WASHINGTON — The National Academy of Medicine launched its National Plan for Health Workforce Well-Being to address the growing challenges of burnout among healthcare workers, at an event hosted by the Association of American Medical Colleges (AAMC) on Monday.
Their report, a response to long-standing concerns about burnout exacerbated by the COVID-19 pandemic (60% of physicians reported burnout in a 2022 survey), emphasized the need for broad cultural change, investments in research, and efforts to destigmatize mental health.
Darrell Kirch, MD, president emeritus of the AAMC and a former dean of two medical schools, noted that at least two or three of his former students died by suicide and “none of them sought help. Clearly, in retrospect, they were depressed, [but] they were afraid to admit the distress they were in.”
A key priority area, according to the report, is focusing on reducing mental health stigma. Kirch pointed out that credentialing and licensing applications contribute to this stigma by asking clinicians whether they’ve ever experienced a mental health problem.
More than half of state medical boards continue to ask such questions in applications, said Christine Sinsky, MD, vice president of professional satisfaction at the American Medical Association, citing a map found on the Dr. Lorna Breen Heroes’ Foundation’s website.
“What a grossly inappropriate question. The [right] question is, ‘Are you medically fit to practice?’ Period,” Kirch said.
The National Academy of Medicine plan also focuses on making mental health care more accessible. The report recommends increasing telemedicine options for mental health, as well as expanded hours of availability, since many healthcare providers work long hours, and some in remote areas. It also recommends debt forgiveness programs to encourage more interest in mental health care careers.
While the action plan is about programs and concrete policies, it’s also about building a positive culture, said U.S. Surgeon General Vivek Murthy, MD, MBA. “It’s about changing how we think about the people who are there delivering care and keeping our communities safe. It’s about seeing them as whole people and not simply as skill sets.”
Clinicians like to talk about seeing “the whole patient,” he noted, but it’s equally important to see the “whole health worker … and we don’t do that.”
“We tell our health workers that their strength is defined primarily by how many papers they can publish, and how many facts they can remember, how many hours they can stay up, and how hard they can work without complaining. That is only a shadow of what real true strength is,” he added.
To foster a culture of well-being, the report recommends establishing “reasonable productivity expectations,” offering mentorship programs, ensuring that work breaks are “expected and routine, not exceptional,” and developing clear protocols for reporting and addressing discriminatory behaviors.
Another priority area, according to the report, is investing in research and assessment with the aim of developing response strategies to improve well-being. Significant funding and efforts at the national level have helped to track the mental health of the general population, Kirch noted, and the same approach should be applied to clinicians. These tools should measure not only the number of workers with burnout, but also “the degree of burnout and their related mental health status,” he said.
Burnout is an occupational health problem, Kirch continued, but the path from burnout to a “true mental disorder” is a short one.
While the federal government can help, all institutions have a responsibility to invest in their workers, and “in a nearly $4 trillion-a-year health system, there should be money available to invest in the well-being of the workers,” he argued.
In conversations with chief wellness officers, one phrase Kirch said that he hears often is “all burnout is local.” He’s learned there can be two healthcare teams doing similar jobs but only one is burned out.
Such problems can be tracked by individual institutions using diagnostic tools, including “hot-spotting” — more commonly used to track problems among a particular set of patients, such as “superutilizers.”
Once a problem has been identified, the next step is to implement a “rapid response” protocol to determine whatever “corrosive elements” are responsible, such as staff shortages, a toxic work environment, or a lack of “social cohesion,” Kirch explained. After determining the root causes, institutions can work “with mutuality and support” to address them.
The 6-year journey of this plan stems from the efforts of dozens of individuals in the private and public sector, including representatives from CMS, CDC, Veterans Affairs, and the Agency for Healthcare Quality and Research.
This work isn’t over yet, said Victor Dzau, MD, president of the National Academy of Medicine. The next step is to actually apply these policies and strategies.
Over 30 organizations across medicine, nursing, and pharmacy have endorsed the plan, and Dzau called for all members and partners to adopt and implement its recommendations.
If you or someone you know is having thoughts of suicide, please call or text the Suicide & Crisis Lifeline at 988.
Source: MedicalNewsToday.com
