Providing a healthy work environment for clinicians, one that encourages well-being and promotes commitment to patients, is part of an ongoing effort at Sanford Health.
It starts that first week, in fact, as new providers begin their orientation process. The American Medical Association reports more than 40% of physicians experience at least one sign of burnout. Supporting health care providers from early in their employment helps prevent burnout, says a recent report from the National Academy of Medicine.
“That first day at Sanford we spend it all reaching out and thanking them for going into medicine,” said Dr. Craig Uthe at Sanford Health. “We thank them for choosing Sanford. It’s a well-being workshop.”
It is part of a broad effort at Sanford Health to build on why health care providers are attracted to their professions in the first place. The aim is to provide effective support to those whose occupational challenges are unique.
“Our hope is to create a philosophy at Sanford where you’re part of a family,” said Dr. Luis Garcia, M.D., Sanford Health’s clinic president. “We care for you and we’re there for you.”
Clinicians and change
Industry-wide, responsibilities for providers have changed. New challenges are constantly emerging as providers attempt to maintain care quality.
How health care professionals view a lifetime in the profession has changed as well. Coupled with Sanford Health’s distinctive rural footprint, clear thinking and long-range plans are necessary.
“The perspective of joining a practice from the standpoint of the physician has changed significantly,” Dr. Garcia said. “A generation ago, your first job was going to be the job you were going to be in for 15, 20 or 30 years. The new generations are not thinking like that.”
Balancing family and community life is a higher priority than it once was. Accordingly, that warrants a different approach.
“We’re adapting to that generational change at the same time that we’re continuing to take care of business,” Dr. Garcia said. “That’s where our priorities are. You are part of a family at Sanford. You’re part of a great place to work and we care about you. We have the support systems in place for you to be successful. At the same time, our ultimate goal is always going to be the patient. The centerpiece is always the patient.”
Placing emphasis on clinician wellness begins with assessing and fine-tuning that which is helpful. On that count, Sanford Health takes direction from providers themselves.
“People basically go into medicine for combination of four reasons: It’s altruism, intellectual curiosity, a sense of ‘calling’ and general career security,” Dr. Uthe said. “They’re common themes. We try to provide resources to all our clinicians so that they can stay focused on those things that they went into medicine for. And every person has a unique reason behind that.”
Dr. Erica Schipper is a Sanford Health obstetrician/gynecologist who cut back on her schedule when she and her husband started a family. It wasn’t a dramatic alteration but it was enough for her to help negotiate the changes that come with continuing to devote the necessary time to her patients while also taking on motherhood.
“Having a few less appointments makes it easier for me to keep up,” she said. “So do I give up a little bit of money to do that? Yes. But you have to learn what works for you. So for me, having the liberty at Sanford to be able to say I’m just going to see a few less patients a day was really helpful.”
“Charting” is the term providers often use for record-keeping of patients. It is an important and necessary part of the profession but on a busy day squeezed with patients it can be a grind. Schipper does her best to avoid taking that part of her day home with her. If it is unavoidable, she’ll wait until after her son goes to sleep.
“I believe it’s necessary to stay connected to your reasons for going into medicine,” Schipper said. “You need to stay excited and interested. That can involve reflecting in the morning on what kind of energy you want to bring to your practice before you start seeing patients, or reflecting at the end of the day on what went well and how you feel you made a difference.”
Dr. Schipper, a Pierre native who conducted her residency at the National Naval Medical Center and at Walter Reed Army Medical Center, seeks out continuing medical education opportunities because they help energize her. She works at collaborating with her staff to make patient visits efficient, and she maintains a regimen of healthy eating and exercise.
In addition, she has frank conversations with herself. If she feels like things are drifting off course, she makes a correction.
“It’s very easy to say, ‘Well, I’ll be there for my son when I get through this month or this quarter,’” she said. “Or, ‘I’ll prioritize my health when I get through this busy season.’ But the fact is, as physicians we’re always busy and we’re always going to be busy so we have to strike that balance now. We can’t wait for some day in the future.”
Maintaining a sense of proportion applies in all clinicians’ roles. Answers to the question “Why am I doing this?” may vary widely within the profession. But the responses, whatever they may be, can supply valuable insight and direction toward sustaining a fulfilling career.
Clinicians and self-care
“As clinicians we are constantly striving to find balance between work and family responsibilities along with activities we pursue for personal wellness,” said Dr. Brian Gatheridge, who practices psychology at Sanford Health Detroit Lakes Clinic.
“It’s often a matter of identifying and reminding ourselves of why we chose to become a health care provider. That’s while striving to create the type of practice we desire in the environment we desire.”
Ultimately, those internal reminders can serve a vital role in self-care.
“One has to be aware of their individual self-talk,” Dr. Gatheridge said. “Do we come to work with positive or negative thoughts? We also need to be aware of our own resources for coping in response to stress associated with our work and life outside of work.”
