Year 2. March 6. Are We Well?
Last Thursday through Saturday, the Association of Professors of Medicine, APM - a member of the Alliance for Academic Internal Medicine (AAIM), held their 2023 annual Winter Conference meeting. You will see from the agenda that chairs of medicine and other department leaders from across the country have been very focused on critical issues that impact our departments. I was pleased to chair a symposium entitled, “Burnout and Faculty Well-Being”.
Three speakers focused on the critical importance of focusing on faculty wellness as a mission-critical indicator of the vitality of our departments of medicine. Mark Linzer, MD, MACP, director, Office of Professional Worklife (OPW), director, Institute for Professional Worklife (IPW), Hennepin Hospital, University of Minnesota, kicked off the session, with the case for preventing physician burnout as being essential for the future of departments of medicine with implications for the quality of the care that we provide for our patients, who also want their physicians to be well.
Sarah Richards, MD, senior vice president for physician experience at the University of Nebraska College of Medicine outlined their programs and experiences in supporting team and leader well-being.
Our own Tisha Wang, MD electrified with audience with her presentation, "Our Path to Wellness - One Year at a Time."
It was gratifying to listen to the story of how as a department we recognized the significant impact that burnout was having on our department, the results of our initial assessment of the scale of the challenge, the initiatives that were implemented and the initial results of those efforts. The final quote in Dr. Wang’s presentation:
“The most important work in progress is the concept of considering physician well-being + retention in every decision that we make,”
is an important commentary on a core value and priority of our department’s leadership.
Dr. Wang presented the results of our 2022 DoM Wellness Survey, initiatives that were implemented such as townhalls, our DoM Wellness Website, mental health resources, new wellness policies, template and clinic modifications that addressed physician autonomy, tools to increase physician support such as coaching and other initiatives.
Preliminary analysis of the 2023 Wellness Survey indicate that these efforts have already begun to bear fruit. Our response rate thus far is ~ 32% (last year’s response rate was 80%), So, if you have not responded to the 2023 survey request that was recently emailed to you, PLEASE DO SO NOW.
What have we learned so far from the early returns? Faculty departure rates have decreased by >50%, burnout rates appear to be reduced by >20%, and so far, there has been a 35% increase in respondents who agreed or strongly agreed that leadership was receptive to their concerns.
We will share in greater detail, the results of the 2023 survey after it closes on March 10, so please send us your feedback. We want to hear your voice!
Our efforts were applauded by our colleagues across the country and Dr. Wang’s presentation was so well received and she has already fielded multiple invitations to present our approach at other forums.
Tisha, I’ll be happy to serve as your agent!
During the meeting, I also learned that Dr. Wang was selected for a one-year fellowship in the Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program. Full details of the announcement can be found here. Congratulations Tisha!
Is our System of Health Care Delivery Well?
Despite numerous technical and therapeutic advances, our health systems are far from perfect, and much work needs to be done for example to increase health equity in terms of access and outcomes.
I would encourage you to tune in to the recording of the recent DoM Grand Rounds given by Utibe Essien, MD, MPH that describes disparities in initiating guideline approved treatments to patients from communities of color, even when they have similar levels of insurance or equivalent health care access such as through the VA system.
Last week, Dan Ly, MD, MPP, PHD, and colleagues from the division of general internal medicine and health services research, published the study, “Inequities in surgical outcomes by race and sex in the United States: retrospective cohort study,” in the BMJ, which assessed the inequities in mortality by race and sex for eight common surgical procedures across specialties that included elective and non-elective cases. Researchers used a retrospective cohort study evaluating Medicare data from 2016 – 2018 of a participant pool that included Black and White Medicare beneficiaries undergoing 1 of 8 surgeries. They found that after adjusting for potential cofounders, Black men had a higher mortality rate overall and for elective surgeries when compared to White men, White women, and Black women. Non-elective surgeries did not demonstrate a difference. The research team has brought to the attention of the world, the importance of understanding factors that contribute to poorer outcomes and the challenges Black men face when in need of surgery. The paper has garnered international media attention including CNN.
“Our findings point to possibilities such as poorer pre-optimization of co-morbidities prior to surgery, delays of care due to structural racism and physician bias, and worse stress and its associated physical burden on Black men in the United States,”stated Dr. Ly in this recent interview with CNN.com.
Read the full article below:
Among seniors, Black men more likely to die after surgery than their peers, new study suggests | CNN
Among older patients, Black men may have a higher chance of dying within 30 days following surgery than their peers, according to a new study. The study, published Wednesday in the medical journal BMJ, suggests that this inequity could be driven by outcomes following elective surgery, for which...
