Sunday, December 31, 2017

Wellness and Resiliency Summit

2017 Wellness and Resiliency Summit
Authors: Ashely Alker, MD, AAEM/RSA President 2017-18 and Robert Lam, MD FAAEM, AAEM Wellness Committee Chair
Originally published: Common Sense May/June 2017

Emergency medicine has historically had the highest rate of reported burnout among all specialties. In the 2017 Medscape Lifestyle Survey, 59% of emergency physicians self-identified as “burned out.” A survey conducted by the University of North Carolina-Chapel Hill showed that approximately 70% of residents met criteria for burnout. In one survey residents were asked about their quality of life, and 15% reported “life is as bad as it could be.”

In January, for the first time ever, all national emergency medicine organizations convened in Dallas for an Emergency Medicine Wellness and Resiliency Summit. In a spirit of collaboration, wellness champions and emergency medicine leaders came together to find solutions for the ongoing crisis in physician wellness and resilience. In attendance were representatives from the Council of Emergency Medicine Residency Directors (CORD), American Academy of Emergency Medicine (AAEM), Society for Academy of Emergency Medicine (SAEM), Association of Academic Chairs of Emergency Medicine (AACEM), American College of Osteopathic Emergency Physicians (ACOEP), Accreditation Council for Graduate Medical Education (ACGME), AAEM Resident Student Association (AAEM/RSA), Emergency Medicine Residents’ Association (EMRA), American College of Emergency Physicians (ACEP), American Board of Emergency Medicine (ABEM), and the American Hospital Association (AHA).

This broad representation created a unique opportunity to look at the root causes of burnout and support resilience across the entire arc of an emergency physician's career. Of the many drivers of burnout, AAEM highlighted the need for transparency, fairness, and due process in the workplace; the challenges and relevance of maintenance of certification; the unique challenges facing physicians training in emergency medicine; the use of metrics to give mainly negative feedback; and the epidemic of physician suicide.

As burnout is a complex problem with individual, institutional, and systems-based causes, solutions were proposed in the areas of community practice, academic practice, knowledge gaps, and personal well-being. Much attention was paid to looking at the systems-based drivers of burnout, and to engaging in dialog with stakeholders like the American Hospital Association, Press Ganey, and vendors of electronic medical record systems. Key questions for research were defined, as well as the need for new tools to measure the joy of EM practice. A summary of the group's consensus, ongoing concerns, and proposed solutions will be released in a landmark publication written by representatives of all participating organizations.

In keeping with the spirit of cooperation and collaboration, attendees discussed the creation of an Emergency Medicine Wellness Institute to nurture collaboration, combine resources, further research, and support emergency physicians. Such an Emergency Medicine Wellness Institute would be a joint venture of all EM organizations.

The consensus from the summit was hopeful. Hopeful that together, not only can we tackle this problem in our own specialty, but we can lead the way for the entire house of medicine. How can you help? Here are some simple things you can do to make a difference for yourself, your organization, and our specialty. 

  • Do an anonymous online self-assessment of burnout, depression, or stress at www.aaem.org/about-aaem/leadership/committees/wellness-committee.
  • Create your own resiliency plan that includes scheduled exercise, mindfulness, and renewed relationships.
  • Renew your purpose. A nice resource from the AMA can be found here: https://www.stepsforward.org/modules/improving-physician-resilience.
  • Consider job-crafting based on your signature strengths and needs. Can you incorporate your strengths into your work every day? Would working a bit less add to your well-being? Would adding outside interests like education or subspecialty practice in emergency medicine give you greater satisfaction?
  • Talk to your institutional leadership about the systemic problems that drive burnout in your group.
  • Be part of the solution and join the AAEM or RSA Wellness Committee.
  • Come to the Annual AAEM Scientific Assembly. Our vision is to make the Scientific Assembly a motivational retreat where you renew your passion for our specialty, learn individual resilience practices, and renew relationships with your colleagues.

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