These physicians battle burnout on the front lines

Even before the COVID-19 pandemic began, feelings of depression and burnout were rampant among clinicians. It is no surprise that the pandemic has made matters worse, with 49% of healthcare workers reporting feelings of burnout, according to a national survey of more than 20,000 healthcare providers.

As a response, the National Academy of Medicine and other professional organizations have called on healthcare systems to institute interventions to promote clinician well-being. Healthcare organizations have heeded this call and, as a starting point, many have appointed chief wellness officers at their organizations who are tasked with integrating the well-being of the healthcare staff into the organization’s culture. These physicians are changing the dialogue surrounding clinician well-being. 

Tait Shanafelt, MD

As one of the first chief wellness officers in the country, Dr. Tait Shanafelt has brought the topic of clinician burnout to the forefront. He is currently the chief wellness officer at Stanford Medicine in Stanford, CA, but his interest in the mental health and wellness of healthcare providers dates as far back as his residency years at the University of Washington. 

As a senior resident, Dr. Shanafelt noticed that the medical interns he was supervising suffered from exhaustion and burnout. His observations culminated in one of the first studies published on physician burnout and its impact on patient care. 

After residency, he joined the Mayo Clinic as a hematology and oncology fellow, and he later became a faculty member. He was named director of the Department of Medicine Program on Physician Well-Being and made numerous efforts to prevent burnout in his staff. While others were working to address burnout at the individual physician level, Dr. Shanafelt enacted change by targeting leadership, the environment, and the organizational culture. 

Due to his efforts, the burnout rates among physicians at Mayo decreased 7% over 2 years while the national rate saw an 11% increase. 

Since 2008, Dr. Shanafelt has thought deeply about physician wellness and has overseen multiple national surveys that have included more than 30,000 physicians. His work has shed light on the increasing rates of burnout among healthcare professionals and the link between burnout and physician errors. 

Amy Frieman, MD, MBA, FAAHPM

Dr. Amy Frieman was appointed the chief wellness officer at Hackensack Meridian Health in Edison, NJ, shortly before the start of the COVID-19 pandemic. 

Trained as a palliative care physician, Frieman was drawn to well-being work due to her own experiences with burnout during her medical training. She turned a difficult ICU rotation into a lifelong focus on making sure clinicians have positive work experiences. 

Since taking on the position of chief wellness officer, Dr. Frieman has made strides to remove the stigma associated with mental health issues that often prevents healthcare providers from seeking care. During the pandemic, she launched the “Even Heroes Need to Recharge” campaign, which provided clinicians with real-life examples of physicians and other healthcare providers who have sought help for burnout and were willing to discuss their experiences. 

In addition to her work on destigmatizing mental health issues, Dr. Frieman has focused her efforts on system-level interventions. 

In an interview with the American Medical Association, she said, “If we want to solve for burnout, if we want to improve the clinician experience, we can't do it by teaching our physicians and clinicians to be more resilient inside of a broken system. We have to fix the system.” 

Lisa MacLean, MD

Dr. Lisa MacLean has been the director of physician wellness at Henry Ford Hospital in Detroit, which has reported lower rates of burnout compared to the national average, since early 2017. 

She has promoted clinician well-being by focusing on two areas: 

1. Establishing a caring workplace culture. By ensuring that the organization’s leadership and culture are caring and supportive, physician well-being—and ultimately patient well-being—can be actualized. To meet this need, the leaders of Henry Ford Hospital created a physician well-being task force and advisory committee to ensure the hospital’s culture is receptive to the needs of its doctors and other healthcare providers.

2. Creating meaning in work. The cornerstone of this area of focus at Henry Ford is building physician resilience as well other attributes that exemplify emotional and professional well-being. 

Dr. MacLean and her colleagues have instituted monthly wellness rounds covering a variety of topics on physician burnout and well-being, with each session attended by 100-150 individuals. 

Building physician resilience starts early on at Henry Ford—orientation programs include a talk on resilience. The overall goal is to create a healthy team culture where each member can thrive. 

Heather Farley, MD

Dr. Heather Farley is the chief wellness officer at ChristianaCare in Wilmington, DE. To support her staff during the pandemic, Dr. Farley and her colleagues have implemented in-person rounding of healthcare providers at the frontlines, with more emphasis on COVID-19 units and the emergency department. 

During every shift, Dr. Farley’s staff from the Center for WorkLife Well-Being push around a cart with food, drinks, and comfort items such as lip balm and hand lotion. The idea is to not only supply healthcare providers with basic needs, but to use the cart as an opportunity to have deeper conversations about well-being. 

While rounding, Dr. Farley’s team places an emphasis on being proactive and connecting caregivers with resources and support, including identifying any unmet needs. 

Dr. Farley has also instituted a robust peer support program, with more than 70 trained volunteer peer supporters in various roles, including physicians and residents. Her team has seen a threefold increase in individual peer support requests and a 10-fold increase in group support encounters during the acute phase of the pandemic compared to their baseline. 

“Yes, therapists and counselors are absolutely helpful, but what clinicians often say that they want and need in these times is peer support from someone who's been in their shoes to help them process some of the difficult emotions that they experienced after those events,” Dr. Farley said in an interview with the AMA. 

Sources 

1. Berg, S. How Henry Ford Hospital is working to prevent physician burnout. American Medical Association. 2018. 

2. Berg, S. Q&A: How to ensure physician well-being is top of mind in 2021. American Medical Association. 2021. 

3. Berg, S. Q&A: She was hired to boost doctors’ well-being—then COVID-19 hit. American Medical Association. 2021. 

4. Prasad K, McLoughlin C, Stillman M, et al. Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID-19 pandemic: A national cross-sectional survey study. EClinicalMedicine. 2021;35:100879.

5. Richter R. In a first for U.S. academic medical center, Stanford Medicine hires chief physician wellness officer. Stanford Medicine. 2017.