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I.M. Thriving

IM Thriving Masthead

August 16, 2019


Announcements

ACP Supports National Physician Suicide Awareness Day, September 17

(National Suicide Prevention Lifeline: 1-800-273-8255 and crisis text line at 741-741)

National Physician Suicide Awareness Day

ACP is an official supporter of the Council of Residency Directors in Emergency Medicine (CORD) effort to help spread awareness about the issue of physician suicide. CORD is leading a collaborative effort with ACP and other medical organizations to encourage grassroots activities around National Physician Suicide Awareness (NPSA) Day on September 17.

CORD's resources include a curriculum, podcasts, videos, and articles. CORD's Vision Zero statement calls on individuals, residency programs, health care organizations, and national groups to make a commitment to break down stigma, increase awareness, open the conversation, decrease the fear of consequences, recognize warning signs, and learn to approach colleagues who may be at risk.

Through ACP's Physician Well-being and Professional Satisfaction initiative, ACP continues to work to address the root causes that affect physician professional fulfillment and well-being, including reducing administrative burdens and improving the practice environment. ACP's available resources include emergency phone numbers and recommendations, workflow innovations to enhance well-being, a portfolio of four 10-minute micro skills for well-being, and a curated lists of multimedia tools focused on increasing professional fulfillment. ACP has deployed over 160 well-being champions to support ACP member physicians in their local communities through evidence-based interventions.

NPSA Day ACP Forum Discussion the Week of September 9

ACP is hosting a NPSA Day discussion in our Well-being and Professional Satisfaction public forum the week before NPSA Day. Well-being and Professional Fulfillment Task Force members and other experts in the field will facilitate and add to the conversation. We invite you to join and share the link with your communities to amplify awareness and provide a space to remember colleagues, share stories, and best practices. Stay tuned for further details.

Noteworthy Resources

National Physician Suicide Awareness Day Resources

“Our goal, not to lose one.”—Thomas J. Nasca, MD, MACP

The primary purpose of NPSA Day is to create a day to commemorate colleagues lost to suicide and to raise awareness about the issue by shedding light on it. Through this, we hope that we will lessen the stigma for physicians and all other clinicians to speak about their struggles either privately or openly and seek help.

A special thank you to our New York ACP Chapters and Tammy Lin, MD, FACP, for these curated resources.

From the Trenches

We are delighted to share a short piece on resident wellness by Dr. Pooja Jaeel, a third-year Med–Peds resident at UC San Diego.

Dr. Pooja Jaeel

While leaving the hospital at 8 p.m., I see the summer sun finally set, bathing the walls and ceilings with an orange and red glow. I'm struck by the thought that the hospital feels more like home than my own apartment. After 2 years, I know what every hour in the hospital feels like—the sudden emptiness around 10 p.m. when visiting hours end, the flurry of activity around 7 a.m./7 p.m. nursing shift changes, the 4 a.m. smells of breakfast coming from the still-closed cafeteria. Even after I leave, hospital life colors my experiences and interactions. Whether it's suddenly waking up in the middle of the night remembering an order I've forgotten to write or asking too many probing questions about a friend or relative's medical condition—you can take a resident out of the hospital, but you can't take the hospital out of the resident.

Given the all-encompassing nature of our work, wellness for me means to find and nurture the person I was before I entered medicine. Inspired by the example of a friend and co-resident, I have started creating a “Human To-Do List” consisting of actions that make me feel more like a “real person” during my week. My list this week, for example, includes the following:

  • Call one friend outside of medicine during my commute home.
  • Listen to this week's “Wait Wait … Don't Tell Me!” on the radio.
  • Eat at least two lunches without charting in front of a computer simultaneously.

These items are not profound or large goals that will set me up to accomplish a tangible outcome in the future. Instead, they are modest, intentional attempts to stay connected to my nonmedical community and grow as a person. These small tasks help me put hospital life in the context of the rest of my life and the diversity of people and activities that fill it.

By developing the person I am when I'm not wearing the white coat (or more accurately, the embroidered residency Patagonia jacket), I think I become a much better, healthier, and relatable doctor when I do.

Want to be featured in our newsletter? Share your success stories and those of inspirational colleagues (both ACP Champions and partners) by e-mailing acpwellbeing@acponline.org.

