Imagine a scenario…
Doctor A is a highly skilled and experienced surgeon. But not every surgery goes exactly to plan. Thankfully, that’s exactly what Doctor A has trained for, and they are prepared for those moments. That’s why they’re in the room—to safely navigate their surgical team, and their patient, through whatever unique challenges may arise.
Yet still, sometimes—through no fault to anyone—lasting and consequential complications arise.
Everyone involved is adversely affected. However, Doctor A is the one who is ultimately shouldered with the blame. The trauma shakes their confidence. The threat of a lawsuit looms. Their wellbeing starts to suffer.
As the stressors pile higher and higher, so does their caseload. There’s no time to process their grief. No time to talk through their challenges with anyone. No time to rediscover the purpose and joy medicine used to bring them.
And even if there were time, they’d never feel comfortable voicing these problems to anyone anyway. The risks seem too great. There might be consequences to face from their employer or perhaps their medical board. It may even be used against them in a medical malpractice trial. So instead, they swallow their stress and feelings of fatigue and carry forward.
This is what burnout looks like and, at an increasing rate, through countless other avenues, more and more physicians find themselves suffering from it, costing physicians, their employers, and their patients in the process.
With COVID raging and burdens on our providers only growing, answering the question of how we are taking care of the people
who take care of us grows more pressing every day.
Luckily, an answer is beginning to take form.
To better serve and support clinicians struggling with stress, burnout and the effects of COVID-19, the Michigan State Medical Society (MSMS) recently launched SafeHaven™, a comprehensive and confidential health care provider well-being program offering clinicians a host of resources designed to aid in addressing career fatigue and behavioral health concerns.
And while physician burnout and efforts to address are nothing new, the SafeHaven™ approach is.
The key word: confidential.
Building a Better Foundation to Support Physician Wellness
Overly stressed. Unrelenting exhaustion. A growing sense of apathy. There are several common symptoms of burnout, and more and more physicians are exhibiting at least one these days. In fact, the number are startling.
According to a national survey conducted by the American Medical Society, 42 percent of physicians, across specialties, have suffered from burnout to some degree.
“Like plenty of others, we saw a tsunami of burnout coming our way, and we were doing our best to find and implement some solutions,” says Terri Babineau, MD, chief medical officer of SafeHaven™. “Before SafeHaven™ got its start, I had been doing a lot of work with the Medical Society of Virginia on physician wellness, and despite all our early efforts with creating resources and holding workshops, we continued to observe growing burnout rates. At that point, we realized there were some big institutional drivers to burnout and some systemic changes needed to be made if we hoped to have any real success.”
To better understand the challenges health providers were facing, Doctor Babineau and other from the Medical Society of Virginia had discussions with hundreds of physicians and PAs across the state in hopes uncovering some answers. Early in that process, a common theme emerged: providers feared consequences from their employers or licensing board if they admitted to feeling symptoms of burnout.
“Our physicians just didn’t feel protected—that was the lightbulb moment for us,” says Doctor Babineau. “A lot of these providers had Employee Assistance Programs (EAPs) and other resources available to them, but they just weren’t being utilized over concerns of it somehow affecting their employment or license status.”
Realizing that, the Medical Society of Virginia set out to change the state’s laws and succeeded in implementing the confidentiality, immunity and privileged legal protections physicians and PAs needed to feel comfortable seeking help with addressing personal burnout concerns. The SafeHavenTM bill passed unanimously through the Virginia legislature and, one year later, the program was expanded to protect nurses, pharmacists, and medical students.
“It was a monumental moment when that first SafeHavenTM bill was officially signed into law by the Governor,” says Doctor Babineau. “We went from a world where physicians only had access to EAPs with minimal confidentiality protections to the potential for full protection through SafeHaven™. We just knew this was an innovation that was going to make a real difference in getting physicians more activity engaged in seeking out the help they need. The SafeHaven™ program offers necessary mental health resources that are truly confidential and actually support health care workers.”
To help administer the program, SafeHaven™ selected VITAL WorkLife—a national behavioral health consulting practice with over twenty years of experience committed to improving physician wellbeing. The SafeHaven™ Program includes VITAL WorkLife’s comprehensive suite of resources designed specifically for physicians to help mitigate the effects of stress and burnout and allow for better work/life integration, including:
- Face-to-face and virtual counseling and peer coaching sessions
- Legal and financial consultations and resources
- Access to a virtual assistant
- VITAL WorkLife app and online resources
- In-the-moment 24/7 behavioral health support
“We considered a number of other providers to help with providing SafeHaven™ services, but VITAL WorkLife was clearly the best fit for our program and physicians in general,” says Melina Davis, CEO and executive vice president of the Medical Society of Virginia. “And that was reflected in a lot of the services they had to offer like the 24-hour call line and app-based resources. People could get the care they needed when they needed it, and for physicians and other providers, sometimes that’s a short 10-minute window at 2 am. They just had the most in-depth experience with physicians and that mattered, because it’s a population that comes with some unique challenges.”
