Time for Wellness

The recognition of physician burnout as a significant problem in medicine has been established in recent years and has become even more evident during the COVID-19 pandemic. The daily stressors that come with a career in medicine further compounded by weekly and sometimes daily changes to our practices, personal lives, and the impact on family and friends brought on by the pandemic have stressed the health care system to its breaking point. This has led to physicians leaving the profession early and nationwide understaffing in hospitals and clinics of all types of healthcare professionals.  Promoting wellness is not only a matter of personal importance, it’s important for the health of patients.

Wellness initiatives instituted have included things like meditation, resiliency training, and employee assistance programs and have mixed results of effectiveness. Personally, I would argue what got you here (persevering through college, medical school and residency) means you are resilient. While we can all learn new things from some of these programs, this cannot be the only answer, as these strategies put most of the burden of change on the individual.

As I recently reflected on what wellness means related to one’s career, I realized it is autonomy, complexity, and a connection between efforts and rewards. To improve wellness in this context requires organizational and culture change, not just strategies directed at the individual. For many, these individual strategies require the thing we all need more of, time.

Time is what I keep coming back to. Organizational strategies to improve efficiency, reset expectations about time spent at work/working and minimize the burden of administrative requirements are needed. One possible benefit of the pandemic is the realization of the flexibility of how we work.  The burden of meetings is real and can often force us to stay at work long hours without opportunity for rest, physical activity, or time with family/friends. Additionally, just traveling around an institution for meetings, tumor boards, and clinical duties has a significant impact on our time. The quick implementation of virtual format for these meetings shows the resiliency of us as a medical community, and I hope it is here to stay for those settings it is appropriate.

Protecting non-work time is a cultural shift for many and requires organizational support. A significant activity that can invade non-work time is email, particularly the sense of needing to respond. One strategy to manage this that has been recently described by Dr. Julie Sosa via Twitter is a tag line “I value your responses to my emails messages but please respond according to your schedule”. Others in the comment section recommend creating drafts that are then sent the next work day or using the scheduling function so emails are sent during work hours. What should be underlined here is “Your schedule”. For some that is 6AM on a Saturday, for others that is Monday through Friday only, for the insomniacs out there it is 2AM.  We are a diverse group of individuals with unique personal commitments, hobbies, and productive times that should be respected.

Wellness at work requires breaks from work to refocus. Vacation time without a trip or other event planned often goes unused. Early on I was given the advice to schedule vacation often and early. I recommend scheduling vacation every 3-4 months even if it is just a long weekend with no other solid plan than a staycation to reorganize your rock collection. Even short breaks can give time to reset and rejuvenate.

To do these things will require a change in culture, and that comes from not just our leadership but our surgical community. We must instill this cultural change in our trainees and medical students. It should be the expectation that we support each other as peers, set limits on our work, and actively engage in activities that improve our health by allowing time for this.  Modeling this behavior and discussing how we achieve this with trainees will improve and change our culture.

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Valerie Grignol, MD

Dr. Valerie Grignol is an Associate Professor of Surgery in the Division of Surgical Oncology at The Ohio State University. She completed her General Surgery Residency at The Medical College of Wisconsin and went on to complete her Fellowship in Complex General Surgical Oncology at The Ohio State, where she remains as a faculty member. She is board certified in both General Surgery and Complex General Surgical Oncology. She is an active member of AAS and currently serves on the Education committee. Dr. Grignol’s clinical practice focuses on treatment of soft tissue sarcomas and breast cancer. Her research interests include improving quality of care for patients with cancer through collaborative groups. She also works to develop biomarkers for early detection and monitoring of sarcoma. She is the Fellowship Program Director for Complex General Surgical Oncology Fellowship at OSU.

Latest posts by Valerie Grignol, MD (see all)

• Time for Wellness - December 13, 2021