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

Support Services for Physicians

Counseling and psychotherapy. Counseling and psychotherapy are available to all physicians and family members. Physicians come for counseling generally at their own initiation, but the servicealso handles referrals mandated by behavioral issues.

On-boarding interview. As part of the credentialing process, physicians participate in an initial interview with a therapist. The embedding strategy offers a nonthreatening opportunity to establish a relationship between the new physician and the mental health professional. The therapist initiates a discussion about health and self-care practices, invites the physician to consider his or her professional development and future goals, and encourages the physician to tap into resources to support growth and development. Self-care is presented not as an option but as a best practice, therefore normalizing and integrating the personal with the professional.

The on-boarding interview introduces physicians to the physician support services program, as well as acting as a critical triage point for incoming physicians. The credentialing interviews have proven to be the single most important source of self-referral to the physician support services, responsible for more than 50% of clients seen in the program. Often, a physician will call to make an appointment for therapeutic services within 1 month of the on-boarding interview.

Executive coaching and consultation. Physician leaders benefit from coaching relationships at many points in their careers, in both the clinical and administrative arenas. Coaching services can improve performance, achieve better work/life balance, manage stress, improve health and well-being, increase interpersonal competence, and develop leadership skills. Coaching and consultation are particularly helpful when the physician is faced with challenging leadership or interpersonal tensions with patients, office or hospital staff members, partners or colleagues, and other healthcare professionals. The physician and the coach collaborate to understand the source of the problem, then design and implement trust-building, communication-enhancing, and conflict-resolving interventions to address the dysfunctional situations. Consultation, a shorter-term interaction, is provided upon request to administrators and medical staff leaders who face difficult medical staff issues.

"Finding Meaning in Medicine." Originally developed in the late 1990s by Rachel Remen, MD, these physician-to-physician facilitated dialogues invite doctors to speak from the heart about personal experiences in the everyday practice of medicine that remind participants of why they became doctors and encourage them to see their colleagues as people. These conversations enhance trust, goodwill, and collaboration among the physicians, which is a "win" for everyone -- the individual physician, the patients, and the healthcare system in which they function.

Physician leadership retreats. These retreats give physician leaders an opportunity to engage with peers as they increase awareness of personal styles, goals, and values in combination with a realistic and honest assessment of the present environment of medical practice. It offers them tools to grow their own resiliency while gaining an individual and collective voice to engage the systems where they work and foster needed change.

Collegiality events. "Physicians in Concert" is an event designed to build a sense of community within the medical staff, while creating visibility for Physician Support Services within the community. These occasional concerts feature music performed by members of the Florida Hospital medical staff, providing them the opportunity to show another side of their talents and the audience a chance to enjoy some music.

Resiliency training. The daily demands of a complicated medical practice challenge providers to concentrate on the task before them, yet be able to recover rapidly and confront new problems and situations. Resiliency training teaches physicians to strategically incorporate into their lifestyles nutrition, exercise, self-reflection, mutually supportive relationships, and good health practices. Resiliency when confronted by adversity is supported by a holistic approach to improved overall health and well-being.

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