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In today’s AMA Update, Geisinger's Chief Wellness Officer Susan Parisi, MD, shares advice and insights from her first year in the role. Dr. Parisi discusses starting physician well-being programs, as well as the cause and effects of physician burnout at both the individual and health system-level.AMA Chief Experience Officer Todd Unger hosts.
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- Susan Parisi, MD, chief wellness officer, Geisinger Health
Unger: Hello and welcome to the AMA Update video and podcast series. Today, we're talking about the importance of having a chief wellness officer and the critical role that it plays in reducing physician burnout. Here to share her experience is Dr. Susan Parisi, the first ever chief wellness officer at Geisinger in Danville, Pennsylvania. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Parisi, thanks so much for joining us today.
Dr. Parisi: Thanks, Todd. Glad to be here.
Unger: Well, it's been nearly a year since you became Geisinger's first chief wellness officer, and when you stepped into this position last summer, I think it's fair to say that we were just emerging from several years of a pandemic crisis. What were you tasked with doing in this newly created role given that environment?
Dr. Parisi: Yeah, I mean, first and foremost, it was really an honor to be chosen as Geisinger's first chief wellness officer, especially to have such a large organization make such a deep commitment to this work. My first task was really to understand the scope of the needs here at Geisinger for the teams to get a baseline pulse on our clinicians, our nurses, our staff, our learners and what they were facing in their day-to-day work.
And then from there, using national best practice frameworks and system well-being and that data as our north star to really develop and create a strategic vision, priorities and programs that support the needs that emerged through that work.
I think one of the things that was really different about Geisinger was many organizations focused primarily on physicians and advanced practice providers. Geisinger expanded the role to encompass all their health care workers, which was not surprising after seeing the impact of the pandemic and the impact it had on all the sectors of the health care workforce. So really developing that strategic vision.
Unger: Mm-hmm. Well, I'm curious, what did you learn, and is there anything that surprised you or was different than what you might have expected when you took the role on?
Dr. Parisi: Yeah, so what did I learn? I think the first thing was I knew there was a need for this work. But I don't think I fully appreciated the depth and the breadth of the need, just how much our health care workers are suffering. I think during the pandemic, we were all working really, really hard to keep our health care systems working and our patients cared for. And those of us that were working in this space predicted that there would come a time when the stress, both emotional and physical, would catch up with us.
And I'm really relieved that Geisinger implemented this role when they did, as it's really much needed. I think the things that surprised me were how willing the leaders at Geisinger have been to embrace the role and the work with me and my team. I feel very much supported in the work and throughout the system. How willing our health care workers and our leaders have been to ask for help and refer others for help really has been a surprise.
It's one thing to be here. It's another thing completely, entirely different to have your programs utilized. And then finally, I don't think I could have ever predicted some of the things that have gone on in the community here at Geisinger in the past year. And it just really says to me how important it is to have a strategy as a north star and follow through with that strategy.
Unger: And I guess the good news is that Geisinger had begun several initiatives to respond to the trauma that physicians had experienced over the past few years, I guess, in process when you came on board. I'm curious if you can tell us a little bit more about what those were and how you've been able to build on them over the past year.
Dr. Parisi: Yeah, Todd, so I was really fortunate to have a solid foundation when I came here to Geisinger. I mean, first and foremost, I had a small but mighty team to assist with the work and the support, and I have a multidisciplinary team. So I have team members that are social workers who can really provide individual and team supports, a program director who has really strong operational skills, and program coordinators who can continue the development and implementation of our initiatives. So really important to have that coming in.
Some of the foundational programs that were here were our peer support program, which was really largely rooted in the prior second victim programs. And what we did was we revamped and relaunched it to have a more proactive approach. We have a wonderful well-being navigator program. And we also have a personal crisis response team for those events that are really unexpected and above and beyond the usual day to day in health care.
Unger: Now, one of the things that you said you did in that first year was get that baseline measure, which is so important in a wellness program, especially because you want to measure success. How do you know that you've been successful or what are kind of those metrics that you've got in place to be able to judge?
Dr. Parisi: Yeah, I think in this work, success in the well-being space is really a moving target. In the ever-changing landscape of health care, and particularly for Geisinger, some of the identity-shifting year that we've seen, there's no simple answer for measuring success in this role. I personally believe that as the organization shifts, success looks like a parallel shift, so being perceptive and adaptive and flexible to what well-being strategy and support look like in real time. So that cultural and organizational evolution is really important.
