One of my roles at work is to lead our physician group wellness committee. This is not a role with protected time or tangible rewards, but it is one I feel passionate about.
That said, it is really really hard to know what I (or we, as in the committee) can or should do to promote physician wellness.
I had some extra time yesterday during my work day (it does happen sometimes, though not often!) and since I did not want to do my Calcium and Electrolytes presentation, I decided to browse some official sources of physician wellness material.
I ended up watching this video, which I thought was well done. I liked the emphasis on leadership listening — really listing – to physician’s concerns. There was also more than one mention of coaching-inspired techniques. Then I came up with this list:
(After I was done, I added: “If you are a parent, do not skimp on childcare.”)
The title is tongue in cheek. Obviously I do not know the “secret to this whole thing.” When I was a first year medical student, we did a motivational interviewing exercise with a patient actor in which we were supposed to help them move towards quitting smoking. I ended the conversation to “That’s the secret to this whole thing!” and Josh and I have used this ridiculous phrase sarcastically ever since.
Anyway, the above list is obviously not complete NOR is it the secret. It is not going to make an overworked front line COVID-patient ICU physician magically happy and calm. It is not going to compensate for a chaotic office environment or lack of support staff or unreasonable patient volumes. But maybe for some it is food for thought. So I am sharing it here.
What would others add?
If you work for any sort of larger company, what are things that have been put in place that truly enhance wellness and job satisfaction?
31 Comments
I’m in allied health and previously had a 100% clinical job at a large children’s hospital in the midwest. They had a great wellness program, with a particular focus on heart health, and here are the things that I think made it successful:
1) accessibility – there was a small gym in the hospital (not in a different building, like at my current institution) and it was something like $10/month, so ridiculously cheap, and there were several well-marked paths inside and outside that had distance marked with encouragement to walk inside or outside even for 15-20 minutes;
2) free (!!!) fitness classes to all employees that were offered before, during, and after work hours with a variety of types/skill levels offered (yoga, boot camp, weights, etc.)
3) BUY IN from a lot of people.
I think #3 was the key – the administration was encouraging of people to use the gym and walking paths and fitness classes, even during the day (obviously as long as it didn’t interfere with work or clinics). They frequently had departmental challenges to get mileage in, people were visible when they used the walking paths, and the exercise classes were well-attended. Basically, they made it relatively easy and acceptable to prioritize exercise while on campus for work. I don’t know how much of this is possible now in the times of COVID or how things may have changed in the 10 years since I worked there, but I was very happy in that job and have often thought about how nice it was to have a culture that promoted employee wellness in that way.
I second the suggestion of having a gym on the property, if possible. A few jobs ago, I had a very long commute, and it was so much better from a life perspective to be able to work out RIGHT after work and then head home. It was also ridiculously cheap and well equipped. Was it awkward? No, because I didn’t see many coworkers there, and the ones I did we gave a little nod of solidarity and left each other alone.
“To be happy at home is the ultimate result of all ambition to which every enterprise and labor tends to.” That quote made me find my balance at work and home.
My counselor emphasizes consistent protein intake. Which seems like a no brainer. But speaking as a nurse, during busy 12 hour shifts at work where it’s a constant stream of demands, making time for actual sustenance for ourselves can fall by the wayside. The workflow can be different for physicians on the floor, but the days can be steady stream of “interruptions”, making attention to nutrition challenging to say the least! Unfortunately a snickers bar won’t cut it, and even a protein bar only gets you so far during a shift… the trick is getting multiple forms of protein consistently throughout the day. It’s vitally important to make it a priority though! Shocking how much it can affect wellness!
She also encourages meditation, and what surprised me was that even a very short session counts! It’s been unthinkable for me to try to plan a significant meditation in the rush of life most of the time. Your consistency in your morning routine is olympic in my book!! But what has translated into success for me in that realm has been an app called Insight Timer. Free guided meditations that you can search and filter by time. <5 minute sessions has been the ticket for me! Some in my favorites tab that I do frequently are literally 1 minute. It’s. Amazing. You can also search by topic (i.e. concentration vs relaxation), music, gender of the speaker, etc. It’s been a game changer for someone like me who struggles with maintaining a routine and lets self-care / personal wellness fall through the cracks amid the myriad of life/work demands. Unfortunately self-care is the easiest to stick on the back burner when putting out fires all day at work and home.
