JACR Tweet Chats — Join the Conversation

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Join us for the #JACR® Tweet Chat with a new topic every month. The following article is a summary of comments from the May 2019 Tweet Chat for those who missed it. Full transcripts are available at www.jacr.org/twitter-archive. The May 2019 JACR Tweet Chat topic was Clinician Well-Being: Why it Matters to You and Your Patients. The session was co-moderated by Ian Weissman, DO @DrIanWeissman and Sheri Jordan, MD @SJordanMD. The ACR has a dedicated Radiologist Well-Being Program with an assessment tool and complete curriculum to address this critical subject.

Topic 1: As a clinician, how do you define well-being? Why is it important?
This topic was met with responses noting that well-being is essential for safe, high-quality patient care and has been deemed a national priority by the National Academy of Medicine. Participants further observed that well-being is about maximizing the quality of your life, thriving in a supportive environment both at work and at home, being happy, healthy, and prosperous, and maintaining human connections with patients and by collaborating with colleagues. Responses also touched on the mental, emotional, and physical facets of overall wellness as well as the importance of achieving balance. As has been echoed throughout training, it is difficult to care for others if you haven’t taken care of yourself. The importance of wellness was also underscored by a comment taken from an article on patient satisfaction by Dike Drummond, MD: “Clinician satisfaction is the only lasting foundation for patient satisfaction. It takes happy doctors and staff to have happy patients — in that order.”

Topic 2: What factors, negative or positive, impact well-being?
Responses showed that the factors impacting well-being are numerous. Negative factors include excessive workload, lack of appreciation and recognition, isolation from colleagues, lack of autonomy, lack of input and involvement in decision-making processes, lack of transparency, concerns about medical errors, lack of technical, emotional or staffing support, work-life conflict, sub-optimal financial compensation, and lack of activities to aid decompression. Toxic hierarchies that allow for demoralization and intimidation can also play a strong negative role. As noted in an article by Alison L. Chetlen, DO, et al., “Addressing Burnout in Radiologists,” positive factors can be divided into physician-directed and organization-directed interventions. Physician-directed interventions include restoring physical, emotional/spiritual, relationship, and work-life balance, mindfulness, professional mental health services, improving physicians’ self-confidence and communication skills, and small group sessions. Organization-directed Interventions include open communication and transparency from leadership, routine measurement of wellness, providing workflow autonomy, promoting strong leadership style and mentorship opportunities, EMR and PACS support, promoting a healthy and collegial work environment, establishing an organizational wellness committee, and providing wellness and burnout resources. Participants also noted the importance of having support systems of family and colleagues, connecting with patients, having personal time, and maintaining adequate diet, exercise, and sleep. The takeaway is that there are a large number of variables with varying degrees of impact that will also differ in necessity and effectiveness from physician to physician.

Topic 3: What strategies have you used to improve your well-being or the well-being of others? What have you found to be most helpful?
Comments largely focused on personally addressing the variables in topic 2, but equally as important, as Kimberly Beavers, MD, noted, by also reaching out to and supporting colleagues who are struggling. ACR members can take advantage of the Radiologist Well-Being Program. Healthcare organizations must also embrace their responsibility to build a practice environment that fosters a culture of wellness.

Topic 4: How do the causes of burnout affect diverse clinician populations such as women, people of color, and people with disabilities differently and/or disproportionately?”
Disabilities may not necessarily be readily visible such as in mental health disorders, as Suzanne M. Parets-Araya, MD, noted. The effects of burnout among underrepresented populations in medicine may be compounded by the feeling of constant pressure to prove themselves, and lack of support systems. The lack of lactation facilities, lack of paid parental leave, and perceived judgment for taking full length maternal leave also play a role in generating work environments that disproportionately affect women and contribute to dissatisfaction. Underrepresented minorities experience unique problems, increasing the difficulty in reaching out to someone who truly understands what you are going through and worsening a sense of isolation. Maximizing diversity among healthcare providers to be as diverse as the populations they serve could go a long way to address institutional racial disparities, improve diversity of thought, organizational innovation, and adaptability.

Be sure to join in on the next JACR tweet chat with a new topic every month!

By David Mihal, MD, ACR-YPS Communications Liaison

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