Health care providers face some of the greatest levels of stress of any profession. Though this may occur for understandable reasons, our chosen responsibilities do not diminish the necessity we have to also care for ourselves. In fact, multiple studies show that we have a greater susceptibility to depression, fatigue, anxiety, sleep deprivation, and many other, even more serious, health and social risks. And if we do not place our own wellness in a position of primacy, we not only do ourselves a disservice, but those we hope to heal. Although not always intuitive, an important first step comes from identifying what the barriers might be to improving our wellness and to identify the key triggers of burnout. The department is committed to working with and supporting our faculty, trainees and staff to identify those triggers and ultimately to minimize them. I am aware of many, but certainly not all, of the multiple issues within our working environment that contribute to burnout. However, it is our goal to mitigate their impact on your life. Please do not hesitate to reach out and let me know directly what we can do to keep you healthy so that you can deliver the high-quality care we know you want to provide.
Our residency program has taken a lead in increasing awareness of the consequences of overwork and determinants of wellness for our trainees. There are a number of open channels for communicating feedback to supervisors for intervention when it seems like someone is struggling, as well as various private and supportive avenues that residents can take advantage of on their own. Every Thursday afternoon, for example, the department has reserved time for our residents with counselors in the UI Employee Assistance Program. They should know this already, but it is worthwhile reminding everyone that even if a problem seems small, no one should have to handle it alone. Our Chief Residents have also reminded me that there are monthly workshops within the curriculum, during which the importance of trainee and provider wellness is raised and specific coping strategies for various situations are taught. As these physicians are beginning their careers, our department is committed to helping them build healthy habits that will carry them through the decades and challenges to come.
As a leading training program in Internal Medicine and its subspecialties, our faculty have honed the skill of leveraging the complexity of our clinical practices into opportunities for educating our trainees. I highlight, by way of example, the approach that the Division of Immunology has used. For more than five years, their standing weekly division Grand Rounds has opened the floor usually monthly for what Division Director Dr. Scott Vogelgesang calls “clinical stumpers.” Similar in structure to a tumor board, a faculty or trainee physician from the division presents a complex diagnostic case and solicits the advice of the other minds in the room. Not only does this broaden the differential diagnosis, but even in those instances where conclusions remain indeterminate or uncertain, physicians can be reassured that they have called on the skills and experience of at least a dozen other professionals. This team-based approach invariably provides new directions to explore, a perspective they may not have considered, and illustrates—particularly to trainees and students—effective investigative and diagnostic approaches. It is not surprising therefore that our Immunology/Allergy and Rheumatology trainees have developed a national reputation for winning many of the annual knowledge bowl competitions at the annual meeting of the American College of Rheumatology. Dr. Vogelgesang notes that the division is exploring ways in which these sessions could be developed into a more formalized clinical service for external referring providers, furthering the mission of the only academic medical center in our region.
I finally want to share an important example of our faculty and staff engagement with our community. The recently formed Community Engagement and Services (CES) team is made up of a cross-section of physicians, administrators, and other staff. They have worked together to identify a number of potential worthy causes within the community that department members can work together to support. They have recently identified our first project, which is to send as many Iowa City students back to school fully equipped for success. A wish list of items provided by the Iowa City Community School District, ranging from backpacks to binders, was recently emailed and is also available in each division’s administration office, where collection boxes have been placed. The CES will send out regular reminders over the next few weeks, and they encourage us to show the community just what Internal Medicine can accomplish when we all work together.