Soon after its implementation, other state medical societies across the country began to express interest in the SafeHaven™ program, including MSMS.
“Physician burnout has been a growing problem for years now, so we’ve known for some time that we needed to find a better way to care for our physicians,” says Kevin McFatridge, MSMS Chief Operating Officer. “When we first learned about SafeHaven™, it was clear this was the answer we had been seeking, and thankfully it was something we were able to bring to our state relatively quickly being that we already have a lot of the necessary foundational protections already in place here in Michigan. Now that it’s officially up and running here, we’re sure it’s an offering that going to provide a lot of relief to our members.”
Solutions in Action – Peer Coaching
Sometimes, just talking through things with someone who has been in your shoes is enough to make a difference.
It’s a claim that might sound flimsy, but there’ a growing body of evidence to suggest the intervention known as peer coaching can have a significant positive impact on physicians’ well-being. According to recent research from the Mayo Clinic, physicians receiving peer coaching sessions experienced a 17 percent decrease in burnout compared to a five percent increase in burnout for physicians who went without coaching.
Through SafeHaven™, physicians are eligible to participate in up to six sessions per incident of confidential peer coaching with one of VITAL WorkLife’s highly-vetted, certified coaches, many of whom are also physicians from a range of specialties.
“The challenges physicians face are unique and intense,” says Mitchell Best, CEO of VITAL WorkLife. “Being able to talk through those difficulties with another clinician who has been there and understands the unique pressures of practicing medicine makes a real difference in getting physicians in need of help to buy in to the coaching process and the value it can provide.”
And that process is simple. Working in collaboration with a coach of their choosing, physicians work to define their values, such as doing a good job, enjoying their work, or having time for their families. Once those values are defined, clinicians and coaches work together to set goals based on those values, and then identify action steps and troubleshoot any obstacles on the way towards achieving those goals.
“We’re asking clinicians to tell us where they are now and where they want to be,” says Robert Leschke, MD, an emergency medicine physician and certified coach based in Madison, Wisconsin. “Peer coaching is about helping clinicians look at their situation from a different perspective and then giving them the tools they need to progress in their life and career and ultimately go on to become happier and more productive.”
It’s a process that works according to the nearly fifteen years of quantitative and qualitative data VITAL WorkLife has collected on the impact coaching has on clinician well-being. According to pre- and post-coaching surveys, 92 percent of participants reported an improvement in overall well-being with an average improvement of 58 percent across specialties.
For physicians, it’s a great way to simply get back on track and reconnect with the joy they once found in medicine. And for organizations, it’s a proven investment in heading off potential problems before they bubble into real ones.
“You don’t need to wait until a clinician is in crisis to activate the coaching process,” says Doctor Leschke. “Any suggestion that a clinician’s attitude or mood might be taking a little dip is an opportunity to be proactive and preventative rather than to be reactive to a crisis.”
Solutions in Practice: Counseling and In-the-Moment Behavioral Health Support
Invariably, medicine and trauma go together. However, it’s not always the patient who is suffering. In fact, the clinicians providing the care are just as vulnerable.
“We realized early in the process of developing SafeHaven™ that a number of our member physicians were suffering with some really deep trauma and were in need of counseling to help resolve it,” say Melina Davis. “They wanted help but felt uncomfortable pursuing it for a variety of reasons. Part of that was related to concerns about confidentiality, but another part could definitely be attributed to physicians’ tendency to put their needs and their own well-being on the very back burner.”
To help address this growing problem, SafeHaven™ offers clinicians access to face-to-face or virtual counseling sessions with an experienced, licensed behavioral health professional who can help clients navigate any emotional turmoil or mental health issues that may be impacting them. Along with that, they’re also working to normalize the act of seeking out help when it’s needed and raising awareness of the importance of self-care among the health care provider community.
“It’s a challenge because most physicians just won’t take the time to ever ask themselves how they’re doing,” says Davis. “That just goes against how they were trained. You’re taught to just dig in and keep going without giving yourself and how you’re feeling much thought at all.”
