Q&A With Leading Physician Well-being Participants
LPW Scholars Highlight Their Leadership, Wellness Journeys
September 26, 2022, 1:05 p.m. Cindy Borgmeyer — The AAFP’s Leading Physician Well-being program, now entering its third year, is a unique, tuition-free certificate program funded by the United Health Foundation and designed to help AAFP members develop the skills they need to lead change in their practice or health care organization that enhances the quality of care teams provide to their patients, improves the morale of the care team, and helps communities stay focused on health-enhancing activities.
A comprehensive FAQ offers more information about the program, and interested members are invited to review a tentative schedule of next year’s activities.
With the application window for the 2023 LPW program now open, AAFP News asked AAFP members who have previously participated in the program to share some of what they’ve learned and accomplished.
Meet those program scholars:
Timothy Riley, M.D., is an associate professor and associate vice chair for wellness in the Department of Family and Community Medicine at Penn State College of Medicine in Hershey, Pa., focusing on clinician wellbeing. He is board-certified in family medicine and is a qualified mindfulness-based stress reduction teacher.
Michelle Owens-Kumar, D.O., is hospice clinical physician for Hospice Austin’s Christopher House in Austin, Texas, where she provides medical care to patients in the hospice’s inpatient facility. She is board-certified in family medicine and in hospice and palliative medicine.
Hani Chaabo, M.D., FAAFP, ABOIM, is board-certified in family and integrative medicine. He is medical director of well-being at Ridgecrest Regional Hospital in Ridgeland, Calif., and runs the Stress Reduction Clinic at Ridgecrest Rural Health Clinic , delivering a mindfulness-based lifestyle change program he developed. He also is faculty for the AAFP’s Physician Health First initiative. He has worked with refugees and marginalized LGBTQ communities, steered national-scale public health projects, and is a recognized national speaker on mindfulness, organizational well-being and stress reduction.
Angela Rodgers, M.D., FAAFP, is a staff physician in the Department of Emergency Medicine at Contra Costa Regional Medical Center and core faculty in the Contra Costa Family Medicine Residency Program. She also is assistant clinical professor in the University of California, San Francisco, Family and Community Medicine Department and is board-certified in family medicine.
Here’s what they had to say.
What drew you to apply to Leading Physician Well-being?
TR: I have been passionate about improving the sustainability of work for clinicians for many years. The Leading Physician Well-being program offered an opportunity to build my knowledge about burnout and well-being and to enhance my skills related to system change.
MO: My husband and I are both family physicians, so we both received the mailings about the program. He said, “This looks like something you should apply for,” and I decided I would. That was in fall 2020. Like a lot of my colleagues, I was feeling disconnected, reeling from COVID, and I wanted to find out what it means to practice self-care — to do something to fill my cup — while providing hospice and palliative care.
HC: I took on the role of medical director of well-being at our organization, and I wanted to understand what best practices are recommended by national experts and connect with like-minded peers.
AR: I wanted to learn more about how to prioritize and maintain a routine of well-being in my own life and educate my residents/learners about incorporating a foundation of well-being while in training. As someone early in my post-residency career, I also felt it was important to learn more about growing in leadership and the basics of performance improvement.
What has been your favorite experience with the program to date?
TR: The AAFP Physician Health and Well-Being Conference was attended by all LPW scholars, and we had dedicated experiences before, during, and after the conference. It was an amazing opportunity to connect as an LPW community and provided a wealth of learning and growth opportunities.
MO: Definitely the sense of community and the connection with other LPW scholars, as well as with faculty. The program offered a cup-filling platform to care for my own well-being, which allowed me to go out and make a difference for others.
HC: Learning about systems-level improvements and being peer-supported in pursuing a personal improvement project.
AR: Meeting incredible mentors in well-being/leadership and connecting with colleagues nationwide who are working on exciting projects. I’m currently a facilitator for the AAFP Well-being and Burnout Project ECHO (Extension for Community Healthcare Outcomes), which is part of the AAFP’s Physician Health First Building Resiliency Intersectionally During Graduate Education, or BRIDGE, program funded by the Health Services and Resources Administration. I would not have had this amazing opportunity if it wasn’t for meeting a leader in ECHOs within the LPW program.
As a busy family physician, how have you managed to fit the program into your schedule?
TR: As academic faculty, I am accustomed to having long-term projects that require dedicated time. The coursework associated with LPW was very manageable. The project synced perfectly with initiatives I was already hoping to do, so it did not represent a lot of extra burden.
MO: When I participated — I was in the first cohort in 2020 — I let my leadership know about it ahead of time. I got some support, but I did have to take vacation time to complete some of the activities. It was manageable, though, and certainly worth the investment, especially when you think about it in terms of the importance of spending time focused on your well-being.
HC: My CEO and CMO were fully supportive and facilitated protected time for me to attend the program. I also have 0.1 FTE for my medical directorship. For assignments and projects, I found the workload to be very manageable during this allotted time and on weekends.
AR: As a family physician working in the emergency department, the shift work made it possible to set my schedule to have time to complete the program. My department was supportive of me participating in this program.
How have you benefited from the program personally?
