Showing posts with label mental health. Show all posts
Showing posts with label mental health. Show all posts

Thursday, January 26, 2023

Physicians are facing a mental health crisis: Here are 5 ways doctors can take control of their health

Physicians are burnt out – a natural consequence after heroically manning the front lines of the pandemic. What’s less understood is the stigma preventing doctors from seeking treatment for their burnout. As a society, we suffer from a core weakness rooted in ignorance: A large portion of the population, physicians included, still do not see mental health as an integral component of their overall wellness.


This oversight has dangerous consequences for doctors who desperately need treatment. Mental health care is a fundamental human right and indicator of overall health. Treatment and regular mental health services need to be an industry standard to prevent physicians and their patients from dire consequences and unnecessary suffering.

Doctors and nurses notoriously face a poor work-life balance due to industry demands. With the rise of asynchronous and 24/7 on-demand care, there is little to no line between work and home – and potentially adverse professional consequences to setting boundaries. The pandemic inflamed an already festering issue: A shortage of workers and a years-long trauma left many overworked and overstressed. With no solutions in sight, we’re facing a national health crisis.

As of September 2022, 40% of health care workers felt anxiety or dread about going to work, and nearly half (49%) of U.S. health care workers say they are at their breaking point or looking for new work due to the stress and trauma they endure on the job. Physicians are working through trauma, trying to manage some semblance of a personal life, and navigating an increasingly online world, all while trying to provide quality care for patients in their most vulnerable moments.

While many health care workers have left the field over the last two years, those who stayed are struggling more than ever. Male physicians are particularly at risk: 58% of male health care workers in the U.S. reported they are either at their breaking point or are looking for a new job. The data for women isn’t much better, with 45% of those surveyed reporting a similar experience. These results predict a ticking time bomb: This already understaffed industry is headed for collapse.

Mental health stigma adds more fuel to the fire; one in every three men surveyed do not want to admit to having a problem (compared to one in 10 women), and nearly one in three men avoid getting help because they fear potential judgment from colleagues and family (compared to one in 10 women). Men are stereotypically expected to adhere to a toxic masculine doctrine that prioritizes toughness over vulnerability. The “tough-it-out” mentality (coupled with an already impossible workload) discourages men from seeking care. If physicians want to provide quality treatment, they must take care of their health first and foremost, and realize that mental health care is not an accessory or an afterthought. Physicians and patients do not need to hit rock bottom before getting the help they need.

Beyond stigma, 25% of men and 17% of women physicians say the health care system is too hard to navigate. What hope does a patient have if professionals are overwhelmed by their own industry? Whether it’s perception or the reality of nonsensical logistics, physicians must become more comfortable with caring for their own mental needs if they expect to understand and serve their patients. Here are five concrete steps that health care workers can take to improve their health in mind and body:


1. Acknowledge physicians are human too.


It might be easy to forget that health care workers are not superhuman. We like to praise physicians who work themselves into the ground and avoid investing in real support, but the truth is that we’re all mortal. If you have a body and a mind, you need rest, recovery, and care. Though it may feel natural and professional to prioritize patients’ health and well-being above all else, it is impossible to provide quality care when experiencing burnout, trauma, and exhaustion. If health care workers delay addressing their own mental and physical needs, they will soon become patients themselves.


2. Acknowledge mental health care is health care.


We must acknowledge that mental health care is health care. Treating anxiety, depression, or burnout is equally as important as treating a pulled muscle or a broken bone – in fact, poor mental health can adversely impact physical health. Getting support for your mental health isn’t anything to be ashamed of; it’s a necessary part of routine wellness care.


3. Find a health care provider that addresses your unique needs with an iterative approach.


All health care workers should understand and appreciate the value of finding a provider who addresses their unique set of needs.We do this in treatment at APN by providing a specialized health care professional track, custom-tailored to the specific needs of physicians and other health care providers.

If you are experiencing symptoms of depression, anxiety, or PTSD, it is essential to connect with a therapist who can address your concerns through customized treatment, not a one-size-fits-all approach.

Treatments like Eye Movement Desensitization and Reprocessing (EMDR) can be especially helpful in addressing trauma concurrent with regular talk therapy. Ketamine-assisted therapy and Deep TMS can be beneficial alternatives for those unable to find relief from mental health symptoms with medications and other traditional modalities.


4. Share helpful resources.


If we want to learn how to navigate backward systems, we need to demand better resources. Health care workers can access Physicians Health Programs through the Federation of State Physician Health Programs to help them navigate issues and find treatment options. Health care management should prioritize clear communication and create internal programs to ensure their employees receive care.


