This passage from a guest essay published in The New York Times on March 30, 2022, offers insight into the culture within which many physicians practice medicine. It illuminates the discussion currently taking place across healthcare–and other–news media about staff shortages, physician burnout, and “The Great Resignation” we’ve witnessed over the past two years.
But before the public conversation about physician burnout began, there was at least one entrepreneur and organization already working to offer physicians support that works.
Locumpedia spoke recently with the practicing radiologist who created DocWorking, a company founded “to amplify the conversation about physicians’ health” and help doctors better care for themselves so they can more effectively care for the health of others.
Wife, Mom, Radiologist & Entrepreneur
Diagnostic radiologist Jen Barna, MD, didn’t grow up knowing she wanted to be a physician. She didn’t decide to apply to medical school until she was in grad school, at Washington University in St. Louis, in a PhD program for molecular and cellular biology.
Once accepted by the University of Tennessee College of Medicine, she deferred beginning med school for a year in order to stay with her husband while he finished law school. That was when the eventual doctor found a job working as a physician recruiter–an occupation that showed her the job landscape for physicians and opened her eyes many locations and practice options she hadn’t considered before.
From there the young couple moved to Memphis for her to begin medical school and for him to begin his legal career. Their two children were born while she was in medical school.
“Embedded in medical education is a culture that teaches doctors-in-training to prioritize caring for patients over meeting their own personal needs. Physicians’ families are affected and this often goes unrecognized,” she says.
“The physicians themselves are lowest on their own priority lists, which is counterintuitive since it’s imperative that they care for themselves in order to help others. This culture prevails during residency and fellowship so that by the time a physician is practicing post-training, self-neglect is often ingrained in their way of thinking. This can lead to burnout, which is pervasive now, but is nothing new to the healthcare community.”
Locum Tenens, Coaching Offer Sense of Control
As most of our readers know, this is why increasing numbers of physicians, and other clinicians, choose locum tenens medical practice (which Dr. Barna has tried) as a way to maintain some control over their own schedules and lives, as compared to more traditional medical career paths.
As someone who delivered, and began raising, two children while in medical school, Dr. Barna understood, perhaps better than most of her fellow future physicians, the time and sacrifice required to become–and succeed as–a physician. “I’ve heard the decade-plus of medical education described as ‘sacrificing your twenties,’ ” she said.
“I know firsthand how limited our time is to take good care of ourselves,” Dr. Barna added. “I also know it can be transformational to step back and see things from a different perspective, and to gain tools to put yourself back in the driver’s seat of your own life. That’s why I created DocWorking.”
DocWorking Helps Docs Work Smarter
The company started small, seeking to support physicians with all the benefits expert coaching can provide. “What we found is that the need is great while physician-focused solutions are few.
“So we designed programs around what our experienced team of coaches has seen work for physicians: solutions that maximize benefits using minimal time. Executives, actors and athletes
have used coaching to great benefit. Physicians and other healthcare workers who have dedicated their lives to helping others deserve this same level of support,” Dr. Barna says.
“At DocWorking, we help them gain the vision and tools to identify what they want to achieve and move toward that with focus and intention. If they need help navigating out of burnout, we’re here for that; and we can help them reach their goals beyond it,” she notes.
“Physicians are longing for relief from the overwork, overwhelm and lack of time that fan the flames of physician burnout. These tools–along with ongoing access to trusted thinking partners in our coaching and peer communities–are designed to prevent burnout.”
What causes burnout?
Writing for The Doctors Company, Christine K. Cassel, MD, MACP, professor of medicine and senior advisor at the University of California, San Francisco, School of Medicine, discussed clinician burnout in a post from the first quarter of this year.
In her article, “Clinician Burnout: From a Crisis to a Movement,” Dr. Cassel noted that, while burnout was a problem that preceded the pandemic, the challenges of providing care in its wake shined a spotlight on the issue, causing many clinicians to rethink their priorities and careers.
As Dr. Jilani observed in her recent NYT essay, “The pandemic seems to have made things worse: A survey conducted in the fall of 2020 and presented at the American Psychiatric Association suggested that as many as 36 percent of frontline physicians suffered from PTSD.
“Doctors also have a high risk of death by suicide compared to many other professions. An estimated 300 to 400 physicians die by suicide in the United States every year—about a doctor a day.”
Dr. Cassel highlighted a report, the compilation of which she chaired for the National Academy of Medicine (NAM), writing, “When we delivered our report in late 2019, the demands we documented included excessive workload, unmanageable work schedules, inadequate staffing, administrative burden, interruptions and distractions, inadequate technology support, time pressures, and moral distress. And that was before the pandemic.
“The occupational health definition of burnout is ‘what occurs when job demands exceed resources,’ Dr. Cassell said. “To find solutions, we need to remember that these systems are made up of people, and that is where ‘human-factors science’ comes in…solving burnout isn’t just about clinicians learning to meditate. It is about changing the systems in which we work.”
The author also highlighted research indicating how the shift away from independent practice to hospital or health system employment has left many clinicians feeling “like pawns with little or no control, autonomy or ability to contribute to systems improvement—which is itself a major contributor to burnout.”
Fearing the Consequences
In her March 30 NYT essay Dr. Jilani said, “Residency can consist of sleep deprivation, hunger, constantly being told you are not a good enough doctor and working a torturous 100-hour week, all while six figures in debt.”
