1.How Do YOU Excel at Keeping Yourself Well ?Personal Stories and Research Results

2. Medical SchoolClinical MedicineEarly Years of PracticeEstablished Years of PracticeEnd of Career 3. Healers ArtConsider the nature of the professional aspirations,commitments, and values of current medical studentsRandomly selected 100 student mission statementsfrom 10 representative schools nationally3 Major Themes emerged Professional Skills,Personal Qualities, Scope of Professional PracticePURPOSEMETHODRESULTSRabow, M.W., Wruhel, J., Remen, R.N. (2009). Promise ofProfessionalism. The Annals of Family Medicine 7(4), 336-342). 4. Professional Skills"Give me courage to do things I amscared to do in order to help others."Personal Qualities"Give me the strength to always becompassionate & fully present to all mypatients in all situations."Scope of Professional Practice"Help me remember that everyperson and every relationship issacred and presents an opportunityto grow." 5. Healthcare Industry in TransitionRising Costs Shortages Healthcare Reform ReimbursementDeficits Aging U.S.PopulationQuality & Delivery Outcomes Driven Electronic MedicalRecords (EMR) Collaborative CareModelPhysician Role Decrease in U.S.Physicians Clinical vs.Leadership PhysicianDissatisfaction Quality of Life 6. Physicians as Servant LeadersServant Leadership Profile-Revised (SLP-R)by Wong and Page (2003) 62 Questions 7 Factors Developing & Empowering Others Power & Pride Serving Others Open Participatory Leadership Inspiring Leadership Visionary Leadership Courageous Leadership 7-point Likert Scale ranging from1 (Strongly Disagree) 7 (Strongly Agree) 7. Serve 1stPromote &EnableRooted in Beliefs& Values10 PrinciplesVisionService to othersTrustCredibilityHeart / CoreRelationshipsVisioningStrong CharacterPeople 1stCompassionate CollaboratorLeads with foresightAuthenticBuilds CommunityDevelops PeopleShares LeadershipGreenleaf (1977)Farling, Stone, & Winston (1999)Laub (1999)Page & Wong (2000)Sipe & Frick (2009)Servant Leadership Theory 8. Servant and Non-Servant Leadership Groups (N=67) SLP (R) Factor 2 Power and Pride Total Possible Score 56 Servant Leader Score 28 and lower Non-Servant Leader Score 29 and above69% Servant Leader 9. Self-AwarenessServant leaders possess a self-awareness that their own healingis a motivation for leadershipFocus on SelfServant leaders understand the firststep to leading others, and a searchfor wholeness, is the necessity tochange within oneselfShriberg, D. & Shriberg, A. (2011). Practicing leadership: Principles and applications (4th ed.),p.77. John Wiley & Sons. Hoboken, N.J. 10. Comparison of Physicians to General Population10+ hours;38% working 60hrs ormore40%Dissatisfied with worklifebalance; 23% of generalpopulation38%At risk for burnout; 28%general publicBurnout and Satisfaction with Work-Life Balance Among US PhysiciansRelative to the General US Population. Shanafelt, et al. (2012). Arch InternMed / Vol 172 (18) 11. Building the CaseSteelcase reports 55% lowermedical claims for participantsin their wellness program over6 yearsJohnson & Johnson saved $225 peremployee/year in reduced hospital,mental health, and outpatientservices in 9 years of their corporatewellness program.Deloitte saved $41.5 millionby retaining employeeswho had flexible workschedules(Work & Family Connection, 2005)(Work & Family Connection, 2005) (Corporate Voices, 2005) 12. Physician Well-Being is defined as the intentional cultivation of an optimal personal and professional experience byand for physicians. We recognize four domains of experience in which well-being may be optimized:1. Bio-Physical2. Psycho-Emotional3. Socio-Relational4. Religio-Spiritual Further, we hold that optimizing physicians experience in these four domainsresults from the pursuit and practice of a balanced life.14 13. 