From Med School to Practice
Novel Programs Advance Members’ Well-being, Leadership Skills
Oct. 24, 2022, 3:30 p.m. David Mitchell & Cindy Borgmeyer — Burnout is a well-documented issue among medical students, residents and new physicians. In fact, just over half of family physicians report symptoms of burnout, according to Medscape’s 2022 Physician Burnout & Depression report. To effectively thwart this growing problem, it’s vital for family medicine to take action during the early career years and even in medical school, where burnout often starts.
The AAFP has joined with key stakeholders to tackle the burnout dilemma. New resources and well-being programming for students and residents embrace peer-to-peer learning techniques and safe spaces. Practicing physicians can benefit from an innovative program that gives them the leadership skills and expertise they need to improve the well-being of physicians and other clinicians in their practices and organizations.
Leading Physician Well-being Program Trains Physicians in Practice
Practicing family physicians are accustomed to having patients rely on them for support — after all, that’s what they signed up for. But they’re often far less comfortable being the ones who need to be supported.
Leading Physician Well-being, a tuition-free certificate program funded by the United Health Foundation, is helping meet that need by giving participants a safe space in which to share their personal well-being struggles, as well as the specialized leadership skills required to champion well-being among other health care professionals in their practice or organization.
According to Heather Woods, manager of CPD Education in the Academy’s Continuing Professional Development Division, who administers the program, those skills include building expertise about the current state and importance of well-being, how to measure it and best practices to achieve it. Scholars also learn how to lead through wielding influence, implementing change management and performance improvement activities, and communicating effectively with medical colleagues and others.
Although the program is open to all practicing AAFP members, it has a special focus on recruiting participants from physician groups for whom leadership opportunities have been largely limited — new physicians, women, physicians from minority groups or other groups underrepresented in medicine, and those who work in rural practices or with other vulnerable populations.
Each LPW cohort is divided into home groups of about 15 individuals who meet once a month, Woods explained. “As one part of the program, they do a personal health improvement project where they state their SMART (specific, measurable, achievable, relevant and time-bound) goals at the beginning, and then every month they’re checking in with their home group on how they’re doing.” In those sessions, she added, they often disclose their vulnerabilities and tap into a support network of faculty and fellow scholars that’s second to none.
Story Highlights
That sense of community is at the heart of the program, said Woods, who shared this comment from a first-year LPW scholar: “It feels much better to be able to go down this journey knowing that you’re not alone in trying (to) make change in this way and that progress is going to happen because hundreds of us are trying to do it. And that if we run into roadblocks, there’s peers and there’s faculty members who have a wealth of knowledge already that I can reach out to.”
According to a report that examined findings from the program’s first cohort, one major challenge is the fact that although physician burnout is primarily created by systemic factors, most interventions focus on changes at the individual level.
Recognizing that resolving such challenges will require changing stakeholders’ values and beliefs, the report stated, the LPW program was designed “to provide its graduates with the technical skills needed to understand the nature of burnout and well-being, as well as the adaptive skills needed to create change and manage improvement inside their place of employment and in the broader health care system.”
Project ECHO Supports Residents
In recognition of the growing burnout problem among students and residents, an increasing number of medical schools and residency programs are providing education regarding well-being.
In an initiative funded by the Health Resources and Services Administration, residency programs may apply for their residents to participate in a five-month Project Extension for Community Healthcare Outcomes focused on improving well-being and preventing burnout.
The Resident Well-being and Burnout Prevention Project ECHO® will offer programs a way to increase morale and support their residents’ well-being through a structured program led by experts. Participants in the online program will earn CME, support their peers and work through dozens of topics related to well-being.
“It’s just for residents, so it’s an avenue to discuss some well-being topics in a safe space that doesn’t involve their faculty or program directors,” Woods said. “They’ll be able to talk through some of their well-being concerns or issues that they’ve seen within their residency and get feedback from their colleagues. It’s really to create a culture of well-being within the residency program.”
Programs must apply and be accepted to the ECHO before their residents can participate. Once a program is accepted, any of its residents can attend sessions. However, programs must send at least three residents to each weekly session in an eight-session cycle.
Seven residency programs are a little more than halfway through a pilot that started in late August. Applications for a second cycle are expected to open within the next two to three weeks. Woods said the program is being updated and improved based on weekly feedback received during the pilot.
Bridget Lynch, M.D., M.P.H., of Albuquerque, N.M., a former LPW program scholar, is chair of the Project ECHO. In fact, all of the ECHO faculty members have participated or are currently participating in LPW.
“Having LPW scholars serve as faculty in our well-being programming is by design,” Woods said. “It connects all of these programs under the Physician Health First® umbrella and completes the circle.”
Students Become Well-being Champions
A new program designed to give students the skills needed to create a culture of well-being and increase joy in their own studies and practice started with a pilot this fall. In the Family Medicine Interest Group Well-being Champion Program, five medical students from four schools are working with Catherine Pipas, M.D., M.P.H., FAAFP, professor of community and family medicine at the Dartmouth Institute for Health Policy and Clinical Practice and the Geisel School of Medicine and well-being co-chair of the Academy’s LPW program. These FMIG Well-being Champions are developing workshops on topics related to finances, resiliency, relationships, substance use prevention, burnout prevention and suicide prevention.
The champions will present their own workshops, which include didactic presentations, hands-on activities and toolkits, to FMIGs and other student organizations on their respective campuses this fall. In the spring, they will trade topics and train to deliver workshops developed by their fellow champions.
The Academy is expanding the program by recruiting a second group of champions through the FMIG Network. Although students don’t have to be involved with their school’s family medicine student organization to be selected, they do have to be AAFP members. Woods said the new champions will be mentored by the original champions.
“Those signing up to be leaders in this space are showing not only their institutions, but the rest of family medicine, that this is important to them and that they’re taking it seriously,” Woods said. “They get some leadership roles and speaking opportunities, which is fantastic, but it’s really about bringing to the forefront that it’s not just our physicians who need help here. It’s our medical students and residents, too, and we’re providing them tools to support themselves and the future of family medicine.”
A facilitator guide is expected to be available before the 2023 National Conference of Family Medicine Residents and Medical Students July 27-29 in Kansas City, Mo.
“We’ll be able to allow any student to take the facilitator guide and participant guide and execute this programming within their own medical school,” Woods said.