5. Find a telehealth provider if you cannot schedule in-person care.


It can be challenging to commit to in-person therapy, but luckily, telehealth options can fit even the busiest schedules. Mental health apps can be a lifesaving option, bridging the service gap and providing support when you need it most. If you’re not entirely comfortable with individual therapy, group telehealth sessions can be a great way to establish a feeling of understanding and camaraderie; a therapist will oversee the session and ensure safety for all involved.

The reality of this crisis is that there are no quick fixes – we are in this predicament because systemically, we failed to act. Now, the only way forward is long overdue change, and it starts with aggressively confronting mental health stigma.

The clearest path toward change starts with redefining mental health care, shifting the narrative, and reframing how we act toward those receiving treatment. Physicians should not be forced to identify as their diagnosis or need for support. We must regard mental health as an essential foundation of overall health.

When we view health care through a mind-body lens, we empower physicians and patients to become their own wellness advocates. Only then can physicians be genuinely healthy and capable of providing patients with the quality of care they deserve. The time to act was yesterday. We must lead the way and support health care providers before the entire system collapses around us.


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Sunday, October 16, 2022

MGMA 2022: Physicians don’t have to be mental health experts to become mental well-being advocates

Not every physician has to be a mental health expert to assist their colleagues, staff, and patients in improving their mental well-being.

Mental health is not just about people who suffer from mental diseases, which may be about 5% of people, said Leia Spoor, MPH, DABLM, clinical director in the Texas offices of employee consulting firm Holmes Murphy & Associates. Spoor presented “Create a Culture Where Mental Wellbeing is OK,” during the 2022 Medical Practice Excellence Leaders Conference of the Medical Group Management Association.

Rather, everyone has mental well-being, which exists on a spectrum with four categories that can change by the day, hour, or moment, depending on circumstances, Spoor said. Apart from mental disease, other people may be languishing, or demonstrating functional impairments due to extreme stress, depression, or self-medication.

Most people, an estimated 75%, live and work each day with moderate mental health, dealing with regular life stressors that could be better managed. The goal is to support a general shift for everyone toward flourishing, being in great spot mentally and physically in life, Spoor said.

One Gallup poll showed a national backward slide from 2019, when 76% of people said their mental health was excellent, to 2021, when that figure dipped to 34%. It was the largest decrease in a lifetime, due to factors such as the COVID-19 pandemic, the nation’s contentious politics, and societal unrest, Spoor said.

While it’s clear more people could use help, the national average wait time for behavioral health services is 48 days. Lack of providers is on the list of reasons why people don’t seek help, but so is stigma – a negative perception that causes someone to think less of a person, or stereotyping or labeling a person because of a condition.

Physicians and health care staff can help overcome that by becoming advocates willing to do three things:

  • Notice changes that are not typical or unusual for a person.
  • Talk to that person, checking in and letting them know you care.
  • Act, by offering to connect that person to appropriate services and supports.

Advocates do not have to suggest diagnoses or treatment options, and Spoor used a medical analogy to describe the role. Not every person is a cardiologist, but many people learn CPR so they might help others if needed.

Likewise, not every person must become a mental health expert. But they can engage others in meaningful conversations, Spoor said.

Her advice:Keep asking. Questions do not have to be complicated or invasive to start a conversation.
  • Be real. Be authentic, describe what you are hearing, and ask the person to clarify if that is what they mean.
  • Be relatable, and don’t worry over what to say back. The goal is not to solve the problem, but to listen, show interest, help the person feel heard and less alone, so they feel less stressed.

In health care, physicians and leaders must remember that the whole person comes to work every day, with concerns about their careers, finances, social and emotional connections, community involvement, and physical health, Spoor said.

Leaders should compile information and help staff understand resources available, starting with employee health benefits, and possible other resources such as health and wellness, weight loss programs, advocacy, and caregiving services.

An easy resource is the new 988 National Suicide & Crisis Lifeline, which started in July, Spoor said.

Leaders also should be practical because not every solution requires a new vendor program or website. For example, if a worker is stressed over a family situation, help may be as simple as allowing comp time or flexibility to start 30 minutes late, then make up time later in the day, she said.


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Tuesday, September 6, 2022

Can Technology Solve the Burnout It Helped Cause?

It’s time to admit that health care technology has largely failed to deliver on its promise to make the management of patient care simpler, easier, and less stressful for clinicians.


Two decades ago, technology was presented as the solution to so many of the U.S. health care system’s ills. EHRs and other tools were going to streamline recordkeeping, allow seamless communication between providers and payers, and, most importantly, free up clinicians to spend more time on patient care and less on administration and paperwork.

