Interview with Tait D. Shanafelt, MD, chief wellness officer at Stanford Medicine, on laying the organizational groundwork for professional well-being by creating and hiring for a chief wellness officer position. To learn more on this topic, review the related toolkit.
Tait D. Shanafelt, MD, chief wellness officer, Stanford Medicine
- Christine Sinsky, MD, vice president of practice transformation, American Medical Association
Introduction: Hello and welcome to the AMA STEPS Forward® podcast series. We'll hear from health care leaders nationwide about real-world solutions to the challenges that practices are confronting today. Solutions that help put the joy back into medicine. AMA STEPS Forward® program is open access and free to all at stepsforward.org.
Dr. Sinsky: Well, hello. It's my pleasure today to be speaking with Dr. Tait Shanafelt, chief wellness officer at Stanford Medicine. Dr. Shanafelt is also the associate dean at the Stanford School of Medicine and the director of the Stanford WellMD Center. We are very pleased to have Dr. Shanafelt as an author of four of our STEPS Forward® modules. So, Tait, thanks so much for taking the time to share your wisdom with us.
Dr. Shanafelt: Thanks, Chris. Great to be with you today.
Dr. Sinsky: I think one of the things people might be wondering is, with so many priorities that health care organizations have, why should leaders focus on the well-being of physicians and other health professionals?
Dr. Shanafelt: I think one of the things that organizations have been increasingly learning or appreciating over the last several years and perhaps never more so than during the pandemic is how essential the well-being of their people, their engagement, their ability to bring their best to their work, to go above and beyond, is for the organization to be able to serve its community and achieve its mission. We often, conceptually think about these different reasons various organizations really buy into this. So, we often talk about the moral or the ethical case that, you know, part of our responsibilities as organizations is to take care of our people and our workforce. We talk about the business case around quality, the impact on quality, patient experience, costs. The regulatory case, particularly for those of us who train medical students and residents, we have some regulatory requirements to attend well-being. Our organizations all want to be leaders. So, we often think about sort of the recognition case or sadly, there are many organizations that sort of wake up to this challenge when one of our colleagues commits suicide. And we've heard that as the tragic case. So, there are these sort of different reasons that many organizations become serious about committing to this problem. And fundamentally, all of these elements are essential for us to succeed as organizations.
Dr. Sinsky: Not all CEOs are on board. What are some of the specific soundbites, if you will, that we can share with them to help them get on board to support establishing a chief wellness officer position?
Dr. Shanafelt: It's an important question of what are some of the ways in which we engage our leaders, to help inform them and hopefully focus their attention to the importance of action in addressing this problem. Maybe I'll speak first generically. We often, sort of highlight some just foundational pieces. First that occupational distress, burnout being one of its most common manifestations, is highly prevalent among health care professionals and physicians, specifically. That the well-being of health care professionals impacts patient care, quality of care and patient experience. That occupational distress or burnout has substantial economic costs to the organization with respect to productivity, malpractice risk, turnover. Important to emphasize that personal resilience is not the answer, that this occupational distress is driven more by characteristics of the work environment and the cultures of our organizations, also that different disciplines are unique. And so even though we care about all of our health care workers, we need to recognize that what might be the biggest source of distress and what actions we might need to take to help provide support, can be quite different for different occupations due to the nature of their work and the demands of their work. That improvement is possible. That there is strong evidence that organizations that commit to this can move the needle. And there are some specific approaches to do that. And so that, this isn't just something we would like to move but we don't know how, there are actions we can take. So, I think we, we often think about those as sort of some of the key messages.
But I'll then maybe just pivot and say that the real art here is knowing what your organization's other priorities are. And to then think about how do you take the evidence or the different dimensions of these core building blocks that are most relevant to the priorities of your organization and have a conversation on that front. So, if your organization's focused this year or currently is around quality or cost reduction, patient experience, building a network and growth, you might be thinking about what are the ways in which we have evidence where the well-being of physicians is either an aid to that effort or could hold us back if we don't address it. And to really think about nuancing the message. So that it's the right way to frame it for your organization, as opposed to just a generic message.
Dr. Sinsky: Why should we encourage organizations to establish a chief wellness officer position rather than simply having this as wellness champions or wellness committees?
Dr. Shanafelt: Most wellness committees typically don't have the authority or resources to truly drive organizational change. And when we have something that's important to our organization like quality, like patient experience, if we were going to try to grow a network, we would appoint a leader to oversee that effort. We would put the right structure around it. We would develop a strategy and then we would execute that strategy to help us achieve something that we have prioritized as important. And I think this domain is no different. That if we really want to have meaningful results and change, we have to have that same approach of establishing a leader, putting in to place the right structure and then pursuing the right processes to lead us where we are trying to go as an organization. And so, what I would say, or would encourage those who perhaps are on a wellness committee that are really trying to help their organization advance, the most effective things I've seen wellness committees do is actually lay the groundwork and make the argument for a CWO and a formal program to be established and to really help scope that out and help their organizations move down that road. And I think in the "Establishing a CWO" STEPS Forward® module, we try to provide sort of a roadmap, if you will, or some key steps that wellness committees might take to help their organization move down that road.
Outro: Thank you for listening to this episode from the AMA STEPS Forward® podcast series. AMA’s STEPS Forward® program is open access and free to all at stepsforward.org. STEPS Forward® can help put the joy back into medicine by offering real-world solutions to the challenges that your practice is confronting today. We look forward to you joining us next time on the AMA STEPS Forward® podcast series, stepsforward.org.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.