Survival 101:Work Life Integration & Wellness

Jason Liebzeit, MDAssistant Professor

Sheryl L. Heron, MD, MPHAssociate Professor/Associate Residency Director

Assistant Dean Medical Education & Student Affairs – Grady Campus

Department of Emergency Medicine Emory University School of Medicine

SAEM: Chief Resident Forum – 6/2011

Disclosures

No commercial financial relationships to disclose

Objectives Learners will:

Describe the concept of work-life integration Recognize burnout and describe strategies

to combat it Formulate a personal plan for self-care

during time as a Chief Resident Discuss time management techniques

Overview

What is work/life integration?

What’s next?

Career Demands

Relationship Demands

Attention to Self

The Big Picture

Work-Life Balance Integration

Work Life/Family

The End of the Road (or the Beginning)

What’s Next? It’s good to be the Chief

Academic

Community

Fellowship

Locum Tenems

http://www.nytimes.com/2011/04/02/health/02resident.html

Burnout

Elevated levels of burnout exist among a substantial percentage of surveyed Emergency Physicians

Classified broadly in terms of negative perceptions of self, negative practice habits and attitudes, and unhealthy lifestyle.

Goldberg et al: Acad Emed 1996 - , Vol 3, 1156-1164

Burnout

Self- recognition of burnout

Lack of job involvement

Negative self- assessment of productivity

Dissatisfaction with careerGoldberg et al: Acad Emed 1996 - , Vol 3, 1156-1164

Burnout Correlates

Sleep disturbances

Intent to leave the practice within 10 years

Higher levels of alcohol consumption

Lower levels of exerciseGoldberg et al: Acad Emed 1996 - , Vol 3, 1156-1164

Work-Life Culture

What exists?

Is it valued?

Are there policies?

ACEP: Wellness

Institution

Emory University Department of Emergency Medicine Wellness & Well-Being Committee

Emory University Work Life Initiative

Strengthen work-life culture for individual and families

FSAP

My Wellness

Family

Professional

Physical

MentalSocial

Spiritual

Financial

Relationship Demands

You’re almost done, it’s my time now

Prime age to begin/expand families

Sandwich generation

Realities of Life

Residency Training & Pregnancy

Personal & Family illness

Impairment

Sleep Hygiene

Time Management

Enhances Work-Life Integration by:

More Control of your life

Improved Relationships

Increased Productivity

Attention to Self

Organization Organization Organization

Prioritization

Resources

Creating a Schedule

Prioritization Yearly, Monthly, Weekly, Daily

Family/Non-negotiables Vacations, Reunions – 1st priority

Fill in the Blanks

Utilize your Resources

Resources

Family

Colleagues

Community

Administrative Support

You

Institutional Resources

Human Resources?

Dual Career Programs?

Family Medical Leave?

Mentoring Programs

Faculty Staff Assistance Program

The Big Picture

Keeping the Balls in Motion

Monitoring the Balls

Dropping the Balls

What Keeps You Well?

Identify what keeps you grounded

Articulate clearly and often

Share them with your family and friends

Tap into them

Benefits of Work-Life Integration

To the organization:

Measured increases in individual productivity, accountability and commitment

Better teamwork and communication

Benefits of Work-Life Integration

To the Organization:

Improved morale

Less negative organizational stress

Benefits of Work-Life Integration

To the individual:

More value in your daily life

Increased productivity

Improved relationships

Reduced stress

http://www.worklifebalance.com/5steps.html

What about us?

Survey of 193 ED Physicians (ACEP members) Validated measures of career satisfaction,

tolerance for uncertainty, and burnout

High level of career burnout No demographic variables were associated with

burnout status

High anxiety caused by concern for bad outcomes (odds ratio=6.35) was the strongest predictor of burnout

Kuhn et al: Annals EM: Feb 09

What about us?

32.1%, exhibited Emotional Exhaustion core symptom of burnout not related to age or type of practice

Physicians did not feel anxiety because of:

general uncertainty, difficulty in disclosing uncertainty to patients, or admitting errors to other physicians.

Kuhn et al: Annals EM: Feb 09

The Good News

Despite exhibiting emotional exhaustion, the majority of respondents are satisfied with the career of emergency medicine

Kuhn et al: Annals EM: Feb 09

The Good News

Random sampling of 1008 Emergency Physicians

2004 - 65.4% EPs reported high career satisfaction, while 12.4% EPs reported low career satisfaction (n = 515)

Cydulka & Korte; 2008 – Acad. EMED – June 2008

Career Satisfaction

Higher career satisfaction was associated: Teaching settings, research, publication,

leadership positions, belonging to medical organizations/medical politics

1/3rd of respondents (33% in 1994, 32% in 1999, 31% in 2004) reported that burnout was a significant problem.

Cydulka & Korte; 2007 – Acad. EMED - Abstract

Changing the Conversation

Burnout Well-Being/Resiliency Develop a shared definition of

physician wellness Culture Change

More positive Educational Environment Raising awareness of burnout and stigma Enabling prevention strategies

Ecklberry-Hunt et al: JGME: Dec 2009

Changing the Conversation

Heron et al. Does a curriculum on wellness affect burnout in an Emergency Medicine Training Program (CORD 2011, SAEM 2011)

Heron-Liebzeit Protocol

Keep a calendar & honor it

Learn to say “No”

It’s okay to be away

There are 24 hours in each day

Heron-Liebzeit Protocol

Get rid of clutter

Monitor the balance Self-check Empower others

Honor who & what keeps you well

Use your resources

Summary

Work/life integration is realistic and attainable

Burnout is a reality, but you are well-equipped to combat it

Prioritize your time

Utilize your resources

Conclusion

Good luck

Remember the Big Picture

Congratulations