By Sandra Caffo
Quality care is what people expect to receive from physicians. However, we don’t likely think about what might impact a physician’s ability to provide this care. Doctors are part of a profession that is one of the most respected in this country – and, indeed, all around the world. As difficult as it is to get into and complete medical school, that difficulty often escalates once the physician begins to live with the day-to-day, 24/7 pressures of being a doctor.
A recent article in Healthcare Finance News reported that more physicians feel the stresses of their profession than ever before and that the impact of that stress is often underestimated. Not only did 87 percent of respondents to a Physician Wellness survey say they were moderately-to-severely stressed/burned out on an average day, but also 63 percent said they felt more stressed out than they were three years ago.
The modern physician faces questions from all sides including: Are his or her care choices medically appropriate … efficient … cost-effective? How is the Affordable Care Act going to impact where and how physicians work? Physicians face increasing complexity in treatment decisions, along with decreases in autonomy and control. Frustration can seem an inevitable byproduct.
In 2008, UPMC first addressed this issue by starting a physician assistance services program for its physicians. As a hospital system that employs 3,000 physicians, it made sense to develop a systematic program that could help physicians better manage their demanding lives at work and at home, while also helping physician leaders and health systems to address the impact of negative workplace behavior. Its aim remains constant – to assure a culture of collaboration, safety, and success.
“Physicians don’t ask for help,” said Anna M. Roman, Senior Vice President, Administrative Services and Physician Relations for UPMC, and one of the creators of the UPMC program. “And they would never use a traditional EAP (employee assistance program) because they wouldn’t think it would be credible, because it wouldn’t understand the special demands on physicians. That’s why a very specific EAP with an intervention program for physicians was needed.”
Surveys have shown that physicians are more prone to depression, have higher rates of suicide and have higher rates of the divorce than the general population. “I like to say physicians are normal people, but with bigger issues,” said Roman. “This program gives them an opportunity to go for help at someplace safe.”
To meet an increasing national demand for such services, UPMC WorkPartners – through its affiliated LifeSolutions Employee Assistance Program (the EAP for physicians) – is now offering the UPMC physician assistance services program to all physician practices and health care organizations that would want to purchase it.
When UPMC first created the program it concentrated on providing physician support and addressing problematic physician behavior. Physician onboarding was added later with a focus on identifying interpersonal skills and that will support successful adaptation to a hospital or a health care organization’s culture.
Taken together, these programs span the employment cycle of a physician – from the initial adjustment phase to successfully practicing within the system.
A physician assistance service is only effective if it helps create a culture of collaboration in a healthcare organization. A respectful work environment can lead to a reduction in medical errors, and improve staff retention. Recruiting and retaining physicians now represents a significant investment in time and money. It has been estimated that the cost of recruiting a physician, combined with salary guarantees and practice set-ups can range from $300,000 to $800,000.
A survey conducted by the Mayo Clinic revealed that physicians struggle to find a satisfying work-life balance, and, as a group, suffer from high levels of emotional exhaustion. Helping physicians understand how to maintain strong family relationships in the face of work-related challenges is a major challenge for any physician assistance service.
When a physician’s behavior is problematic, meeting expectations requires active problem-solving strategies. It is also essential that the program work with the physician to correct the behavior.
Educating physician leadership to understand the problematic physician behavior in the context of the psychosocial challenges of medicine is an equally important component of the program. Physician onboarding provides an opportunity for an organization to convey its values and expectations, and to identify opportunities for the physician to integrate into the culture. Physician onboarding emphasizes that health care organization’s value interpersonal skills, along with clinical expertise.
Because the modern health care landscape continues to evolve, physicians, physician leaders and health care organizations need to have the confidence they can successfully deal with the temporary challenges and setbacks which can negatively impact performance over time. Physician assistance services can be used to create a resilient culture that is crucial to success.
Sandra Caffo, LCSW, LMFT, CEAP, is Senior Director for LifeSolutions, which is part of the UPMC WorkPartners suite of health and productivity solutions. As Senior Director, Ms. Caffo leads a staff that delivers EAP services to regional, national and international employers. For more information about how to put LifeSolutions’ expertise to work at your company, contact UPMC WorkPartners at 1-866-229-3507, or email: [email protected].
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