Employee assistance programs (EAPs) are widely offered across health systems and organizations. However, physicians make up less than 2% of those who use an EAP. The lack of use is often because doctors don’t trust the information to remain confidential. However, a new wellness program in Nebraska—LifeBridge—aims to address well-being by using physicians as coaches.
With the help of the Nebraska Medical Association’s Executive Vice President Amy Reynoldson, LifeBridge was launched just in time to combat the added stress of COVID-19. As a free program for any physician in Nebraska, LifeBridge offers confidential services for physicians and operates separately from employers, insurers and state licensing agencies.
“We knew that the EAP model, at least in Nebraska, wasn't working,” said Todd Stull, MD, psychiatrist and LifeBridge medical director in Lincoln, Nebraska. “Not only were physicians not accessing it, but they were also afraid to access” an EAP program “for fear of exposure.”
Additionally, there may not have been many services available through EAP “and it didn't provide some of the things that they needed,” said Dr. Stull.
“Seeing a couple of physician suicides that were really getting … attention and talk in the physician community definitely highlighted the need for doing more,” said Joann Schaefer, MD, a family physician and LifeBridge coach in Omaha. “We formally launched the full program like we wanted to this past summer, but we got something out the door immediately for COVID because in a crisis, we needed to do everything we could to support the front line.”
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“We felt pretty strongly that we needed coaches who were physicians, because they had the ability to understand from their experience much more so than maybe someone who has a nonphysician coach,” said Dr. Stull.
“Most of my coaching calls have been about career transitions, struggles at work with team dynamics, contracts” and other struggles “all definitely made worse by COVID-19,” said Dr. Shaefer. “Physicians need help in these situations too and we are here for them.”
Since launching, “it’s been very positive,” she said, adding that these are physicians who “have just been in that kind of helpless mode where they’ve lost family members, they’re on the front line and they’re very stressed.”
“There’s no break from it and they don’t feel respected or listened to,” Dr. Schaefer said. That is where physician coaches can help get them “to find a place to give them permission to have joy and pleasure back in their life in a different format.”
It’s about helping these physicians “reconnect and be more comfortable at work again while getting through their grief,” she said, noting that “when we’ve gotten physicians over that hump, it’s been very helpful to them. … They describe it as life-changing for them.”
While this part of the program is still a work in progress, if “somebody has more difficulty, the coach will say, ‘This is probably beyond the scope of coaching. Let’s get you set up with someone else,” said Dr. Stull. “We are in the process of screening and identifying a registry of people who physicians can see if they have more serious problems.”
However, there is a need for “ease of access, confidentiality and timeliness of appointments, so that if you’re in the registry, we want you to be able to get that physician in short order for an appointment, not three months down the road,” he said. This will allow them to set up a “Zoom appointment or the equivalent, especially during COVID—but timeliness is particularly important.”
“This is really more of a formal … patient-doctor relationship” such as one with a psychiatrist or therapist, said Dr. Stull. “It’s a little bit different in that context, because then you have the option of billing insurance or following some other treatment strategies.”
“We want to ultimately create … a culture that's different within medicine,” said Dr. Stull. “The culture needs to be about physicians being at their best so that they can provide the best care for their patients and operate at the top of their skillset, not at the bottom of their skillset.”
“We know physicians are resilient … but to really empower medicine and physician health, it is going to require a unified effort to develop the culture we want to create,” said Dr. Stull.
The AMA offers resources to help physicians manage their own mental health and well-being during the COVID-19 pandemic and provides practical strategies for health system leadership to consider in support of their physicians and care teams during COVID-19.