Physician Health

Why health system leaders should be open, authentic on burnout

Sara Berg, MS , News Editor

As the pandemic continued the summer of 2020, AMA member Nigel Girgrah, MD, PhD, found himself like many people, languishing and struggling. While he recognized the triggers of physician burnout, he was unable to follow his normal coping measures—travel restrictions prevented him from visiting family and friends in Canada, and he was unable to exercise due to a knee injury.

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“My ‘aha!’ moment was that everybody has a version of this story. And I have a quarterly chief wellness officer message that is an open letter that goes out to our 34,000 employees,” Dr. Girgrah, a transplant hepatologist and chief wellness officer at Ochsner Health, said during an AMA Insight Network virtual meeting about strategies, insights and tips for increasing professional well-being.

The network aims to help AMA Health System Partner Program members save time and money, gain early access to innovative ideas, get feedback from their peers, network, and learn about pilot opportunities. Learn more.

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“I wrote one about me and that story. Then I talked more broadly and described the issue of mental health stigma in health care,” he said. “I sent out that letter, worrying I was going to get called up to the executive offices and the state licensing board would track me down. But what I got was an overwhelming number of lengthy messages and emails from people saying they were going to reach out for help.”

During the virtual meeting, Dr. Girgrah shared more about his journey and his commitment to normalizing discussions about mental health at Ochsner.

“We've been measuring burnout with the help of the AMA for the past three years and trying to benchmark ourselves year over year,” said Dr. Girgrah. “This year we had the chance to be an alpha site for the expanded mini-Z well-being index, which allowed us to dig deeper into” measuring depression, using a validated post-traumatic stress disorder survey and looking at themes around post-traumatic growth.

“If you’re an organization that’s interested in patient experience, you need to be interested in well-being,” he said. Since 2013, Dr. Girgrah and several others began to study and measure burnout in our organization and did a number of assessments.

“This led to a number of recommendations including resourcing my role and the office of professional well-being, which I lead,” Dr. Girgrah added.

Health systems should not wait to implement solutions, said Dr. Girgrah. After learning physicians and nurses wanted more opt-out offerings than opt-in, Ochsner piloted work with mental health startups.

One is a mental health company with “empathetic support givers who are available 24/7, armed with a 1-800 number and an app,” said Dr. Girgrah. “They can do outbound calls and can schedule inbound calls. That has been very well-received and we’re planning to expand  the program.”

The other mental health startup is a company that offers “a group therapy session with a licensed behavioral health specialist,” he said. “What’s neat is you can create avatars of yourself and disguise your voice, being completely anonymous, and you can enroll in group therapy sessions on certain topics.”

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Also essential, of course, is to discuss the elephant in the room, said Dr. Girgrah. That is burnout.

“We will be launching a mental health resource group early next year as an opportunity to create some momentum and normalize the discussion.”

“COVID-19 is truly an ambiguous threat,” he said. “When a threat is ambiguous, you have to balance communications and project certainty, while acknowledging uncertainty and balancing optimism with your concern and fear.”

“It really just gets down to sharing a little bit about yourself first, even the warts that exist,” said Dr. Girgrah. “That makes it easier for other people to bring the best of themselves into the workplace.”

The AMA Joy in Medicine™ Health System Recognition Program provides a road map for health system leaders to implement programs and policies that support physician well-being. Applications for the 2022 Joy in Medicine Program opened in January. Learn more by reading the program guidelines (PDF).