AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts in medicine on COVID-19, medical education, advocacy issues, burnout, vaccines and more.
In today’s AMA Update, the chief medical officer of Dr. Lorna Breen Heroes’ Foundation joins to discuss the realities of physician burnout and shares advice on seeking mental health services as a health care professional. Stefanie Simmons, MD, is also an emergency department physician and vice president of clinician engagement for Envision Healthcare’s national medical group. AMA Chief Experience Officer Todd Unger hosts.
- Dr. Lorna Breen Heroes’ Foundation aims to reduce burnout of health care professionals and safeguard their well-being. Learn more.
- Call or text 9-8-8 if you or anyone you know needs help. The National Suicide Prevention Lifeline is now the 988 Suicide and Crisis Lifeline. It provides free 24/7 confidential support for people in distress, crisis resources for you or your loved ones, and best practices for professionals in the U.S.
- Access the AMA Recovery Plan for America’s Physicians.
- Stay up to date on all the latest advocacy news by subscribing to AMA Advocacy Update.
- Read AMA's issue brief (PDF) on supporting mental health and wellness.
- Get the facts on medical licensing, credentialing, and physician mental health.
- The AMA is your powerful ally in patient care. Join now.
- Stefanie Simmons, MD, chief medical officer, Dr. Lorna Breen Heroes’ Foundation
Unger: Hello and welcome to the AMA Update video and podcast series. Today, we're talking to a physician leader who has taken her fight to protect physician mental health to the national level. Here to discuss her journey is Dr. Stephanie Simmons, chief medical officer at the Dr. Lorna Breen Heroes Foundation. Dr. Simmons is also an emergency department physician and vice president of clinician engagement for Envision Healthcare's National Medical Group in Ann Arbor, Michigan. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Simmons, welcome.
Dr. Simmons: It's my pleasure, Todd.
Unger: We have been fortunate enough to talk to Corey Feist, the co-founder of the Dr. Lorna Breen Heroes Foundation many times as we worked with him and the foundation on passing that important legislation, and we always appreciate hearing about the important work that's happening there. Your journey to promote physician wellness and protect physician mental health didn't begin at the national level. It started with you. And at one point early on in your career, you said that you were one of those many physicians who felt like they just couldn't talk about or seek help for a mental health issue. Why don't we just start by having you tell us a little bit more about that and what prevented you from seeking care at the time.
Dr. Simmons: Sure. Thanks, Todd. When you say "early in my career," it was about as early as it can get. So I'm a generally happy person, and it wasn't until I had my second child during my emergency medicine residency and experienced postpartum depression that I really understood the biological nature of mental health—that you can be very happy with your life, where you are, what you're doing, who you're with and still have profound sadness. And so at the end of my residency, that's what I was facing.
But I knew that I was about to apply for a new job. I knew that I was about to apply for disability insurance. I knew that I was about to start, maybe, new state applications. And from everything that I had heard from all of my colleagues and all of my teachers was that having a formal diagnosis or treatment on your books could be damaging to your prospects for all of those things.
And so at that time, I didn't seek care. And I believe and I know that it extended the amount of time that I suffered. It affected myself and my family that I did not seek the care that I could have used.
Unger: Yeah, and we hear that story so many times—and, of course, the impetus for a lot of the changes that were being made. I'm curious, once you recovered, I'm curious about what that story is. How did you then begin to look at how you could help your colleagues?
I know that you first worked to make changes within your own health system, and later, you became a national advocate. So tell us about that journey. Where did you start and what did you learn from that experience?
Dr. Simmons: Thank you. You know, it wasn't just my story at that point because I was on this journey alongside others who were going through similar situations. And like many caregivers, it's easier for me to try to solve a problem for someone else than to solve a problem for myself. And so what I started doing was coaching and talking to other clinicians who were struggling with their interactions with patients, or with their team, or with other colleagues.
And really, if you scratch the surface of those interpersonal interactions, what you often find is burnout or mental health. And so I found myself, instead of just coaching on communication, actually helping to connect people with resources in the medical group that I was working in at the time, in the hospital and health system that I was working at at the time, and really scratching the surface and uncovering a well of need in healthcare for additional resources—but also to help to start to break down the stigmatizing language that exists in state medical licensing and hospital credentialing questions.
Unger: Well, you've certainly found your way to the right place to make a difference. Tell us about your current role at the foundation and what your areas of focus are right now.
Dr. Simmons: Thank you. Early in the pandemic, when I heard about the foundation starting, I cold called the co-founder, Corey Feist who is now someone I work with closely every day, and I said, this is the work I'm doing. How can I be of service? How can I help?
Because there had been a group of us doing this work who were knocking on a heavy oak door around professional well-being and burnout. You know, are you there? This is a problem. We need to come in. And what I saw with the foundation and with the work during the pandemic was that door starting to crack open, and people looking out and going, we're seeing that this is a problem. Who's out there? Who can help? Who's out there that can do some of this work?