TR: This program has re-energized me in my efforts to shift my local health care system toward improved clinician well-being. It has helped me identify areas where I am less effective and make the decision to move away from them. It crystalized the importance of clinicians owning our own well-being, which has led me to make changes in my own daily schedule to make me more available for my family and less stressed at the end of the day. I have a new perspective on partnering with local leaders longitudinally to create change. Finally, I have made personal connections among current and former LPW faculty and scholars which have led to additional professional opportunities.
MO: One benefit has been having permission to take care of myself. Another is the plethora of resources the program has given me and my colleagues. That’s been especially helpful, as I’ve changed positions, in enabling me to advocate for my physician and nursing colleagues.
HC: I connected with like-minded peers from around the country, which gave me confidence in my projects. Having peers at the AAFP fine-tune my project was crucial for its success. I’ve also managed to honor my personal improvement project, which was deepening my piano skills. Yay!
AR: I have received great resources, mentors and support along my well-being and leadership journey. Mentorship is a huge benefit.
What changes or learnings have you been able to bring back to your practice?
TR: As a residency educator, I was able to empower our residents to identify ways to care for themselves and build a culture of well-being in our program. I have been more focused and effective in leadership roles, which I hope will help me advocate for meaningful system change.
MO: In my previous position, I created and implemented a well-being program that proved so successful that my leadership wanted to scale it to the entire organization. My new position was very interested in my well-being lens and the fact that I was able to nurture my colleagues’ well-being.
HC: Empowering our different units to identify and steer improvement initiatives relevant to their specific clinical workflow and environment.
AR: I have created a well-being survey plus needs assessment for my residents, and as a new core faculty member, I have had the opportunity to make changes to improve resident wellness. My survey plus needs assessment will be given annually to our residents, and the results will be trended to create a strategic plan on bolstering well-being at our program. I also plan on giving well-being, leadership and performance improvement lectures for our residents.
This program gives you the opportunity to complete a PI-CME project. Could you describe the project you’re working on and why you chose it?
TR: Due to a nurse staffing shortage and a large burden of clinician cross-coverage in one of the offices in my department, we chose to remove an advanced practice provider from clinical care every afternoon and task them with covering away providers and handling urgent medical issues, which inevitably arise. This allowed the remaining clinicians to have sufficient nursing staff and reduced their coverage burden while providing the nurses with a readily available resource when urgent issues come up. We chose this due to the pragmatic challenges of having enough nurses for clinicians to see patients, and due to the known impact of asynchronous work (like coverage for clinicians who are away) on burnout.
MO: For my project, I conducted a series of monthly well-being debriefings from April 2021 to August 2022 using the Zoom platform. For six months of those debriefings, I administered pre- and post-surveys using a Likert scale that asked participants to rate their overall emotional well-being. We also asked specifically about feelings of burnout. Among our key findings was that 88% of those surveyed reported that their well-being improved — even after just a single debriefing.
HC: I am working with our departmental medical directors to train them in conducting continuous quality improvement initiatives with the health care professionals they lead. We started with using an AMA Steps Forward Module entitled Listen-Sort-Empower to train leaders to hold productive QI meetings with clinicians, identify improvement initiatives in their units, and then task team members with completing those initiatives and measuring efficacy every three to six months. We also formed an interdepartmental well-being task force bridging medical staff, administration, quality and IT to escalate needed improvements that cannot be effected at a local level due to needing an organizational approach. In this way we created a bottom-up approach to improvement.
AR: My experience has been that physician burnout is most prevalent among BIPOC (Black, Indigenous and people of color) residents, and evidence aligns with this finding. My PI-CME, or systems well-being improvement project (SWIP), was on improving BIPOC resident well-being by having them complete a survey that asked what could enhance their well-being. Most who completed the survey wanted to have more group gatherings with their BIPOC colleagues and faculty, so I instituted community-building dinners to allow for this important time together. My postsurvey revealed that the community dinners improved their self-reported well-being. It was a very meaningful project to me and I’m hoping to continue the dinners to foster community.
What’s next for you on your leadership journey?
TR: I am excited about local initiatives to enhance sustainability for clinicians, especially residents, and will use the skills I have learned to energetically advance those projects. I hope to be involved as faculty at future AAFP Physician Health and Well-Being conferences, and to take part as a facilitator in an AAFP Resident Well-Being and Burnout Prevention ECHO. Finally, I hope to expand my involvement in the Accreditation Council for Graduate Medical Education’s efforts to advocate for resident well-being.
MO: I’ll be presenting a CME session on physician leadership during FMX with Jason Marker, M.D., M.P.A., (LPW program chair and leadership faculty) and two other program scholars. I’m also a program ambassador for cohort year 2 scholars (2021-22). And I’m settling into my new position as associate medical director with Vynca, a national leader in advance care planning and related services that recently acquired ResolutionCare, an innovative provider of virtual palliative care services. One of my key roles in this position will be to determine how to build and implement a sustainable culture of well-being among this company’s network of caregivers.
HC: I’m hoping to become the first chief wellness officer at our organization. I also am creating well-being educational modules tailored for health care professionals and other learners.
AR: I am currently settling into my new role as core faculty and wellness co-lead. I am looking forward to presenting at future AAFP conferences. I am enjoying my facilitator role for the AAFP ECHO while learning more about well-being resources and platforms to educate about physician well-being. I aspire to become a residency program director one day, and I’m looking to get more involved in AAFP leadership.
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