Like any issue, conversation is key to identify remedies. Physician burnout is no different, and Northwell Health is taking strides in opening communication and centralizing initiatives that could make an impact.
In September, North Shore University Hospital was the first New York area hospital to screen the provocative documentary, Do No Harm, Exposing the Hippocratic Hoax. which was also videoconferenced to 10 other Northwell hospitals. The documentary chronicled flaws in medical education that are being attributed to clinicians taking their own lives.
Northwell clinical leaders understand how complex the burnout issue is and its reach beyond residency.
“This is not something that has a simple and universal answer,” said Ira Nash, MD, executive director of Northwell Health Physician Partners. “The approach we have been taking is to get people talking about it, understand the scope and try to understand this from a system perspective — what are the environmental factors sucking the joy out of practicing medicine?
“We need to offer help at the individual level, get more people in the conversation and find the preventive measures that we can put in place.”
The Faculty Council at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell began discussing physician burnout last year and invited two clinicians regarded as experts — Stephen Swenson, MD, and Wayne Sotile, PhD — to speak.
Dr. Swenson spent three decades at the Mayo Clinic before his current role as medical director for professionalism and peer support at Intermountain Healthcare and has written extensively on professional burnout. Dr. Sotile authored The Resilient Physician and is founder of the Sotile Center for Resilience in North Carolina.
Their message had a lasting impact.
“We are trying really hard to come up with meaningful steps,” said Penny Stern, MD, Northwell’s director of preventive medicine and president of the Faculty Council at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. “Something we got from the Mayo Clinic is encouraging physicians to get together socially. Hang out in small groups and have a meal together, meet other like-minded people, but not under clinical circumstances.”
Dr. Nash also spearheaded the development of Physician Partners’ Well-Being Committee — a 25-member unit led by Jacqueline Moline, MD, the health system’s vice president of, occupational medicine, epidemiology and prevention.
“We hope to provide a toolbox,” Dr. Moline said. “We need to identify best practices from our colleagues around the country who are confronting this. Let’s start something here and give people an opportunity. Some have worked on burnout prevention within their department and have come up with a fantastic curriculum.”
Dr. Moline said the committee’s biggest hurdle is developing unique programs for Northwell’s exorbitant and diverse practices, as well as all experience levels.
“How do you tailor initiatives that are relevant for so many people?” she said. “Also, establishing programs not just for those who are starting their careers, but seasoned clinicians. How do you develop a program that fits a four-person practice and a hundred-person practice? We grapple with this.
“There are a menu of different options — take a few days off and offer physician-to-physician support. But the real issue is can we change the culture so it is OK to take a sick day for mental health. If you are feeling mentally unfit, you should be treated no differently than if you have a sore throat. We rally around people who have a cancer diagnosis. Why can’t we rally around someone with mental illness?”
Dr. Moline said the committee will launch the Connect the Docs initiative in 2019. Modeled after a similar program at the Mayo Clinic, Connect the Docs will feature 27 dinners for physicians across the health system.
“These will help physicians to get together and connect with their peers,” she said. “A simple program like this can decrease physician burnout and have more of a sense of community through commensality.
“The dinners won’t have an organized agenda but will include a facilitator who will start the conversation. The goal is to not have a gripe session, but to discuss certain topics.”
The committee is contemplating partnering with the Humanities in Medicine program at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell to provide opportunities to explore creative outlets. Utilizing mobile apps to keep physicians active and engaged on goals, eating right and their well-being is also under consideration.
Northwell already has some avenues available for employees feeling burned out. The health system’s Employee and Family Assistance Program, for example, provides confidential counseling for a range of issues. The Physician’s Resource Network also offers personalized cost-free consultation and short-term counseling for all attending physicians, residents, physician assistants and medical students.
The health system also supports employees with through additional programs such as the Physician and Executive Concierge Team, the myWellness Platform (about 50 percent of Northwell’s physician are enrolled), skills training at the Center for Learning and Innovation and discounts for various fitness centers.
Around the system, there are individual efforts to provide wellness and resilience activities. Since 2013, Team Lavender has given caregivers emotional support to help cope with tragic events.
Patricia Flynn, assistant vice president for employee wellness at Northwell, noted that Southside Hospital routinely organizes lectures, daily activities and surveys for physicians.
The Employee Wellness program also hosted 250 employees from across the health system during its Well-Being Retreat in September. The event featured Amit Sood, MD, a professor of medicine at the Mayo Clinic who directs the Mind-Body Medicine Initiative and creator of the Mayo Clinic Healthy Living Resilient Mind program, as well as a panel discussion on creating a culture of wellbeing.
“For employee wellness, my job is to create a culture where people can get healthy, supplying nutritious food in cafeterias, ensuring you have a supervisor that is supportive, offering yoga classes and other supportive programs. Anyone who calls us we can help them,” Ms. Flynn said.