Physician burnout has reached epidemic levels, as documented in national studies of both physicians-in-training and practicing physicians. While organizational approaches to address physician burnout are most effective, physician self-care also can play a role. A Hawaii medical group has launched a model focused on making it easier for physicians to eat right, move more and serve as examples for their patients and colleagues.
In 2007, only 79 percent of physicians at Hawaii Permanente Medical Group (HPMG) were proud to be part of the organization. To improve well-being, HPMG created the “SELF CARE” model based on eight evidence-based practices that have been proven to promote physician wellness and resilience:
- Sleep.
- Exercise.
- Love and laughter.
- Food.
- Compassion.
- Awe.
- Resilience.
- Engagement.
“You may think that having a culture of wellness in Hawaii is simple because it is beautiful, but I can assure you that we have the same challenges,” said Lois Gregg, MD, at the International Conference on Physician Health in Toronto. The event was cosponsored by the AMA, Canadian Medical Association and British Medical Association.
Physician satisfaction saw an increase of 19 percent in 2018, with 98 percent saying they were proud to be part of the medical group. Ninety-seven percent also said that HPMG provides an environment that supports health and wellness, while 87 percent were satisfied with the way they are currently taking care of their own health—up 10 percent from 2016.
“Health and wellness—a living part of our vision and mission—demonstrates that caring for the caregiver is imperative,” said Dr. Gregg, a family physician and co-chair of HPMG’s health and wellness committee. “As we care for ourselves within a culture that cares about our well-being, we strengthen the joy and purpose of our work.”
Here is how the SELF CARE model helps improve physician well-being by exercising and eating right.
Joining other physicians in exercise
The self-care principles were first introduced to the HPMG community at their 2015 professional development day, which was entirely dedicated to physician wellness. With about 400 participants, each person chose up to three breakout sessions to attend. The sessions focused on topics such as yoga.
“We get to indulge in activities for our own health and enjoyment, and we create and strengthen bonds with our colleagues in a nonprofessional setting,” said Dr. Gregg. “The overarching message of the day is that well-being matters, we are valued and we are part of a bigger organization that cares about us.”
Activities are chosen from physician survey responses to ensure the best sessions are offered—keeping the importance of self-care in mind. Physicians are not only asked, “What do you want to do?” but “What might you be able to teach?” From this, HPMG has provided a variety of sessions, including yoga, surfing and hula.
Another example of exercise is family night at the water park, when physicians and their families participated in opportunities for exercise and leisure.
Leading by example on healthy eating
“Food doesn’t just affect our body—it also affects how we function at work,” said Lois Chiu, MD, chief of neonatology at HPMG.
Physicians spend more than half of waking hours in the workplace, so they need to make better food choices. If doctors do not eat or if they eat poorly, they are more likely to be irritable, tired and less able to concentrate, said Dr. Chiu.
HPMG is improving healthy eating through carefully planned menus at sponsored meetings that promote their commitment. The medical group also promotes messages on the importance of using herbs and spices adding more fruits and vegetables.
“We as physicians should lead by example,” said Dr. Chiu. “But if we don’t practice it ourselves, it is harder to lead.”
Physicians can attend the “after hours pop-up kitchen,” which transforms a clinic conference room into a kitchen complete with cooking surfaces, cutting boards and knives. Led by a chef and physician from HPMG, doctors learn how to cook healthier meals, featuring more plants, and provide better advice for their patients.
“I have experienced firsthand how healthy eating makes me feel,” said Dr. Chiu. “I have seen what my employer has done to help build a healthier me so that I can take better care of my patients.”
