Following a sweeping effort in 2019 to address clinical care team well-being across Weill Cornell Medicine, physicians note a reduction in stress and feelings of burnout compared to previous surveys, according to a new report from the institution.
The report, published online Nov. 17 and in the December issue of NEJM Catalyst Innovations in Care Delivery, suggests that Weill Cornell Medicine's grassroots approach to improving physician wellness may be used as a model for other institutions grappling with health care provider burnout.
"Coming to work to do your best means you have to be at your best," said Dr. Klaus Kjaer, chief quality and patient safety officer at Weill Cornell Medicine and the article's lead author. "You need take care of yourself and your colleagues so that you can take care of your patients. We have realized that there has to be a strategy to create a workplace where our clinical care teams thrive, and we attract the best talent."
Using a survey based on the Well-Being Index developed at Mayo Clinic, the team found that physicians in June 2019 reported an overall mean distress score of 1.84 - above the national mean of 1.57.
Physicians were asked how they felt emotionally and mentally at work and what could be done to improve workplace culture.
The top drivers of stress physicians cited included heavy workload related to the electronic medical records, inadequate team support and poor work-family balance.
After Weill Cornell Medicine responded with measures to improve physician wellness, such as forming peer support programs, offering healthier food options on campus and adding more relaxation spaces, the overall mean distress score dropped significantly to 1.08 by the end of 2019.
Despite the pandemic, the score only increased slightly to 1.2 by June 2021.
"We have definitely seen an improvement in well-being," said senior author Dr. Adam Stracher, chief medical officer and director of primary care for the Weill Cornell Physician Organization. "I think just talking about wellness is important to physicians - making it clear that it is a focus, and that we want to improve it. The development of well-being leaders and programs in each department has been incredibly valuable."
Following the survey, the institution formed a Well-Being Task Force that developed a list of 10 solutions to address physician burnout. The task force then worked with department leaders and held focus groups to tailor wellness programs for each clinical area.
"We let individual physicians and departments identify their pain points, and we provide as much as support as we can centrally to help them achieve their goals," Dr. Stracher said.
For example, anesthesiologists are especially vulnerable to burnout, the authors wrote, citing a survey from the American Society of Anesthesiologists that found the risk of burnout was close to 60%. Work schedules of more than 40 hours a week, lack of support at work and home, and staff shortages contribute to burnout among anesthesiologists, the authors wrote.
Weill Cornell Medicine's Department of Anesthesiology used the wellness initiative as an opportunity to expand its efforts to reduce burnout. As a way to build connections among physicians, it launched an Anesthesia Buddy program in April 2021 for new faculty, regardless of prior clinical experience and level of seniority.
"Community building and anything we can do to strengthen the ties between employees is going to help move us forward," said Kjaer, who is also a professor of clinical anesthesiology at Weill Cornell Medicine. "Having a friend at work is one of the most important predictors of people staying in their jobs."
Peer support programs were also established in the Department of Emergency Medicine and Division of Pediatric Emergency Medicine as a result of the wellness initiative.
The authors noted that while Weill Cornell has made great strides in addressing clinical care team well-being, it's an issue that requires continued attention as physician demands change and health care systems evolve.
Weill Cornell Medicine faculty Dr. Rachel Kowalsky, assistant professor of clinical emergency medicine and pediatrics; Dr. Lori A. Rubin, associate professor of clinical anesthesiology; Dr. Lucy Willis, assistant professor of clinical emergency medicine; Dr. Renu C. Mital, assistant professor of clinical emergency medicine; and Dr. Jacob Kazam, assistant professor of radiology, also contributed to the article.
Theresa Juva is a freelance writer for Weill Cornell Medicine.
