Emergency physician Vanessa Calderón, MD, doesn’t want anyone to experience the same level of stress that she’s experienced during parts of her career or to experience burnout in the ways she did.
She used to wear the hours she worked as badges of honor, including covering for a sick colleague by filling in for their scheduled night shifts up until she went into labor with her second child.
“The problem is this: In medical school, we were all taught to be really strong and how to find the answers. What we weren’t taught was how to be vulnerable and how to ask for help,” said Dr. Calderón, department chief and medical director of the St. Mary’s Hospital emergency department in San Francisco. “And I’d say we did a pretty good job of shaming vulnerability in our medical training and that, I think, is one of the cultural core issues that has led to the burnout epidemic that we have now.”
“We have not let our physician colleagues, myself included, to be human and to ask for help when we need it,” she said.
In the “AMA STEPS Forward® Podcast” episode that explored supporting physician well-being in an emergency department environment, Dr. Calderón shared her approach to measuring physician well-being in an ED setting and provided tips on breaking through the “we’ve always done it this way” mentality. Listen on Apple Podcasts or Spotify.
After experiencing the classic symptoms of burnout, Dr. Calderón has championed physician well-being and came back from burnout thriving.
“I still am ambitious and I love what I do and I love helping patients,” said Dr. Calderón, who also serves as the wellness champion and resiliency director of Vituity, a national multispecialty physician-owned and -led partnership.
But now, among other things, she is more conscious about setting an example of how to take vacation or work in a way that frees others to take time for themselves.
Changing the mindset
Here are some changes emergency departments can make without a lot of resources or committees—changes that can make a difference in the patient and physician experience.
Get physicians what they need to do their jobs. This includes equipment, support staff and other tools for physicians to do their jobs efficiently.
Listen to physicians’ experiences and needs. At the weekly department meeting, Dr. Calderón has a regular agenda item for well-being. They discuss the pain points of the given week and physicians are able to be very specific. “Doctors are not shy to tell you what they need or to complain,” she said.
If there is something broken, fix it. A printer that always gets jammed, a computer that always runs slowly, a room without an otoscope that requires the physician to run to another room to get the tool or to move the patient entirely. These things all add to a physician’s stress and frustration.
Always ask: Does this require a physician brain? What is the downstream or on-the-ground impact of the change we want to make? For example, patients in the ED can be there for hours at a time. They want to know what is going on and they want to be checked on. Dr. Calderón’s department has scribes and she encourages physicians to think about creative ways that scribes can help out, including helping check up on ED patients.
When meeting a patient, Dr. Calderón will introduce a scribe as her assistant for the day and let the patient know that they will be seeing the assistant a lot that day and that they can direct questions to her through the assistant.
Just give it a try
So, what do you say to people who say they don’t want to make changes because “we’ve always done it this way”?
Dr. Calderón said she responds with a smile and says, “What if we just try this as a pilot?” If it doesn’t work, they can always go back to the old way.
Learn more with the AMA STEPS Forward toolkits that help physicians and organization leaders combat burnout and promote professional well-being.