Both Dr. Gatheridge and Dr. Schipper have taken on significant additional leadership roles within their professional communities. For some, that might feel like adding onto a busy day. But many clinicians see it as a personally rewarding way to share their professional acumen and experience.
“You can get the sense you’re helping at a different level,” said Dr. Raul Ruiz, a Sanford Health endocrinologist. “It’s something you can get excited about. It might not be for everyone. We all have to find that different aspect. For some it might be education, or research. In my case, leadership might add a few hours of work but I’m getting some self-fulfillment. I’m participating in something that is helping Sanford Health and helping me grow.”
Dr. Ruiz is chair of Sanford Health’s Physician Satisfaction and Retention Committee. As such, he and colleagues get together and come up with ideas that can increase physicians’ satisfaction with their work.
Those conversations have led to things like trivia nights and events focused on physicians and their families. Promoting wellness is another theme.
“We’ve found that creating a sense of community is very important,” Dr. Ruiz said. “It’s one of the main focuses of our committee. We want to make sure people and their families know there are opportunities to create new relationships and new bonds.”
Working toward better personal and professional health can take on many forms. By expanding options, clinicians can find individually suited ways of improving the quality of their lives.
“We’ve tried to more generously provide services to employees that help them take care of themselves,” said Katie Nermoe, the director of wellness at Sanford Health Plan. “They can’t take care of patients until they’ve adequately taken care of themselves.”
Sanford provides options
Janelle Brandon is the supervisor of Wellness and Lifestyle Medicine Programs for Sanford Health Plan. In her role, she oversees Sanford Health’s Provider Concierge Program.
The program allows providers to contact Brandon and share their wellness challenges. Brandon offers possible solutions and can help with any necessary research needed. She can answer questions that range from “Where can I find a personal trainer who can accommodate my busy schedule?” to “How do I get a home gym set up?”
In other words, by acting as a concierge, Brandon can do the legwork to set up providers for success. She can even create a personal wellness plan and meet with the provider regularly.
“We want to help with some of our wellness and lifestyle solutions to assist on the journey of self-care,” Brandon said. “We want to identify areas where we can bolster the resilience and the ability to cope and manage one’s day-to-day responsibilities.”
Sanford Wellness teams address:
- Well-being education — Exploring new ways to think about and cope with the challenges of a career in health care.
- Lifestyle medicine — Providing personal wellness plans and programs designed to treat and reverse chronic disease, such as obesity, high blood pressure, type 2 diabetes and more.
- Wellness coaching — Helping providers and employees thrive across the six dimensions of well-being: career, social, community, financial, physical and emotional.
- Nutrition coaching — Consultation with a registered dietitian to create a personalized nutrition plan to meet health and wellness goals.
- Exercise coaching — Consultation with a fitness specialist to create sustainable options for leading a physically active life.
Caring for the caregivers
“Taking care of yourself means something different to everyone,” Nermoe said. “We’ve tried to offer a wide variety of different programs and services for that reason. You’ve seen more exercise classes offered in Sanford facilities. We completely renovated the gym at Sanford Center, knowing our executives work very hectic, busy, long hours. We’ve even begun offering yoga classes at the Sanford Center.”
Given that health care providers’ schedules can be an obstacle, people like Brandon can play a vital role in helping providers access that which leads to a better quality of life.
“For example, it might be foolish for a life coach like myself to tell someone to make sure they spend 20 minutes eating,” Brandon said. “When you’re dealing with emergency surgeries and traumas coming via helicopter that’s probably not realistic.”
How can people in those situations take care of others while also taking care of themselves? How can they avoid pitfalls associated with caregiving?
Brandon describes it as “putting on your own oxygen mask” before helping others with theirs.
“In the case of providers, sometimes the stakes are really high,” she said. “It can feel like some of those increasing demands can be too much when those burdens are placed on their shoulders. We are one of those outlets that can help people manage those burdens.”
A Sanford-wide campaign has begun aimed at using evidence-based methods to make a career in health care still seem a good decision decades after the fact. Sanford Health has begun a mentor program for physicians, for instance. It’s an effort that moves forward via knowledge and respect for the potential challenges that come with the profession.
“We’re seeing a lot of positive things happen based on our initiatives,” Dr. Ruiz said. “It’s great to see that we’re working at a place where well-being of the providers is a top priority. It’s very reassuring.”
Achieving the life-work balance can be an intricate process but the target is simple and clear.
“Our goal at Sanford is to help our clinicians live their life the best way they can live it,” Dr. Uthe said. “And within that, how can we help them work at their top efficiency in the work environment? Top efficiency means being with that patient in that moment and giving them 100% of your time. That’s going to drive quality and your efficiency. It’s going to drive all those things that make a health care system work well.”
Dr. Uthe likened it to being a coach who wants to get the most out of the players.
“That’s our challenge,” he said. “How do we help people succeed in the work that they want to do?”
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