84%PREFERTHAT ALLOWJob OptionsPersonal Time87% BELIEVE WORKLIFEIMPROVEMENTS CREATECOMPETTIVEADVANTAGES5 OUT OF 10ARE WILLINGTO SACRIFICE INCOMEFortune 500 male executives1/2WONDER IFSACRIFICESMADE ARE WORTH IT 14. Physician Well-Being is defined as the intentional cultivation of an optimal personal and professional experience byand for physicians. We recognize four domains of experience in which well-being may be optimized:1. Bio-Physical2. Psycho-Emotional3. Socio-Relational4. Religio-Spiritual Further, we hold that optimizing physicians experience in these four domainsresults from the pursuit and practice of a balanced life.17 15. Physician Well-Being: The State of the Art18 16. Measuring Well-Being: Goals Well-Being, not Bad Behavior Brief & Easy to Use Internally consistent = reliable Face, content & initial empiricalvalidity19 17. The National Study on Physician Well-Being 18. Study1 Study2 Study3Avg r Avg r Avg r GBIO .640 .840 .592 .807 .352 .678 .675EMO .695 .883 .662 .859 .546 .846 .837RELA .577 .795 .572 .762 .367 .700 .501SPIR .652 .843 .569 .771 .582 .873 .908Study1: Physicians attending 2012 Physician Well-Being Conference (N = 51; 2012).Study2: ~1200 Religious Health System Medical Staff (N = 150; 2012).Study3: National Study on Physician Well-Being random 1615 physicians (N = 225; 2012).Avg r = Average item-scale correlation. All items have r > .30 on their respective scale. = Cronbachs AlphaG = Guttman Split Half assesses the correlation of half the items with the other half. 19. Discrete Measures BIO EMO RELA SPIRSee Medicine as a Calling NS NS NS YESAttend Services More Once per Month NS NS NS YESReligion is Important in My Life NS NS NS YESConsider Myself Spiritual NS NS NS YESTable 2: Evidence of Convergent and Discriminant Validity of PWSAT SPIR scale. 20. BURNOUTAnd SomeOtherPoorOutcomesSTRESSORS:personal &environmentaldemands, lifecircumstances,family needs,personal drive.Bio-PhysicalPsycho-EmotionalSocio-RelationalSpiritual-ReligiousA Whole Person View ofChannels/Mediating FactorsExcelling at Well-Beingprovides more protectiveassets for healthierhandling of stressors.Low Well-Being indicatesfewer protective assets.Stressors translate moredirectly into poor outcomeslike Burnout. 21. Bio-Physical Effects Associated with Burnout Headaches Gastrointestinal problems Respiratory infections Occupational hazards (wounds, exposures) Cancer & Cardiovascular disease Motor vehicle accidents 22. BIO-PHYSICAL WELL-BEINGPHYSICIAN COMMENTS FROM THE PWSAT STUDIES(NEVER HEARD BEFORE) 23. BIO-PHYSICAL WELL-BEING (BIO)Feel healthy and full of energyGet adequate rest or sleepFeel burdened by the length of my work dayRegularly engage in preventive health activitiesRestrict my intake of dietary fatGet a healthy amount of sun exposureEngage in vigorous physical activity at least three times per weekGet regular health screeningsEat enough fruits and vegetablesBetter manage chronic painOther 24. PSYCHO-EMOTIONAL WELL-BEINGPHYSICIAN COMMENTS FROM THE PWSAT STUDIES(NEVER HEARD BEFORE) 25. PSYCHO-EMOTIONAL WELL-BEING (EMO)Day-to-day work life balanceLearn why you feel worried, tense or anxiousExamine your self-doubtOvercome feeling sad, blue or depressedFigure out how to have enough time in the dayAcknowledge and manage stressTake enough time offGain opportunities for personal growthSeek ways to reduce your burden from the realities of medical practiceReceive sufficient emotional supportOther 26. SOCIO-RELATIONAL WELL-BEINGPHYSICIAN COMMENTS FROM THE PWSAT STUDIES(NEVER HEARD BEFORE) 27. SOCIO-RELATIONAL WELL-BEING (RELA)Take steps to overcome social isolationExplore why you feel lonelyReceive sufficient social supportGet sufficient quality time with familyWork on positive relationships with familyWork on positive relationships with colleaguesListen to others very wellHave positive relationships with administrators where I practiceExamine your frustrations with organizational policiesChange the barriers inhibiting you from roviding quality careOther 28. SOCIO-RELATIONAL WELL-BEINGPHYSICIAN COMMENTS FROM THE PWSAT STUDIES(NEVER HEARD BEFORE) 29. RELIGIO-SPIRITUAL WELL-BEING (SPIR)Life is wonderfulExercise your sense of meaning and purposeTrust in a higher powerSee the healing effects of spiritualityPray or meditateBuild up a personal spirituality reserveBe active in a faith communityEngage in spiritual self-careBe compassionate toward othersPractice whole-person medicineOther 30. Final Thoughts? 31. Medical SchoolClinical MedicineEarly Years of PracticeEstablished Years of PracticeEnd of Career 32. How Do YOU Excel at Keeping Yourself Well ?Personal Stories and Research Results 33. What does Physician WellnessMean to YOU?