician leaders from Michigan Medicine took part in semistructured interviews during April and May 2020. Participants were asked open-ended questions about the attributes and techniques that were important to effectively lead during a crisis. The authors analysed the interviews using thematic analysis.ResultsParticipants described three overarching themes of leadership during the COVID-19 pandemic: (1) bringing together a diverse team with clear, shared goals; (2) using a range of strategies to tend to their teams’—as well as their own—well-being; and (3) engaging in leadership reasoning as a way of learning from others and reflecting on their own actions to inform their future leadership practice.ConclusionThe results of this study reveal several salient themes of crisis leadership during the COVID-19 pandemic. The findings also highlight the role of leadership reasoning, a reflective practice employed by leaders to understand and improve their leadership skills. This finding presents leadership skill development as part of lifelong learning in medicine. Findings may be incorporated into best practices and preparations to inform future healthcare leaders.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 451-452
Author(s):  
Mary Caroline Yuk ◽  
Rebecca Allen ◽  
Marcia Hay-McCutcheon ◽  
Dana Carroll ◽  
Anne Halli-Tierney

Abstract Age related hearing loss, or presbycusis, is a global condition that is increasing in its prevalence. Despite being one of the most common chronic conditions among the older population, there is much more to understand about its association with other aspects of physical and emotional health and well-being. Current research is suggesting that hearing loss is more prevalent in those with cognitive impairment compared to those without cognitive impairment. This study analyzed the incidence of hearing loss and its linkage to mild cognitive impairment in a community-dwelling geriatric population. With the increasing prevalence of this condition in both rural and urban communities of Alabama, it becomes a more pressing matter to understand comorbidities and risk factors for future decline in functioning. This study was conducted in an interdisciplinary geriatrics primary care outpatient clinic in a Family, Internal, and Rural Medicine department affiliated with a university medical center in the Deep South. Ninety-one participants completed the Montreal Cognitive Assessment (MoCA) and a hearing screening. Hearing screenings were conducted in quiet rooms in the medical center using Phonak hearing screening cards. Detection of 500, 1000, 2000, and 4000 Hz tones was assessed. Pearson correlation analyses demonstrated an association between hearing loss mild cognitive impairment. Poorer hearing was significantly associated with lower scores on the MoCA. Conducting behavioral health screenings like this in other primary geriatrics clinics and community settings could improve care and identification of patient needs by integrating important data regarding comorbidities and independent living.


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