BUT! through listening to your BLP podcast and following your posts, I’m genuinely learning “how to plan”, and it has really promoted my success in implementing these strategies! By using your daily planning techniques and tracking protein and meditation, girl, your inspiration has been life. changing! From nesting goals (i’ve always loathed even the word goals! and now they directly contribute to getting my life together! Who knew! Haha!!) to monthly / weekly review you just have no idea how much you have helped me … and in a way that is so fun, not a chore!! It’s your pure joy in these things that comes through your voice that has been instrumental in transforming planning from something I “should really do but ugh, what a chore to keep up with” to “ooo i get to open my W222 and use my jetstream uniball to write on this soothing tomoe river paper!” Never thought that would be me, but the enjoyment of the process has really improved my quality of life!! Directly a result of the content you deliver girl! And for that I appreciate all you do!!!
All that to say – perhaps a workshop for your physician group illustrating your planning techniques would be beneficial in empowering them to implement wellness strategies. And I’m sure your residents could use some inspiration in finding systems to manage the rigorous demands of their educational pursuits! (You even could introduce them to different planners like that “she dreams” one! ah! so much fun!)
Lastly, something offered by the healthcare facility where I work is “Work Life Connections Counseling” for employees experiencing stress related to work, life changes, loss of coworkers or patients, etc. It’s a service that is facilitated by HR, so that could be outside the scope of your committee, but a proposal to HR could be an initiative for the committee to undertake. FWIW 🙂
I am very far from a physician but I think this advice is universal! I work for a small city (1000+ employees) and we have a robust wellness program. My favorite aspect of it is getting a big reduction on fitness center membership each year that we participate in the Health Risk Assessment (which also basically serves as my annual physical).
My company used to give each employees $600 to use towards fitness classes and gym memberships – you could use it to pay half of any wellness expense. It was administered through wageworks. Unfortunately that program got cut during the pandemic when we went into cost cutting mode. We also get points for going to trainings or tracking exercise (the program connects to your Fitbit or Apple Watch so can be very automated) and then once you accumulate a certain number of points you can exchange them for gift cards. Lastly, you get 10% off your insurance premium if you get a biophysical profile done. They bring in a company to do them at some point during the year or you can see your PCP. These all cost money of course, though!! But it’s nice that they value their employees health!
OK, this is completely my bread and butter! I am a consultant on large employer’s employee benefits, and my niche has been Health Systems. In the past I have worked with large multi-hospital systems where they are trying DESPERATELY to improve the health of their staff through wellness initiatives, and the truth of the situation is that most wellness programs don’t have a definitive ROI in the true sense of the word, which frustrates these employers. But, with that being said, a team I worked on developed a very simple wellness program for a local hospital that was hugely successful both culturally and financially, with a high level of employee participation, a reduction in medical claim costs, and an intangible improvement in culture/morale. The key points of focus were – #1 SLEEP. This turned out to be huge for hospital and health system employees. Just by focusing on sleep, we saw a trickle down effect into mental health and diet and other areas. I don’t know the terminology as I don’t work in a health system myself, but those that worked the night shift really struggled with their weight among other things. Rather than introduce a walking program or some kind of education on nutrition (lack of knowledge was not their problem) we introduced health coaching in which they could speak with a dedicated health coach over a period of months and set personal goals and habits to improve their sleep (specific techniques for shift workers, not just generic advise) the employees loved this. Two other areas of focus were a safe lifting course as part of their Safety program (lots of employees with neck and back issues) and requiring they see a provider (surprisingly these physicians didn’t have claims on file for seeing a doctor themselves, which could have been for a variety of reasons). If they completed these steps they received reduced cost for their health insurance. These simple steps made a big impact, so much so that we had employees give testimonials to share with other employees and the program continued to see success. Although wellness isn’t my main focus (I focus more on medical claims analytics and designing health plan coverage), I love talking about this stuff! I am happy to talk more with you about it off line if you want some feedback/ideas. I give you credit for stepping up and participating in the Wellness Committee as in my experience, physicians aren’t always eager to participate in these things 🙂
Thank you for finding something tangible like sleep to address and not mandating 4am yoga and after hours mandatory lectures on wellness, which my fellowship program endorsed. Really, THANK YOU.
Sadly things like yoga! Fitbit! Eat healthy! Quit smoking! Join a gym! Get lots of publicity but make very little impact. People who smoke know they shouldn’t. People who exercise will continue to. Those that need to exercise aren’t going to change because their employer says so, or for a nominal financial reward. If it was that simple we’d all do it… 🙂
There is data about paying people to quit smoking though! I wonder if you could pay them to wear a Fitbit and walk an extra 1000 steps per day.
