This week, the CoM hosted its fifth annual senior leadership retreat. Every year, we delve into a discussion of one of our strategic directions to assess how we are doing and plan next steps. This year we focused on wellness.
I witnessed engagement and keen interest among my colleagues in leadership in this vitally important focus for our whole CoM team. While the day held some hard conversations, they were not hard in the sense of dissension on the value and importance of wellness as a key area of attention. This was wonderful to see as we will need teamwork and alignment to move forward effectively on this front.
So, why wellness now? Most, if not all of us, have been impacted by wellness—our own or that of others in our lives—and I think we share a common understanding of how dramatic the consequences can become when we, or someone we know, is increasingly unwell. What many fail to acknowledge or address is an inherent resistance to being open, or vulnerable, about our own struggles.
I believe the many resources I will share in this blog are useful to all, though several focus specifically on physicians and medical learners. There is no shortage of data on the wellness challenges inherent in medical practice. Wellness, however, is an issue for us all. For the scientist waiting for the results of a grant application, or seeking a potential cure or treatment that could benefit so many and yet not knowing where the process of discovery will ultimately lead. For the graduate student who must work hard for opportunities even while facing significant uncertainty in future employment. For the employee trying to support the needs of researchers, professors, physicians, learners, other staff members, partners and stakeholders.
I included in my February 8 blog a quote from Jordin Tootoo that, “We all fight a fight no one knows about.” One of the strongest messages from our day is this: it is courageous to be vulnerable. We can support one another in this with kindness and compassion.
What exactly do we mean by wellness? We had help from four experts in this regard, who set the stage for our team to have a meaningful discussion. On behalf of our team at the retreat, I acknowledge and thank: Peter Hedley, Director of Student Support and Services, who leads USask wellness initiatives; our own Drs. Anita Chakravarti, Department of Medicine and Alana Holt, Department of Psychiatry; and Brenda Senger, Director, Physician Support Programs at the Saskatchewan Medical Association.
Peter shared details of our university’s work and evolving approach on wellness, guided by the University of Saskatchewan Wellness Strategy, which offers a holistic approach of “healthy mind, healthy body, healthy life.” Through the strategy, USask has committed to comprehensive programming across wellness promotion, prevention and intervention.
Brenda spoke about these wellness elements: physical, spiritual, social, intellectual, emotional, occupational, environmental and financial. The culture of medicine has tended to reward traits such as control, perfectionism, and high dedication to others built on principles of patients coming first; the pressures associated with this culture can and does strain individual wellness in relation to these elements.
The CMA National Physician Health Survey provides a snapshot of the current environment for our physicians. On the positive side, a significant number of the 3,000 CMA members who responded demonstrated resilience, psychological well-being, and, overall, flourishing mental health. However, the survey also shares stark information of burnout, depression and suicidal ideation (this last particularly among residents, so we need to continue with the good work we are already doing to support our residents while considering what else might be needed).
There is too much evidence of both individual and system level factors that are contributing to distress and moral injury, as the 2018 study, Physician burnout: contributors, consequences and solutions, shows us. If our physicians are unwell, patient care and the health care system cannot help but suffer too.
Background information for the CMA Policy on Physician Health highlights that poor health for physicians may develop before or during training and persist into medical practice. As Saskatchewan’s medical school, we set the foundations for success for physicians through the training and environment we establish for our learners. More broadly, we will support everyone in our CoM community—faculty, staff and learners—with improvements in how we support wellness.
For all of us in attendance at the retreat, an important takeaway (highlighted by the likes of health leadership expert Dr. John Van Aerde) is that leadership, engagement and trust are successful when we have a psychologically safe environment where we limit distrust, moral distress and burnout.
We can ensure a culture of wellness in many ways, and we are already moving along this path. Our five-year strategic plan highlights how we are currently supporting wellness:
- In our Quality education strategic direction, we emphasize safe, effective and learner-focused environments and carry that through the design of our medical education programming and leadership development programs.
- In our Faculty engagement strategic direction, we will maximize faculty participation in planning and decision-making, and in how we foster a culture of engagement, work satisfaction and academic success.
- In our Enablers strategic direction, we aim to recruit and retain great leaders, professors, researchers, physicians, students and staff, while ensuring safe, respectful workplaces and a culture of lifelong learning.
During the retreat, our experts and participants highlighted many other resources. We at the CoM all benefit from these strong programs and resources we offer now:
- MD students – Office of Student Affairs
- Residents – PGME Wellness Strategic Plan
- Programs offered by our Division of Continuing Medical Education
- Staff and faculty – Employee Family Assistance Program
- Staff – Career Engagement
- Further wellness and mindfulness resources – Faculty Development website
We can also do more to promote and leverage other programs and resources, such as:
- SMA Physician Health Program
- SMA Physician Leadership Institute
- Schwartz Rounds – also known as compassion rounds; introduced by the Saskatchewan Health Authority (SHA)
- Other wellness and fitness programs offered by the SHA
A great framework from Drs. Tait Shanafelt and John Noseworthy, shared by Alana Holt, provides further useful information, with nine organizational strategies that can reverse the trend of burnout in health care organizations.
Our discussion throughout the day brought forward further suggestions that included, in keeping with the USask Wellness Strategy, that wellness programs and resources need to range from health promotion to crisis intervention. We have great supports in place, but we need to do more to integrate them. This would improve awareness and access, and support wellness more continuously across life transitions in education and careers. We need wellness embedded in our formal curriculum and supported through informal opportunities such as learning communities and mentorship programs. As well, we need to employ tactical strategies for promoting and sharing wellness resources through recruitment, in our orientation and onboarding materials, and so on.
Our participants identified steps they can take in their own departments and units, such as fostering spaces and times for peer connections and community building. Ideas shared included starting meetings with a wellness round-table discussion or check-in, hosting lunch time gatherings—yoga sessions, walking clubs, book clubs and more. There were also commitments offered to support one another in being vulnerable and honest about what we may be struggling with on a personal level.
As I said at the outset, our leadership team was engaged and active throughout the day!
Finally, I encourage you to consider your own wellness and how you can contribute to a culture of wellness. We can help one another on our wellness journey, we can reduce the stigma around seeking help, and we can permit ourselves to prioritize self-care.
As Jordan said, “It’s all about kindness.”