This was the question that medical educators, leaders at academic medical centers, and experts in burnout from the Collaborative for Healing and Renewal in Medicine set out to answer in the “Charter on Physician Well-Being.” The charter, published yesterday in JAMA, offers a framework for promoting physician wellness, beginning in early training. Publication of the charter comes at an opportune time since today is National Doctors' Day.
Several of the key commitments identified by the group include the following:
Advocate for Policies That Enhance Well-Being: This section describes the importance of policies that “better align regulatory and documentation requirements with clinical activity” and reduce excessive administrative work. It also notes the importance of establishing processes to encourage physicians to seek routine mental health care without fear of licensing penalty.
Develop Engaged Leadership: This section describes the role that leaders within medical schools, residency programs, hospitals, health care systems, and more can play in advocating for the well-being of students, residents, and physicians as an organizational priority.
Anticipate and Respond to Inherent Emotional Challenges of Physician Work: Adverse events, patient deaths, and exposure to the pain and distress of patients and their families are inherent to physician work. “Incorporating coping strategies for such experiences into training and continuing education may help mitigate their effect, promote emotional awareness, and normalize seeking support,” the authors wrote.
Prioritize Mental Health Care: Individuals and organizations can do more to encourage students, trainees, and physicians to seek mental health care. This section describes how making confidential mental health services available during off hours and supporting coverage to attend appointments might decrease barriers to seeking care. “More broadly, psychological support should be considered as a means to optimize physician performance proactively rather than solely as a response to crises,” the authors wrote.
“The Charter on Physician Well-Being is intended to inspire collaborative efforts among individuals, organizations, health systems, and the profession of medicine to honor the collective commitment of physicians to patients and to each other,” the authors concluded.
In an accompanying article, Thomas Schwenk, M.D., of the University of Nevada Reno School of Medicine cautioned, “Physicians in 2018 are the proverbial ‘canary in the coal mine.’ While the canary may be sick, it is the mine that is toxic. Caring for the sick canary is compassionate, but likely futile until there is more fresh air in the mine.”
“This is a first step on a national level to lay out guiding principles and commitments that we consider essential for physician well-being throughout a career, beginning with the earliest training,” Colin West, M.D., Ph.D., a clinician and researcher at Mayo Clinic and senior author of the charter, said in a press release.
APA’s toolkit to help psychiatrists achieve well-being and address individual and system-level challenges that contribute to professional burnout is posted at “Well-being and Burnout.”