Success, we can measure numbers, metrics, value, cost savings. But for me, some of the real successes—leadership support, being able to do a well-being assessment, utilization as we see our numbers climb month after month of our health care workers using the program. And then for me individually, when I have an individual, a physician or a nurse or a staff member or a leader, say to me, I'm really glad you're here, you know that success.
Unger: Why do you think that having a dedicated role that focuses on physician well-being and—I guess it's more than a role. It's a leadership role in the form of a C-level executive position. Why is that so important today in our health care environment?
Dr. Parisi: Yeah, I think, Todd, there's a number of reasons. But as I think about—this is not just a role, but a true leadership role sends a message to your health care workforce that leadership is really serious about this work. It's not just checking a box.
There's also another message, which is that we care. We really care about you and your well-being as a member of the Geisinger community. And in a competitive market, an employer that really cares makes an enormous difference in recruitment and retention. So our workers know. They know when leadership is serious about the work.
From my perspective, it really allows me to be proactive in allocation of resources and planning. So it's much easier to say, how will that new policy practice procedure affect the well-being of the health care worker before it's instituted, rather than retroactively trying to change the work flow? And then finally, really, it enables our well-being work to be in strategic alignment with Geisinger strategy and the many other internal stakeholders.
Unger: As you know already, reducing physician burnout is one of the key five objectives in the AMA Recovery Plan for America's physicians. And the AMA has long said that this is not just a physician issue. This is an organizational issue and system level issue. And I think that's probably something that people don't realize that. Tell us more about that philosophy and how it further supports the creation of a leadership role like yours as chief wellness officer.
Dr. Parisi: Yeah, so first, I really want to pause here and say to you that I appreciate the work that the AMA is doing in this space. And it really makes a significant difference, having the backing and support of the AMA, as you try to do this really groundbreaking work. For physician burnout and, by extension, the burnout of all caregivers is really an epidemic. And it impacts every fiber of care delivery. So if our teams are not thriving, then we know the patient experience will suffer.
You know that clinical quality of care declines, increased medical errors. There's decreased patient satisfaction. And then there's the access to care. So care for the patients declines as we lose some incredibly valuable teammates to turn over reduction in FTEs and potentially more devastating loss. We're seeing this manifest daily at a national scale, that there's significantly fewer people that are interested in pursuing a career in medicine than are needed to meet the demands, the future demands. And that gap is growing.
On the flip side, thriving clinicians and empowered clinicians really are catalysts to great care, human connection, innovation and societal strength. So keeping our people well is not just important. It's really imperative.
Unger: Last question for you. I'm curious what advice that you might have for other health systems, smaller practices that are recruiting for a chief wellness officer role like yours. What qualifications should they be looking for? I mean, you came to this job with three decades of experience in health care. You were an OB/GYN by training. Is that important, or what are those kind of qualities they should be looking for?
Dr. Parisi: Yeah, I truly think having that first-hand knowledge of the challenges that clinicians face is really paramount. I have my own personal experience as a provider that drives me to make these changes for my fellow providers. And there really is no substitute for understanding what it feels like to finish a day of seeing patients and have your heart sink when you know you have 20-plus charts to complete.
And then, and then you look at your inbox and it's like starting another day of work. And the rest of the team have left for the day. And then there's the choice. Then you make that choice between your patients and your inbox and your family at that point. Do you finish those charts, the inbox? Do you go home, be with your family, and then do that pajama time afterwards?
And then knowing you're going to get up and you're going to do it all over again the next day. So I think having that first-hand experience is really important to doing this work. And aside from the personal experience, I think there needs to be a desire and a passion for the work. I mean, this is a marathon. It's a journey. It's complex. It's challenging. The mantra is put your own oxygen mask on first. And there are many days where this work feels like burnout on steroids.
So compassion, empathy, ability to listen, really important traits in a chief wellness officer. Tenacity, grit, resilience, patience. And then really an understanding of that body of research that we have in this well-being space now and the difference between individual and system well-being that requires also an understanding of the health care system. And there is no roadmap. So being willing to accept that you're building the road as you go, I think, is really important as you look to hire somebody into this position.
Unger: Well, Dr. Parisi, it's been such a pleasure talking to you and to get your perspective. And congratulations on finishing your first year. We'll be back soon with another AMA Update. In the meantime, you can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us 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.