Also I should have clarified- but the first step is determining leadership’s goals. There is nothing wrong with Fitbit challenges and cooking classes and all sorts of activities if the goal is to engage employees and have fun. The issues I have seen is when leadership wants their committee to make a measurable impact on employee health (ie a direct financial savings in medical claims) and the program isn’t aligned with that. I think all of your ideas are wonderful ones!
I would add: If you are in a leadership position, show your staff that you are doing these things. Show and tell that you are taking vacation time, exercising, walking, meditating, etc. to normalize it in the staff. Plus, when people are feeling better, it will create a more pleasant environment to work in.
In an example from my company, it’s one thing to say that you can take paternity leave. It’s another to see your CEO take paternity leave.
Ooh so true!!!!
This is a great list- I really thought it came from a book already. Thanks for sharing!
I work at The George Washington University and thought you might be interested to check out The GWell Center for Healthcare Professionals which “seeks to promote optimal wellness for all members of the healthcare and health sciences communities across George Washington University School of Medicine and Health Sciences, the George Washington University Hospital, and George Washington Medical Faculty Associates.
The served members of our community include graduate medical and health sciences students, residents, post-doctoral fellows, faculty, nurses, advanced practice providers, staff and alumni.”
https://smhs.gwu.edu/wellness/
-My employer had a massage therapist come on site every week or every other week and you could book massages in short increments. Seemed like it was subsidized as well. It really helped my shoulders!
-Generous time off policy and a culture of actually taking your time off
-Well publicized Employee Assistance Program free therapy sessions and EAP staff to help find a therapist
You probably can’t do much about this, but the most important things for my job satisfaction are good bosses and good friends at work. I imagine that’s true for most people.
The Transplant department I work for has a “Thrive” team/ wellness committee as well. They just launched a department wide virtual book club in January which so far has been really fun! I don’t even know many of the people in it, personally (it’s open to any and all disciplines I think within the dept.) but it seems like a great way to get to know some people and connect while NOT talking about work. 🙂 It will meet once a month on a Monday night, and the books do not have to be medical related at all. I’d never joined a book club before and so far I really like the no-stress, low key virtual format!! a good fit for me. 🙂
So, happy to spend money on childcare, but COVID itself makes it impossible to do that in a safe way. Many of us need to have free access to elderly or immuno-compromised family members… or otherwise want to take quarantine seriously. Like the way public health authorities have been telling us to do for the last year.
So it’s not a matter of skimping on childcare. It’s a matter of not finding external childcare safe. Unless you have an au pair or a nanny who literally sits at home when not with your family, there is no real “bubble” for childcare. It’s a calculated risk to break the family bubble and see how it works out.
This list was not meant to be specific to Covid times – was just brainstorming generally. But I’m curious … if you are a physician with a working partner (maybe another physician or essential worker) and a child … unless you have taken a year long leave some childcare would be involved, right? Agree that a live-in au pair or nanny that would stay in bubble would be the lowest risk option. But I guess I don’t see how no childcare is an option for most physicians?
the most impactful wellness policy implemented in my organisation was a organisation wide 2 weeks closure during holidays. no way is expected to work! it was first time ever but everyone appreciated it as there’s no need to work/check emails with zero guilt.
SHU, I think your brainstorm list is chock full of good advice, and they remind me of Gretchen Rubin’s personal commandments. So it might be helpful to have resources like a workshop or coach to help people identify strategies that may work best for their own unique person. It is neat to read here in the comments about what sort of wellness initiatives employers are implementing.
I think it’s important to teach that periods of intense stress have to be followed by periods of proactive restoration in order to avoid burnout. And restoration periods need to include good sleep, gentle and consistent exercises (because exercise that is too strenuous can be stressful and depleting, particularly in stressful times), nutritious and nourishing foods, meaningful time with people we love, and leisure activities that are legitimately relaxing. And knowing that when you’re facing periods of prolonged stress such as COVID, you have to find ways to incorporate these restorative practices into your every day life. These are things that are within their control, regardless of the institutional support, and in my experience, are tools that make the most difference as I manage stress. It’s when I’m not doing these things I’m dramatically undermining my ability to manage stressful situations.
You inspired me to sleep in this morning 🙂
Everything on your list makes sense, and every adult needs to learn how to care for themselves. These are great skills for everyone.
The catch here is the wounds that healthcare workers are facing are not, by and large, self inflicted. They are inflicted by an inane profit-drive ‘system’, an inadequate social safety net, underfunded public health, employers who don’t actually support adequate time off etc etc.
There is messaging out there to the effect of, “you doctors are so stressed out, you need to stop whining and make time to meditate more” which is horrid and just makes people resentful.