Unfortunately, EHRs are sticky in that everyone uses one, but they lack in driving clinical outcomes as a standalone solution - which just makes things worse and detracts from payer/provider alignment. This is in direct contrast to what I encountered growing up in Israel, where patients, physicians, and the national insurer are all fully integrated, both in terms of interoperability and alignment of interests.

Technology hasn’t improved efficiency to the extent promised or inserted more caring into health care. It hasn’t driven down costs for patients and payers, and it hasn’t saved practices money. As a result, providers at all levels are still working below their licenses.

Tech-driven burnout


Nowhere is tech’s failure clearer than its role in clinician burnout, a long-smoldering problem that has burst into flames since the introduction of the “meaningful use” incentive program.

U.S. Surgeon General Dr. Vivek Murthy sounded the alarm on clinician burnout in an advisory this May. The report detailed how an already serious problem has been exacerbated by the COVID-19 pandemic, causing providers to leave medicine in record numbers at a time when they’re needed more than ever before.

The advisory concluded that the country needs 1.1 million new registered nurses and faces a projected national shortage of more than 3 million low-wage health workers. The Association of American Medical Colleges predicts a shortage of as many as 139,000 physicians by 2033, with the greatest gaps in primary care.

The Surgeon General’s report is only the latest piece of research to cite administrative demands and EHRs as leading causes of burnout. It found that, on average, for every one hour of direct patient care, a primary care provider will spend two hours a day on administrative tasks. That not only frustrates clinicians, but it also contributes to poorer health outcomes for patients.

Tech is the answer


So, what’s the solution to technology-caused burnout? Technology.

It seems counterintuitive to prescribe technology to treat burnout caused by technology, but the answer is not simply more tech, but better tech — tech that will finally deliver on those 20-year-old promises.

Of course, there’s no turning back the clock. We’re not going back to paper records and manila folders. The American health care system will not be streamlined and simplified anytime soon; it will remain a thicket of incompatible systems and competing priorities.

Only tech whose design and processes are informed by the failures of previous systems can solve these problems. Unlike current systems, these tools will need to increase the efficiency of clinicians using them and drive down costs.

The good news is the problems aren’t insurmountable. In fact, they’re being addressed right now.

Fixing EHRs


“And if you gaze long enough into an abyss, the abyss will gaze back into you.”



The philosopher Friedrich Nietzsche wasn’t referring to health tech when he wrote this, but any provider who has spent hours staring at a poorly designed EHR interface can relate.

It’s not surprising that a 2020 study in Mayo Clinic Proceedings found that EHRs scored in the bottom 9th percentile of technologies when evaluated for usability. They were supposed to package multiple streams of patient and payer information into simple, easy-to-manage bundles. That hasn’t happened.

But EHR experiences can be improved, primarily in two ways. The first is by investing in local provider organizations to improve workflows, implement user feedback loops, etc. The second is to deploy complementary tech solutions that improve the user experience, such as robotic process automation, integrated workflows, and EHR overlays.

These solutions can make health workers more efficient by reducing the need for them to manage disparate workflows, thereby lowering labor costs, and making it easier to manage the health worker shortage. EHRs are here to stay. Technology that understands this and mitigates their shortcomings for clinicians are indispensable in combating rising health care costs and reducing burnout.

Ending non-productive work


Tech is simultaneously overwhelming and underperforming.

Clinicians and others must use too many tools and click too many times only to be delivered insufficient results.

Too many tech tools and non-integrated data sources result in information silos; obtaining a comprehensive picture of a patient’s care can require assembling data from emails, paper notes, EHRs, portals, and even faxes.

That sort of copy-and-paste recordkeeping wastes time and leads to lost data, compromised patient information, and poor patient experience. Health workers need a way to assemble all the information from multiple sources into a user-friendly interface.

Tech can consolidate touchpoints and tools and implement interoperability standards. Automation of routine tasks, such as checking authorizations, handling referrals, and entering ICD codes, reduces the number of tech touchpoints and frees providers to focus on the far more crucial lifesaving work we ask of them.

Turning technology around


Everyone from patients to payers has an interest in keeping clinicians happy, engaged, and, most importantly, on the job and operating at peak efficiency.

Independent practitioners often suffer the most from tech burnout because they have fewer resources and less time to manage administration. As a result, many surrender and sell their practices to health care systems just to free themselves from drawing under administrative demands. However, that can result in higher costs for society and poorer care, while also carrying its own stresses for clinicians.

Tech that empowers smaller, independent practices to not only stay viable but to succeed in shared initiatives, such as value-based care models, can help preserve the dwindling ranks of independent practices and general practitioners.

Poor technology got us into this mess; good technology can get us out. In fact, it’s the only thing that can.


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