For many, it’s an unsustainable approach. The stressors on physicians are just too extreme.
“These are people that don’t eat during the day. They don’t go to the bathroom during the day. They don’t drink water during the day, all because they’re not sure they’ll get a break. And some of these shifts are 12 to 14 hours long. Think about that level of lack of care for yourself. It’s no wonder they’re getting burned out,” Davis says.
And with a global pandemic only serving to amplify these stressors and straining hospitals and providers to the brink in the process, it’s more important than ever that clinicians seek out the care they need when they need it. To account for this, SafeHaven™ also provides clients with access to a 24-hour, in-the-moment behavioral help call-in service with a master’s or doctorate level counselor to address concerns or immediate needs when they occur. The key is to first recognize the value in seeking help.
“It really has to be a personal opt-in,” says Davis. We need doctors to get more comfortable with taking a moment to say to themselves, ‘I’m not broken, but I do need some help. I do need someone to talk with about this stuff.’ And when they can get to that place, SafeHaven™ is there with the all the resources they need.”
Solutions in Practice – WorkLife Concierge, Financial and Legal Consultations
Sometimes the most helpful resource may just be a helping hand that can assist with all the other everyday tasks and responsibilities physicians must juggle along with delivering quality patient care. To help in those instances, SafeHaven™ offers clients access to the WorkLife Concierge—an all-purpose virtual assistant that can assist with a variety of everyday tasks and chores.
The WorkLife Concierge service is available 24/7 and can assist with any number of errands and obligations such as tackling “to-do” lists, handling childcare and school pick-up duties, scheduling appointments and a whole host of other standard daily responsibilities, allowing clients to better maximize their professional and personal time.
“The demands on a physician’s time are great—that’s just the way it is,” says Best. “However, the WorkLife Concierge makes a real difference for overburdened providers by tackling a lot of the everyday responsibilities that can be easily delegated. It’s about giving time back to our providers so they can recharge, feel less stressed and ultimately be more present with both their patients and loved ones.”
In that same vein, SafeHaven™ also offers providers access to a host of financial and legal consulting services.
“Physicians are just like everyone else—they have to budget their money, plan for retirement, deal with family issues, you name it,” says Best. “To help with those realities, we provide specific resources through SafeHaven™ that are designed to make these unavoidable tasks and responsibilities easier to handle.”
To help manage those sorts of everyday issues, SafeHaven™ offers clients free and unlimited confidential phone consultations with financial counselors to help address any finance-related problems or questions. Additionally, SafeHaven™ provides clients with free, over-the-phone legal advice and can help with in-person referrals to those who may need to retain an attorney.
“Everything we provide through SafeHaven™ in partnership with VITAL WorkLife is in some way aimed at relieving the stresses and burdens that are weighing down our providers and working to replace those feelings of burnout and fatigue with that sense of vitality and joy so many once found in medicine but have since lost,” says Doctor Babineau. “Physicians’ well-being matters, and we all need to get serious about strengthening and protecting that.”
The Cost of Doing Nothing
Suffering clinicians aren’t the only ones who gain from an investment in their wellness—it’s an outlay benefiting the whole health care system, paying dividends to patients, providers and the health systems that employ them.
From the health system side, the math is simple: burnt out providers often work less or just leave entirely and that lost productivity and potential turnout costs health systems tremendously.
Between recruitment costs, the lost revenue during recruitment and onboarding and the time it takes a physician to reach maximum efficiency, replacing a physician costs upwards of a $1 million. And considering that 31 percent of stressed physicians indicate a desire to retire early with 29 percent expressing a desire to leave medicine altogether according to a survey conducted by VITAL Worklife, the cost of burnout hospitals and health care organizations is vulnerable to an extreme spike without intervention.
“A health care organization like a hospital system’s most valuable assets are the physicians and care team providing patient care,” says Best. “Investing in their wellbeing isn’t just the right thing to do—it’s the financially savvy thing to do.”
According to a 2017 Gallup Survey, physicians who feel cared for report 26 percent higher productivity levels, give hospitals three percent more outpatient and 51 percent more inpatient referrals, have a more engaged patient base, and perhaps most importantly, are dedicated to their patients and committed to the improvement of their organizations.
“The bottom line is this: when clinicians feel cared for, they do better job for their patients and their employers,” says Doctor Babineau. “That’s the kind of environment and culture all health systems should be striving to cultivate, and SafeHaven™ can help get you there.”