Then there is messaging like, “this is a stressful job. we want to support your well being. here are some meditation apps you could try, and we put a meditation bench outside the parking lot for you to use.” This is a little more helpful, but still puts all the onus on the wounded worker.
THEN there is action like, “this is a stressful job. It can be hard to disconnect from your EPIC inbox, and hard to come back to 400 new messages after a few days away. Our system has hired a dedicated person to cover inboxes for vacation, FMLA etc, and handle most of those messages, so that you can actually disconnect and not be immediately crushed when you come back from your time away.”
Yes, I realize this costs money. Its insane to me that there are people are profiting from the healthcare sector, and yet there isn’t the will or the cash to properly support the people actually providing the care (and physicians, arguably, are less abused than everyone else in the system–MAs, RNs, RTs etc. I created my examples from what I know).
We can take care of our own wellness and also demand better working conditions.
Yes yes yes this comment is gold. So very very true though I suspect there is some variation across healthcare systems and working environments.
This comment 100%.
I LOVE this post, and your ideas are great Sarah, as are the comments! I think the key is (as mentioned), leadership modeling these behaviors, and giving more than just lip service to it—actually putting resources (even $!) to address pain points. Things like “having access to free therapist” are meaningless when you can’t figure out how to find time to schedule or go to the appointments, for example. Same with discounts on gym memberships, meditation courses, whatever. If you want people to do it, you can’t make it ONE MORE THING on top of EVERYTHING ELSE especially when you are barely keeping your head above water as it is.
And yes, I feel the rage on the scheduled wellness activities that are just adding to your day, and preventing you from getting the f home to your family or your dog or your TV where you really want to be!
I second Kate’s comment – these are great overall life skills, and if I was chatting with a friend about how we are coping with work these might come up. But if someone in a leadership position at work told me that what could help with my wellness is having a hobby I would find it totally infuriating.
As an example, I’m an FNP in primary care, and because we have been moving for my partner’s job I have worked at 6 different organizations in 4 different states in the past 8 years. The jobs have all had a high degree of moral injury and secondary trauma since I’ve mainly worked with people that are homeless, refugees, recent immigrants, undocumented folx etc, but it has all been work that has been super meaningful and important to me, and I’ve known exactly why I was there. I have been basically the same the whole time – I’ve always exercised, meditated, had hobbies, had a social support network, taken my vacations, and basically everything else on this list (not because I’m special, but because I have enough money without crushing debt, no family members I’m caring for, no health issues, etc etc).
And yet I’ve had jobs where I honestly loved going to work every day, and was incredibly sad to leave, and others where I was so burnt out I felt basically numb to anything and didn’t want to talk to anyone by Friday, or where the stress was keeping me up at night and it honestly affected my enjoyment of other things in my life. The difference was not how much I meditated.
I am sure someone has researched this more clearly, but for me and most of my friends/colleagues I think some of the main factors:
1. A liveable/thrivable wage with reasonable benefits and time off for every single staff member.
2. A reasonable workload!!! That can be completed in general during the hours you are paid to work! Leadership also modeling that and not working constantly. Of course in medicine/nursing you are going to have to stay late sometimes, but if the norm is that everyone is charting at home for hours or seeing patients an hour after you’re supposed to be closed because you’re so behind – people are not going to be happy.
3. A true team where everyone feels ownership over patient care and is listened to and respected. I worked for 2 clinics within the same health system, one where this was true and one where the MAs/RNs and MDs/NPs operated basically as 2 separate entities without listening to each other and I will give you one guess where the staff were miserable and definitely provided worse overall care.
4. Leadership that not only listens but actually responds to the needs of the team. Not listening is obviously bad, listening but then not taking action or not being transparent sometimes feels worse.
Anyways, I’m glad that some of the commenters have found aspects of their employee wellness programs helpful, but I am with Kate – the meditation bench doesn’t really help when you are staring down 400 inbox messages – and I really hope that organizations will move away from the idea that wellness is an individual endeavour.
THese are such great points! Yes. I think both pieces are important but you are right – my list is necessary but NOT SUFFICIENT for job satisfaction. What you have written is the real key yet so much harder to accomplish (read: expensive) that it can be hard to bring up. But we (I) have to. And I have been thinking that it can be dangerous to mask this important piece with the individual responsibility “go meditate!” piece. And it’s hard to sleep well if you have 38438 incomplete charts in your inbox.
I work for a very large pharma company. Last week they offered us a meditation session (it was kinda more like guided relaxation) on Zoom (led by a 3rd party), and it was amazing! I was so grateful they did that and felt wonderful afterward.
That is awesome!!