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PHYSICIAN WELLNESS

PHYSICIAN WELLNESS. THE PRACTICE OF MEDICINE CAN BE HAZARDOUS TO YOUR HEALTH. Gary S. Nye, MD Chair, Physicians ’ Advisory Committee and Committee on Litigation Stress Alameda Contra Costa County Medical Association. WELLNESS VS. WELL-BEING, IS THERE A DIFFERENCE?.

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PHYSICIAN WELLNESS

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  1. PHYSICIAN WELLNESS THE PRACTICE OF MEDICINE CAN BE HAZARDOUS TO YOUR HEALTH Gary S. Nye, MD Chair, Physicians’ Advisory Committee and Committee on Litigation Stress Alameda Contra Costa County Medical Association

  2. WELLNESS VS. WELL-BEING,IS THERE A DIFFERENCE? • Some controversy, e.g.MBC WELLNESS COMMITTEE • Some variations in the literature • Historical differences, e.g.ACCMA • Functional institutional differences, e.g. Kaiser, UCSF

  3. PHYSICIAN MORALE • HOW IS YOUR MORALE? • DO YOU HAVE A DEFINED COPING STRATEGY? • ACPE SURVEY 2006 - 1200+ responses 60% considered leaving medicine 77% fatigue biggest problem 66% burnout 32% family discord & depression 4% suicidal thoughts

  4. MAJOR SOURCES OF STRESS • Lack of Control • Unpredictability • Intense Sense of Responsibility • Change - Rapid change • Finances and Regulation

  5. PRACTICE & BUSINESS ISSUES • MEDICAL SCHOOL DEBT • ECONOMIC CREDENTIALING • MALPRACTICE • REIMBURSEMENT PROBLEMS • REGULATORY CHANGE • RECORD KEEPING • MBC AND RECREDENTIALING ACTIONS

  6. SOME WAYS WE COPE?(ACPE SURVEY) • 53% Talk to colleagues • 35% Search for jobs outside of health care • 27% Lobbying and political activism • 26% Personal counseling • 1% Substance abuse treatment

  7. GETTING INTO TROUBLE • IMPAIRMENT (Can be anyone at any time) • 10 % OF MDs at any one time (soft data) • 6-7% SUBSTANCE ABUSE • 3-4 % MENTAL ILLNESS • 1-2% PHYSICAL IMPAIRMENTS • 3-4% OVERLAP WITH MORE THAN ONE CATEGORY

  8. PATTERNS OF ILLNESS / COMPLAINTS • ALABAMA STUDY ’91-97, 1000 referrals (PHP) • 50% CD • 12% Disruptive • 12% Quality of care • 10% Psychiatric (29% affective illness) • 1% Licensure issues • 7% Sexual misconduct (boundary issues)

  9. WHAT CAN HAPPEN TO US • DEMENTIAS AND AGING • LITIGATION STRESS • MARITAL AND FAMILY CONFLICT • BURNOUT • MEDICAL ERRORS

  10. DEPORTMENT • DISRUPTIVE BEHAVIOR • SEXUAL MISCONDUCT • SEXUAL, ETHNIC, OTHER INSENSITIVITY • UNCOOPERATIVENESS

  11. PROFESSIONAL DANGER ZONES • Fatigue • Isolation • Compulsivity • Self Treatment – Substance Abuse • Curbstone Consultation • Denial – Suppression – Repression • Depression/Anxiety

  12. WHAT PLANET ARE YOU ON? • WHAT IS THE STATE OF YOUR LIFE “CULTURE”? • SELF AWARENESS AND SELF CARE • RELATIONSHIPS- family/professional/personal • SUPPORT FOR AND OF OTHERS • SPIRITUAL AND RECREATIONAL LIFE • CONSTANT PERSONAL INVENTORY / MINDFULNESS

  13. WHAT TO DO OR WHERE TO GO? • YOUR PERSONAL PHYSICIAN- Don’t self treat! • COUNSELOR OR CLERGY • WELL-BEING / WELLNESS COMMITTEE • LITIGATION STRESS COMMITTEE • CMA CONFIDENTIAL LINE • SELF HELP AND SUPPORT GROUPS

  14. California Public Protection and Physician Health Program (C3PH) • MBC Diversion vs. C3PH • Regional Workshops

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