COMMENTARY

Antidotes to Burnout: Fostering Physician Resiliency, Well-Being, and Holistic Development

Herdley O. Paolini, PhD; Burt Bertram, EdD, LMFT, LMHC; Ted Hamilton, MD, MBA

Disclosures

April 19, 2013

In This Article

The Florida Hospital Physician Support Services Program

The foundation of the program is 4 core beliefs.

The well-being of physicians is a matter of national health;

Physicians are human beings before they are MDs;

The culture of medicine as experienced within the hospital should actively support physicians to be healers; and

Physician leadership is crucial in promoting the needed changes.

From the beginning, Physician Support Services was envisioned as more than a place where troubled physicians could be sent when their behavior became problematic. The mission, as articulated by Don Jernigan, then President of Florida Hospital and today CEO of parent system Adventist Health, was to create a service that was absolutely safe for, and respectful of, doctors -- so that doctors would access its services on their own initiative. It would be a place where physicians could grow and develop holistically, as well as a redemptive place to address their emotional and psychological fears and traumas.

In its genesis, the program was operated much like an employee assistance program (EAP), but one dedicated to members of the medical staff. This "EAP model" languished with little utilization for almost 2 years before a new director was recruited. The new director, a PhD and licensed psychologist, decided that the best way to learn about the lives of physicians was to embed herself in their world -- to round with physicians, to scrub in with surgeons, to shadow physicians in their office practices, and to be there in the middle of the night as they responded to emergencies.

She also qualified for medical staff membership by working emergency department call schedules. She was determined to be visible in as many venues as possible so that physicians would come to know her as a human being and she would come to know them and their world and language. In time, members of the medical staff began to trust that they were being heard and understood, and that what was discussed would remain confidential. Demand then grew rapidly, and the service now remains highly used -- with a waiting list for nonemergency cases. More than 90% of the physicians in psychotherapy at any given time are self-referrals.

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