In the News

Preventing Physician Suicide

By Janet Colwell, ACP Hospitalist

Excerpt: “Our study raises an alarming concern that the rate of suicide rises as physicians age and rises to levels that are significantly greater than both the general population and other professionals,” said the study's lead author, Thomas Nasca, MD, MACP, CEO, of the Accreditation Council for Graduate Medical Education and professor of medicine and molecular physiology at Thomas Jefferson University in Philadelphia. “With the rates of burnout increasing, it's crucial that hospitals create an environment where physicians can easily and confidentially receive appropriate counseling and support.”

“It's important for physicians to be observant of their colleagues and watch for signs of someone who may be slipping into clinical depression,” said Dr. Nasca. “Everyone should know what support systems and interventions are available in their own institutions.”

Letter to the Editor: The Physician Suicide Epidemic

By Louise B. Andrew, MD, JD, Emergency Medicine News

Excerpt: The meta-message of all these emergency physicians' stories, perhaps, is that no one knew they were suffering. This is the overarching theme in every psychological autopsy done in every physician suicide. No physician who is suffering will readily admit it. Dr. Swisher's humorous-sounding but truly ominous line when asked how she was, “There is nothing going on here that 100 units of insulin wouldn't cure,” is quite illustrative.

If you see (hear, feel, suspect, or worry about) something in a fellow physician that suggests even the remotest possibility of suffering, you are no doubt correctly perceiving that it is there. Say something. Touch, reach out, refer, embolden, accompany that colleague to seek help. Imagine the guilt you will bear if you tell yourself that everything is probably OK, and it really isn't. Drs. Doty and Tabatabai shared very clearly how that will feel. It is an invaluable lesson that is seldom shared.

Patients Before Paperwork

On July 29, 2019, the Centers for Medicare & Medicaid Services (CMS) published the long-awaited Physician Fee Schedule and Quality Payment Program proposed rule. A number of proposals within the rule aim to reduce administrative burdens for internal medicine physicians, particularly in the area of reduced clinical documentation burden. The Regulatory Affairs team at ACP have been hard at work advocating for these changes and celebrate many of the documentation improvements, including allowing physicians to document based on their medical decision making or the amount of time they spent with the patient—instead of requiring the completion of long, often irrelevant checklists at each patient encounter to justify payment. A press statement describing the changes can be found online.

ACP advocates recently met with CMS Administrator Seema Verma to continue the conversation about how to reduce administrative burden and improve value-based care delivery initiatives. Pictured with Administrator Verma are Robert McLean (ACP President), Scott Manaker (ACP Member), Doug Leahy (ACP member), Brian Outland (ACP staff), and Brooke Rockwern (ACP staff).

ACP Patients Before Paperwork Initiative

Patients Before Paperwork is an ACP initiative designed to reinvigorate the patient–physician relationship by challenging unnecessary practice burdens.

What You Can Do to Help

To help the Patients Before Paperwork initiative, you can provide your feedback with our new online data collection tool. This tool is a means for physicians to communicate administrative pain points with ACP staff, share best practices and innovative ideas with each other, and help inform the creation of additional tools and services. Entries will be added to the Administrative Tasks and Best Practices Library.

  • Tell us about your ideas to address administrative tasks.
  • Send in specific examples or vignettes explaining how these tasks have had an impact on your ability to care for a patient.
  • Let us know how ACP can best serve you to address these issues.

Share Your Experiences and Tips Today!

You may also contact the Patients Before Paperwork team directly at policy-regs@acponline.org or discuss these issues in the Member Forum on Promoting Physician Well-being and Professional Satisfaction.

Coaching

Opportunities for 1:1 Coaching With Kerri Palamara, MD, FACP

Well-being Champions can now sign up for one-on-one coaching sessions. Schedule an appointment today by adding your name to the online sign-up sheet. A staff member will contact you directly to confirm a time.

You can claim CME/MOC for sessions dedicated to learning about coaching and improving your professional performance under the “Self Study—Consultation With an Expert” category in your Activities Tracker. Personal 1:1 coaching sessions are not CME eligible.

Kerri and all of us at the ACP Well-being Program are very excited to make this available to you! For questions regarding the coaching sessions, please contact us at acpwellbeing@acponline.org.

Forum

Discuss the news topic above and share advice and ideas with other Well-being Champions in your private forum.

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