by Chad D. Morris, PhD, and Cindy W. Morris, PsyD
Featured in the July-August 2019 Colorado Medicine Colorado Medicine.
The World Health Organization recently updated the definition of burnout. Now considered a syndrome tied to chronic workplace stress, burnout has increasing legitimacy as a global issue, an issue which clearly affects too many physicians. At the University of Colorado Behavioral Health and Wellness Program (BHWP), we are committed to promoting wellness and preventing burnout. We believe that work and wellbeing demand individual commitment as well as institutional transformation, simultaneously focusing on resiliency for individuals, agencies and health systems. Wellness is a multifaceted approach to living and our team utilizes a parallel process to support health care providers’ whole health goals while facilitating the systems change necessary to support individuals’ wellbeing.
To support Colorado’s physicians, BHWP partnered with CMS to create the DIMENSIONS: Work and Well-Being Toolkit for Physicians, available online at www.cms.org/articles/category/physician-wellness.
This toolkit acknowledges the many competing demands physicians face and provides brief strategies for assessing values, building awareness of personal wellness, and implementing realistic life goals. Toolkit users are guided through a sequence of short learning activities to support healthy lifestyle change. Since this toolkit’s release five years ago, we have utilized the information, activities and resources contained within our toolkit to educate and support practicing physicians as well as physicians in training. Whether at the beginning, middle or end of a career in medicine, there is a consensus that in order to truly provide health care, it is essential to refocus on creating sustainable and supportive workplace practices.
To this end, BHWP has partnered with health care organizations to collect and integrate data from our Workplace Wellness Assessment, which includes a workplace wellness survey, site visits, focus groups and key informant interviews. We examine organizational workflows, employee benefits, applicable policies and programs, and salient community linkages to identify ways in which organizations can create an environment that facilitates wellness. Synthesizing these data, we are able to offer comprehensive recommendations that assist agencies to “start where they are” and work towards wellness solutions aligned with agency missions and strategic goals.
Based on assessment of organizational readiness for change, BHWP also utilizes tools such as communities of practice (CoP) to promote system improvement. CoPs are rooted in social learning theory under the assumption that the best teachers are those with similar professional and life experiences. CoPs use distance learning platforms, which offer structured, peer-learning environments that combine didactic experiences and companion facilitated peer-learning sessions. Through the participation of interdisciplinary wellness champions in CoPs, we have found that health systems change is not only possible but probable. Once an organization takes even a single, incremental, time-limited step toward a wellness goal, there is a ratcheting effect that make subsequent changes more easily realized. Developing a pipeline of physician wellness leaders is key to such initiatives, once again reinforcing the complementary growth of individuals and systems.
These health care professionals who are activated to attend to their own wellness are the best positioned to advocate for health care systems transformation. Indeed, many providers believe that acting as a wellness champion for colleagues is a core component of their own wellness regimen. With an increased personal awareness, these physicians are more apt to lead organizational change focused on critical issues such as a sense of job control, workload balance, and team-based care associated with job satisfaction. We look forward to continuing our partnership with CMS and other interdisciplinary provider groups to further promote individual wellbeing, develop physician wellness leaders, and together bolster our collective resilience.
For more information on our programs please visit www.bhwellness.org or contact us at BH.Wellness@ucdenver.edu.
- Panagioti, M., Panagopoulou, E., Bower, P., Lewith, G., Kontopantelis, E., Chew-Graham, C., ... & Esmail, A. (2017). Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis. JAMA internal medicine, 177(2), 195-205.
- Swensen, S., Kabcenell, A., & Shanafelt, T. (2016). Physician-organization collaboration reduces physician burnout and promotes engagement: the Mayo Clinic experience. Journal of Healthcare Management, 61(2), 105-127.
- West, C. P., & Hauer, K. E. (2015). Reducing burnout in primary care: a step toward solutions. Journal of General Internal Medicine, 30(8), 1056-1057.
- World Health Organization (2019). Burn-out an “occupational phenomenon”: International Classification of Diseases. Retrieved from: https://www.who.int/mental_health/evidence/burn-out/en/