Ensuring the Wellness of our Training Programs
An important imperative as an academic department of medicine is training the future generation of physicians and ensuring that our programs are meeting the expectations of the communities and patients that they will serve. As such, it is good to see when members of our team are provided the opportunity to shape the future of graduate medical education on the national stage.
Jeanette P. Lin, MD Appointed to Accreditation Council for Graduate Medical Education, Internal Medicine Review Committee
Dr. Lin, MD from the division of cardiology, has been appointed to the Accreditation Council for Graduate Medical Education, Internal Review Committee. A revered national leader in the field of adult congenital heart disease, Dr. Lin is an associate professor of medicine in the David Geffen School of Medicine at UCLA and the Adult Congenital Heart Disease Fellowship Program Director. In her role on the ACGME Committee for Internal Medicine she will represent adult congenital heart disease and join other internal medicine and cardiology leaders in developing the goals and curriculum of ACGME program requirements and enhancing health care and graduate medical education.
Her six-year term begins July 1, 2023, and we are proud to have her representing the department of medicine on this important committee.
Douglas Ruiz Carbajal Appointed Chair-Elect of the Association of Program Directors in Internal Medicine/ Program Administrator Advisory Council
Join me in congratulating Douglas Ruiz Carbajal, from the education team, who was appointed chair-elect of the Association of Program Directors in Internal Medicine/ Program Administrator Advisory Council for the Alliance for Academic Internal Medicine (AAIM). Douglas joined the internal medicine residency program education team in 2014 and currently serves as program coordinator. In this role, he manages program operations, which is inclusive, but not limited to complex scheduling logistics across the multitude of training locations, program accreditation, and office administration management.
He currently also serves as a member of the Association of Program Directors in Internal Medicine Program Administrators Advisory Council since July of 2021, which represents and advocates for program administrators within the national organization, while promoting collaboration and professional development within the administrator community. He was a member of the AAIM Learner Handoff Standards Task Force from 2021-2022 that resulted in the development of an Individualized Learner Plan to ease the transition of students from Undergraduate Medical Education to Graduate Medical Education.
He also currently serves in the UCLA Staff Assembly Board of Directors as Vice President of Records and Archives since October of 2022 in an effort to support the broader UCLA staff community. Douglas’ career at UCLA has been characterized by his passion for promoting the development and success of others. I am confident that his leadership will have national impact as he supports the program administrator community in his future leadership role within the Association of Program Directors in Internal Medicine Program Administrators Advisory Council.
Wellness Includes our Planet and Biodiversity
Dr. Barbara Natterson-Horowitz chosen by the National Academies to lead new board on animal health.
I am pleased to share that The National Academies of Science, Engineering and Medicine have appointed Dr. Barbara Natterson-Horowitz, a leading evolutionary biologist, cardiologist and award-winning author, to direct its Board on Animal Health Science, Conservation and Research, or BAHSCR.
Formerly called the Institute for Laboratory Animal Research, the new name reflects the National Academies’ broader scope and expanded interest in how animal health connects to human and environmental health. Natterson-Horowitz will co-chair the board with Robert Dysko, DVM, a faculty veterinarian at the University of Michigan.
“Our mission is to advance species-spanning discoveries to benefit the health of animals, humans and the planet we share.” said Natterson-Horowitz. “Fostering research that traverses disciplines is increasingly crucial for protecting the health of all species.”
Natterson-Horowitz is a UCLA professor of medicine in the division of cardiology and founding co-director of the university’s Evolutionary Medicine Program. At Harvard University, she holds faculty appointments at its medical school and Department of Human Evolutionary Biology.
Dysko and Natterson-Horowitz will guide research collaboration and promote the exchange of knowledge with other units across the National Academies. Board members facilitate the group’s international programs and represent the United States in the prestigious International Council of Laboratory Animal Sciences.
For the past decade Natterson-Horowitz has researched the natural world as a source of insights for human health. I invite you to read her recent publication “Here’s What Scientists Are Learning about Women’s Health from Other Female Animals,” in Scientific American discussing how studying the biology of other female species, can inform possible solutions to women’s health issues ranging from heart failure to breast cancer.
Projected on the massive screen behind me onstage, a herd of giraffes rushes across a sweep of savanna. With the video set to loop, the giraffes gallop endlessly, giving me time to slowly lean across the podium and ask my audience: "Did you spot the pregnant giraffes?"
While I was at the APM meeting in San Diego, my wife took the opportunity to show my mom around San Diego, which she had not seen before.