So the foundation, and all of us alongside the foundation, promptly jammed our foot in that door. And we're currently marching through it with the goal of making a longstanding and long-lasting difference for the healthcare workers of our country.
Unger: Now, you're an emergency medicine physician, I'm sure no stranger to the burnout, certainly, that has occurred over the past few years. How has that perspective helped you in your work as a physician advocate?
Dr. Simmons: Well, my lived experience has been, you know, of 15 years of practice in emergency medicine. Whenever I talk to a colleague and I say, you know, tell me about this time when you were burned out, the answer isn't, what do you mean? The answer is, which time, right? Which experience?
Was it, you know, the devastated child that I took care of but didn't have time—as much time as I wanted—to really comfort and talk to the parents? Was it my colleagues who I see suffering? Was it the overwhelming amount of death and suffering that I saw during the pandemic? Or, frankly, are you talking about just the daily grind of having to work within a system that requests you to spend more than half of your time as a note-taker, as a person clearing insurance for your patient, and more often than not, not being able to do what you really want to for your patient and incurring that moral injury.
So certainly, the lived experience of practicing medicine has been critically important, but also in supporting other health care workers, I hear their stories. And that's often what fuels the innovation and the change that we're making.
Unger: Now, I understand that you were recently in Washington, D.C., and you had the opportunity to meet with a number of members of Congress to talk about physician wellness. Can you tell us about these meetings? Are you finding these legislators to be understanding and supportive?
Dr. Simmons: Absolutely. So you know, this is not a partisan issue. This is not a local or geographically isolated issue. Every person on Capitol Hill has a hospital in their district, has health care workers in their district, and has potential patients as their constituents. And so everyone cares about this issue being addressed in a way that makes substantial difference and change.
And that's where the debate comes in, right? It's, what will make substantial difference and change? Well, the good news is there is an increasing amount of evidence and there's an increasing amount of experience at the hospital, health system and even state level about what does make a difference and what does make positive change for health care workers, health systems, and ultimately, patients .
Unger: The AMA's worked to address physician burnout through its Recovery Plan for America's Physician. And on behalf of the AMA, I just want to say thank you for working closely with our team on medical board, hospital and health system advocacy. Can you talk about what you've learned about the behind-the-scenes advocacy that your colleagues may not be aware of, and give us any advice to physicians who are interested in becoming more involved in this kind of advocacy?
Dr. Simmons: The first thing I want any physician who's listening to this to know is that there is a whole team of people across the country that are pulling and trying to do this work to make your life, and your job, and your life at your job better. That was not something that was apparent to me and that I did not understand when I was working clinically and not involved in this work. So I'd like to say thank you back to the AMA, and also encourage clinicians—our physicians, APPs, nurses—to really get involved with the advocacy efforts.
If there's an issue that's important to you, write your Congressperson. If there's legislation that's up for a vote, let your representative know that it's important to you, why it's important to you and how it impacts your life and the life of the patients you serve. By getting involved, what I've learned is that the voices of health care workers are immensely valuable, that doctors and nurses and advanced practice professionals are some of the most highly-respected people in the country and that we need to share our stories. We need to share our voice in order to be able to make a difference for ourselves for the future of health care and also for our patients.
Unger: You know, that's another point that's come through so loud and clear as we've talked to different people on the AMA Update, is just how important those physician stories are. And they're so important when you get down to that kind of litany of issues, some of which you mentioned previously. When you think about prior authorization, Medicare payment, physician wellness, of course, all of these rely on physician voices to tell the story of the toll that they're taking—and it's a big toll.
Because we have record numbers of physicians talking about leaving the profession, record level of burnout, with more than half of physicians even saying they wouldn't choose medicine again if they were given a choice. What do you say to physicians who are feeling this way who might be really struggling right now?
Dr. Simmons: Well, it's not a hypothetical question for me, Todd, because I have a number of young physicians and physicians-to-be in my life—people who are in their training, who are just starting out in their career. And I also had the pleasure of giving a residency graduation talk recently.
And we still have the honor and the privilege to care for people at their darkest hour and to use our skills and our knowledge to make a difference in people's lives. It can get very narrow and very dark when we're caught up in our day-to-day practice and we're facing the administrative burden and the human suffering that we do. So what I like to remind people is that we can take a step back and really appreciate the broader perspective that our work is within. And also, we always have the opportunity to do some of that work to make a difference and change the operations and the work that we are that we're facing.
Unger: That's great advice. Dr. Simmons, thank you so much for joining us and for all the work that you and the foundation are doing on behalf of physicians. Please pass on our gratitude to Corey and Jennifer Feist as well.
That wraps up today's AMA Update. We'll be back with another segment soon to learn more about the AMA's Recovery Plan for America's Physicians. Check out the AMA website, ama-assn.org/recovery. Thanks so much for tuning in today. Please, take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.