9 Low-tech Audience Response! Do you know of someone in anesthesia found to be diverting controlled medications?Do you know of someone who has died of a drug overdose who is in a healthcare related field?
10 Prevalence of Burnout in Residents and Physicians in Practice Burnout rates of 30 to 76% seen across 15 studies of residents: multiple years, types of programs, US and International teaching hospitals represented (Thomas, 2004)Similar burnout rates among physicians in practice (Chopra et al., 2004)46-80% moderate to high EE22-93% moderate to high DP16-79% moderate to low PALower rates of burnout among academic physicians (Tait, 2003)37-47% burnout in academic physiciansvs. 60% burnout in physicians in private practice
11 Physicians in Training and Practice vs. General Population Higher rates of burnout, stressSimilar to higher rates of depressionSimilar rates of substance abuseHigher rates of suicides—especially for women300 to 400 physician suicides(Center et al., 2003; Shanafelt et al., 2012)
12 OHSU Resident & Faculty OHSU Resident and Faculty Wellness ProgramOHSU Resident & FacultyAll OHSU and Legacy residents and fellowsAll OHSU SOM faculty (0.5 , >FTE)Started in 2004Left to right: Sydney Ey, Ph.D., Dan Helfet-Hilliker, M.D., Mary Moffit, Ph.D., Mark Kinzie, M.D.
13 How to Reach RFWP Clinicians To schedule an appointment or get consultation re: trainee/faculty concern: Directly or page any of the providers listed at Urgent consultation: RFWP pager
14 Resident and Faculty Wellness Program Confidential, free coaching, counseling and medication managementLimits to Confidentiality: risk to patient safety or danger to self or othersPrivate, on-site locationEMR: but not in EPIC and you can opt-out of EMRMeeting w RFWP is not reportable to medical board“Impairment is reportable, treatment is not”Schedule directly by ing any of 3 providersHours: Mon-Thurs 9-7, Fri 9-5Briefly mention that we are trying to lower known barriers to physicians’ seeking help—stigma, time, confidentiality, reportability, helpfulness of counseling
15 Positive Outcomes (Ey, Moffit, Kinzie, Choi & Girard, 2013) 88% of OHSU residents, fellows (N = 448; 71%) knew about our program87% OHSU residents, fellows “somewhat to very willing” to seek counselingUtilization rate (new cases per yr) from 5% to 17% in 8 yrs93.9% of clients “very or mostly satisfied”PDs satisfied w/ referral process/consult
17 “Reaching Out” Research Aims IRB approved study, funded by GMESuicide prevention among medical residents, fellows, and SOM faculty by:Reducing risk factors of untreated depression and substance use, hopelessness and isolationIncreasing protective factors of greater self-awareness, strong coping skills, increased connection, and access to effective MH treatment if needed
18 Stress and Depression Survey We invite all OHSU residents, fellows and School of Medicine faculty to participate in this important new physician wellness initiative. Please take the OHSU Stress and Depression Survey. Click on this link: https://www.ohsuwellness.org/welcome.cfm
19 Invitation to Take Stress and Depression Survey User can take the Stress & Depression Survey by creating a self-assigned User ID and Password (encrypted)The User ID is the only way user is known to our cliniciansOnly aggregate data reported
20 Our Clinician Response & Dialogue User may provide an address to be notified when our team’s response is posted or sign back on to the ISP siteUser’s address is encrypted to protect identity, not known to anyone, including our clinical teamOur clinician responds with feedback, resources, offer to meet in person if appropriate
21 Pilot with OHSU SOM Trainees/Faculty April-June 2014 Response rate: 23% (N=91)78% of OHSU users reviewed clinician response16% of OHSU users dialogued with clinicianHigh distress: 15%Suicidal ideation in past 2 weeks: 6%Due to survey, sought treatment at RFWP: 12%“realized that I needed to take better care of myself”“survey made it easier to come in”
22 Strategy to keep our team members safe Encourage balanced approach to lifeReadily available counseling within department and OHSUMore stringent monitoring of pharmacy transactions and returned medicationsMore realistic guidelines for testing for drug use.