Meaningful Change for Well-being and Joy

I’ve had the privilege recently of partnering with six family medicine residency programs for my CHARM Well-Being Leaders Certificate Course project. CHARM is the Collaborative for Healing and Renewal in Medicine, an international group of medical educators, academic medical center leaders, experts in burnout research and interventions, and trainees, all working to promote trainee well-being. It is hosted by Mount Sinai and led by recognizable names such as Dr. Saadia Akhtar, Dr. Jonathan Ripp, Dr. Colin West, and Dr. Kerri Palamara, to name just a few of the dynamic course faculty.  

The residency programs range from universities to community programs, with some urban-focused and others rural-focused, and range in size from 24 to 51 total residents and faculty. I am currently pouring over the needs assessment results about well-being being more than the lack of burnout, which inquired about parallel tracks of change. I asked what top system changes they felt would most improve their well-being and joy and what they felt were the top items they could change themselves to improve their well-being and joy.  

If you’ve been following me for any length of time, you know that I emphasize that burnout is an occupational issue. 80% of the drivers toward either burnout or engagement come from the workplace systems – categorized so nicely by Dr. Tait Shanafelt and Dr. John Noseworthy in their 2017 Mayo Clinical Proceedings work: Mayo Clin Proc. They categorized them into

-Meaning in work

-Social support and community at work

-Workload and job demands

-Control and flexibility

-Work-life-integration

-Organizational culture and values

-Efficiency and resources

My needs assessment looked at those specific areas and then inquired more specifically, within the areas, which items needed to be prioritized for change. My faculty lead, Dr. Paul Chelminski, noted that within my needs assessment questions, he sees 3 categories rather than two. In addition to organizational and individual, he felt I was able to flush out relational as a different bucket. (More on that down the road).

It will likely come as no surprise to most of you that workload and job demands was the broad category ranked highest for system change that could provide the most impact on well-being and joy.

I’m still sorting through all the statistics, and I look forward to one day highlighting some meaningful changes that each of these programs has undertaken to improve the system for the well-being of trainees. (AND faculty! One of the CHARM faculty members said, “There is no trainee well-being without faculty well-being.” I wholeheartedly agree.)

I (along with other more notable individuals) have highlighted that systems are slow to change. Waiting for the system to change would be a disservice to ourselves. And while there is a shared responsibility for our well-being borne in part by the institutions, we cannot abdicate our portion of that responsibility. I remember hearing somewhere along the line that for those of us in the human healthcare service industry, it is our "ethical imperative to take care of ourselves." Ethical Imperative. Strong words. What do you think of that?

So, please give yourself permission to rest and recover with regularity and ask for the necessary resources so you can continue to show up for yourself, your patients, staff, colleagues, family and community.

Those were the ideas behind my asking what was within their individual control. Learned helplessness (as one of the residents I recently coached named as something to which she had succumbed) isn’t going to be useful. We all have agency somewhere in our well-being. Taking charge of your well-being will put you in a position to ask for what you need, influence change, enjoy your chosen career (and life outside of it), know when it’s time to make a change, and, one way or another, many of you will be the change agents so needed within our systems.

Okay, are you interested in the top individual answer, “as it relates to your health, professional and personal satisfaction, and joy, pick the top area over which you HAVE control that would give you the most favorable impact?”

Exercise.

Yep, it was exercise. This was true for interns, PGY 2, PGY 3, and faculty alike. It was the top answer at each residency as a whole, except for one. It was true in university and community settings. urban- and rural-focused programs. Large and small.

And next week, I will offer a deeper dive into approaching movement and exercise as busy physicians. I’ve given an overview in the past but will dig further using a powerful tool that two very wise professors gave us. Stay tuned.

Until then, have a joy-filled week!  Tonya

If you're interested in talking with me about a coaching partnership for your residents or faculty, schedule a call.