Dr. Anjalee Galion, pediatric neurologist and sleep medicine physician at the Sleep Center at CHOC, has held several roles at CHOC since her fellowship began in 2008. Most recently, she received an exciting new appointment: CHOC’s inaugural physician wellness officer.
CHOC has had a physician wellness committee for about eight years, but the appointment of a dedicated officer is novel — both for CHOC and other healthcare organizations.
In her role, Dr. Galion — who will continue her patient care duties — will partner with CHOC’s human resources and executive teams to develop initiatives to support physicians through efficient processes, improvement science-driven policies, and the resources needed for a healthy and balanced lifestyle.
With provider burnout at an all-time high across the nation, Dr. Galion’s appointment highlights CHOC’s commitment to the health and well-being of its physicians.
Physician burnout on the rise, worsened by COVID-19 pandemic
According to data collected by the CDC, reported instances of physician burnout have been on the rise across the country for the past 10 years. The COVID-19 pandemic only exacerbated these rates, due in part to the intersection of healthcare and politics, personal protective equipment (PPE) shortages and the persisting mental health crisis, says Dr. Galion.
The American Medical Association (AMA) reports that based on a recent survey of 20,000 respondents at 124 institutions across the country, one in five physicians says it is likely that they will leave their current practice within two years because of burnout, heavy workloads, fear of infection, anxiety or depression. One in three physicians says they will reduce their work hours within the next 12 months.
Even before the pandemic, a study showed that one in 15 U.S. physicians have experienced suicidal ideation — with evidence to suggest that physicians are at higher risk of suicide than the general population because of factors associated with high workload volume and medical errors.
Self-care isn’t enough, organizations need to make changes
“Physicians are good at taking care of everybody else, but sometimes bad at saying when they need help,” says Dr. Galion. “And of course, there’s a stigma associated with seeking help.”
The physician wellness program at CHOC intends to combat this stigma. Based on a nationally-recognized model, CHOC’s efforts will pursue organized, data-driven efforts based on the following principles:
|Culture of wellness||Efficiency of practice||Personal resilience|
-Meaning in work -Community/collegiality
-Culture of compassion
|-EHR usability |
-OR turnaround times
|-Self-care (sleep, exercise, nutrition) |
-Meaning in work
Contrary to the common misconception that self-care is the answer to burnout, Dr. Galion says that a culture of wellness and efficiency of practice makes up 80% of what it takes to promote professional fulfillment and wellness for physicians — with only 20% contributed by self-care.
“Wellness is not asking physicians to do more yoga,” says Dr. Galion. “Physicians who are burned out do not need to be asked to do more. CHOC put me in this role because of its commitment to do the other 80%.”
Dr. Galion and team have already gotten to work on making tangible improvements for CHOC physicians.
Physicians will have two dedicated lounge spaces for respite and connecting with others — one in the Bill Holmes Tower and the new Southwest Tower on CHOC’s main campus in Orange. Nutritious meals and snacks will be available for physicians to fuel up for providing around-the-clock care — especially important since CHOC became a Level 1 trauma center.
Besides physical improvements, CHOC is looking to improve science to offer strategic, data-driven initiatives to promote a culture of efficiency and wellness.
CHOC has been selected as one of 150 hospitals to participate in the American Medical Association’s annual wellness survey. As one of only a handful of children’s hospitals included, Dr. Galion is thrilled by the opportunity to measure CHOC’s progress and how it compares to national benchmarks.
A bright future for physicians
In addition, CHOC has begun implementing the Institute for Healthcare Improvement (IHI)’s Joy in Work initiatives — a framework for ensuring an engaged workforce and assessment tools to help measure efforts.
With these initiatives, the team ensures that leadership for the wider organization — CHOC Hospital in Orange, CHOC at Mission Hospital and CHOC’s primary care network — are aligned and speaking the same language of improvement science while sharing results and progress for both physicians and associates. Dr. Galion and Kathleen Wilkinson, director of HR and associate wellness officer at CHOC, make sure to work symbiotically on initiatives for both physicians and associates.
They are asking the questions: How are we aligning with leadership and making our voices heard? How do we find collegiality, support flexibility and promote autonomy? How do we improve efficient processes?
“The answer to these questions is a commitment to making lasting change,” says Dr. Galion. “With a comprehensive approach that is based on improvement science and analytics, physician wellness can be done the right way,” says Dr. Galion.
And CHOC intends to do just that.
“In my opinion, we provide the best clinical care around,” she adds. “It’s my hope that we are not only the global destination for pediatric care but also the destination for all pediatric providers. I truly believe that the best care occurs at the best place to practice medicine.”
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