Noting that medical education also can include shaming students in front of colleagues or patients, Dr. Jilani offered insight into the stigma of seeking mental health treatment:
“Despite the grueling experiences, the medical profession often stigmatizes physicians who seek mental health care and erects barriers to such care. As of last spring, medical boards in 37 U.S. states and territories asked questions that could require a doctor seeking licensure to disclose any mental health treatments or conditions…Ticking those boxes can feel like risking everything we have worked toward over years. It could result in the medical board reviewing our personal medical records, possibly in psychiatric and drug testing and perhaps even in having our medical license reviewed, suspended or revoked, all under the guise of establishing our professional competence.”
Dr. Jilani cited a 2016 study of female physicians in which “close to half said they believed they had met the criteria for a mental illness but avoided care, in part for fear of licensing boards.” She also referenced a 2017 paper indicating “nearly 40 percent of physicians reported being reluctant to seek mental health care because they worried it would jeopardize their chances of getting or renewing their medical licenses.”
In her article for The Doctors Company, Dr. Cassel wrote, “This problem [clinician burnout], which needs people working on it from every angle, offers many opportunities to intervene,”. “Every work environment is its own system, and our own environment is the place to start.”
Clinician coaching offers a way physicians or other clinicians can bridge the gap between job-related stress/lack of self-care and serious mental health issues that can derail a medical career.
DocWorking: Sharing What Works
DocWorking describes itself as “the go-to life coaching and burnout prevention company for healthcare professionals and organizations.” For more than a decade, DocWorking’s coaches have been teaching physicians/clinicians “how to maximize meaning and purpose, in life and at work, using minimal time.”
Lead coach Jill Farmer (a best-selling author and former TV news anchor), along with the DocWorking coaching team, has coached professionals for years. They bring a depth of experience and insight that has taught them what works best to help physicians on the job and at home.
With additional mentors specializing in the medical profession, the DocWorking coaching team helps both individual physicians and healthcare organizations better understand and prevent clinician burnout.
For Individuals
For individual physicians, PAs, nurse practitioners, and other care team members, there’s the foundational “DocWorking THRIVE,” an affordable “coaching-and-community subscription package” of stress relief that can ’train the brain to interrupt stress responses while they are happening,’ with ongoing coaching in the peer-community on the platform and up to 8 continuing education credits (CME/CNE/CE/IPCE).
Members can add-on a small group coaching subscription for 12 additional CME credits and get the benefits of being coached along with their colleagues from different locations and specialties. Similarly, 1:1 coaching packages with CME credits are available from within the DocWorking THRIVE portal.
The DocWorking THRIVE Platinum subscription provides full access along with up to 32 CME credits. “It guides participants toward embracing life in the way most meaningful to them,” DocWorking Founder and CEO Jen Barna, MD, says.
THRIVE Platinum offers all the resources included with the basic THRIVE subscription, plus live monthly small group coaching sessions, 12 one-on-one coaching sessions, and three additional courses for “quick wins” in self-and time management:
- “STAT: Quick Wins to Get Your Life Back” – developed by Coach Gabriella Dennery MD and Master Certified Coach Jill Farmer, a course through which clients “literally can make progress in five minutes a week,” Dr. Barna says.
- “Communication for the Win” – developed by Leadership Coach Lisa Kuzman, a course designed for dramatic improvement in interpersonal communication within a participant’s professional team and organization.
- “A New Era of Physician Leadership” – also developed by Leadership Coach Lisa Kuzman, helps physicians to recognize their own potential as leaders, as well as take a fresh perspective on who they look to for mentorship and influence.
“We’ve created pragmatic lessons, reinforced through ongoing coaching and an interactive, easy-to-use, peer-to-peer online platform that can help you manage stress, improve communication within your team, and gain confidence in setting boundaries to prevent burnout,” Dr. Barna says.
For Organizations
In a study released in late 2021, the Association for Advancing Physician and Provider Recruitment (AAPPR) found that physician turnover increased by more than 4% between 2019 and 2020, to an average of 13%.
Among some 2,300 clinicians responding to a 2021 survey from LocumTenens.com, 41% reportedly planned to change jobs within the year. Overall, 39% of clinicians reported increased levels of stress and burnout due to the pandemic.
A 2018 report from Merritt Hawkins Physician Foundation found that more than three-quarters (78%) “sometimes,” “often” or “always” experience feelings of burnout.
DocWorking’s THRIVE Circle seeks to equip organizational wellness officers and leaders to put the coaching tools to use for themselves and then to foster a flourishing culture in their own organizations.
“Physicians want to work where they feel heard and valued by both administration and colleagues. They are more likely to stay when they feel connected to corporate culture and supported in seeking balance between work and their personal lives,” Dr. Barna says
DocWorking’s THRIVE with Community Concierge for New Hires enables organizations to begin physician retention efforts right after the contract is signed. The DocWorking team works with the clinician and their significant other to build real person-to-person connections in their new community, even before they move there.
Normalize Clinician Coaching
“With the decade-plus of education and self-sacrifice physicians invest before getting that first post-training job–not to mention the debt most of them accumulate along the way–I believe physicians deserve assistance in pushing past barriers and achieving the lives of their dreams,” the radiologist-turned-entrepreneur says.
“We don’t need to wait until providers have burnout. If we implement strategies that are known to work, and make those available to every provider, we can help physicians and other healthcare professionals live their best lives on their own terms, avoid burnout, and show up feeling purpose and meaning in their work,” Dr. Barna suggests, “My goal is to normalize physician coaching. It should be as common as having a personal trainer.”
You can learn more about DocWorking Coaching and Community, and how to put your CME/continuing education credits to work supporting your own wellness at DocWorking.com.
