Health and Wellness Blog

Health and Wellness information, messages and upcoming events relative to Ascension Providence Hospital Educational Community

Questions: Contact Dr. Paul Lessem or Dr. Debra Hollander


October 29, 2018: Know Thyself

Thoughts for the coming week:
     1. Med Ed is working on a universal calendar which will help with scheduling problems, and the Graduate Medical Education Committee is mindful of residents being overcommitted. 
     2. I hope that everyone is feeling ready for CLER (Clinical Learning Environment Review by the ACGME). Feel free to write back with observations. 
     3. Write back and please share your ideas about being part of the community and any solutions which occur to you. 
     4. There was an interesting article in the Sunday Review of the New York Times which demonstrates some key features in combating burnout in another field ("Who Says Allie Kieffer Isn’t Thin Enough to Run Marathons?"). A runner much enamored of her sport suffered what we would call burnout from failing to know herself. She inefficiently followed recommendations about distance running and how she should fit in. She took these to be inflexible rules of her trade and when her times did not improve, and the stress got to be too much, she burned out on running and dropped out. Later she found meaning in her running on her own terms regarding exercise, food intake and how she viewed her body, and came back. She has found fulfillment, joy and meaning in her running, has gotten to know herself and how she fit in to distance running. She has demonstrated true resilience and balance and may well win the woman’s section of the New York marathon. Showing grit is OK and knowing yourself is helpful in recognizing and making appropriate choices. Grit is best applied for success where the activity that it is serving has become meaningful to the person who is applying the grit.

     - Submitted by Paul Lessem, MD


October 22, 2018: Burnout

Several questions for residents to consider:
     1. Are you feeling over scheduled with meetings? There has been low attendance at several meetings including the RPEC and the HOA. Let me know if you have concerns and can suggest solutions if this is the case?
     2. Suggestions regarding the Speak up sessions regarding frequency? Format?
     3. Do you believe that your benefits and medical leave time are not on a par with other residency programs locally? The medical staff is looking into these issues.
     4. What wellness tools or techniques are you using to help yourselves cope?
     5. Are there programs that you are working on where Wellness services could be a help?

     We had a very useful Caregiver rounds on October 2, talking about feelings that we have when we identify with a patient and that patient, despite our best efforts, does not do well. Anxiety, helplessness, fatigue, and sadness were common. Also the feeling of relief that one gets when a long and unsuccessful treatment relationship ends with the patient being transferred or leaving our care. A lot of guilt was experienced about the feeling of relief. The key point that was stressed but perhaps not well registered is that many of these feelings are normal and unavoidable in difficult circumstances. Some, like the feeling of guilt when one has done nothing wrong, are not appropriate. We need to work to tone them down or eliminate them if possible, as they are major contributors to the symptoms of exhaustion, depression, numbing and feelings of futility which we call Burnout.

     - Submitted by Paul Lessem, MD


October 10, 2018: Speak-Up luncheon #2

A total of 9 people showed up for the Speak Up meeting on October 9. Surgery, Medicine and Transitional years were represented by residents and 3 coordinators representing 5 programs were represented. The poor turnout was discussed as were several other issues. The participants were encouraged to submit ideas to be posted including the types of resource that they might like in the library.

Possible Factors for poor turnout cited by participants:
     1. Need for a central calendar and calendar keeper to coordinate and communicate regarding meetings throughout the hospital, in view of many other commitments that residents and others have which are rapidly changing.
     2. Multiple resident time commitments including committee assignments to committees with functions overlapping with wellness. Duties related to Interview season.
     3. No compelling incentive to attend
     4. Although the residents asked for a Speak Up follow-up there is no clear understanding regarding how to use the Speak Up opportunity
     5. Need for persistent commitment from program directors and coordinators

Suggestions and comments from resident participants:
     1. Survey residents with one question: What wellness tools are you using, what wellness services would be helpful
     2. More training in computer software usage tailored to the specific needs of each program
     3. Post all wellness activities on the Website in more of a billboard fashion rather than in the Blog
     4. The blog and website are appreciated

     - Submitted by Paul Lessem, MD


September 27, 2018: Relevant issues from Graduate Medical Education Committee (GMEC) meeting

Three critical issues came up at today’s GMEC meeting regarding resident communication. Feel free to contact me for clarification.
     1. All communications which are destined for a potentially public record must be professionally phrased and well organized. They should not be venues for angry communications or political statements. We are making a record of our clinical and professional activity as an institution in these communications.
     2. We must be careful not to put protected information into emails which could be accidentally sent where they are not intended. Something which is meant to be private should be encrypted and not left where it is accessible or can be distributed as an accidental transmission.
     3. Clinical presentations whether oral or written should be organized to be clinically helpful. These should focus on core issues which are to be communicated about the patient. There are variations in specifics depending on specialty. However, one should be rapidly identifying the patient, the clinical problem or problems being treated, key findings ordered from most vital to least vital, and the current plan including the investigations which are key to further therapeutic interventions.

     - Submitted by Paul Lessem, MD


September 26, 2018: Wellness update

     Welcome to the Medical Education wellness blog. We will be posting important messages regarding wellness events (In the hospital, locally, and nationally), changes to the hospital, to its community and to its programs which have wellness implications, and thoughts and opinions gleaned from your responses. On the website you will find resource phone numbers and emails and a library of resources which is currently under construction.

     There is one previous entry which is a summary of our first Speak-Up luncheon which was held on September 11.
     The Caregiver rounds is being held on Tuesday, October 2, at 7 AM in cafeteria D in Southfield. All students, residents, fellows and interested faculty and medical staff are encouraged to attend. As of this writing we need an interesting clinical case that can serve as a focus of supportive discussion of how to manage difficult issues which elicit strong emotional reactions in caregivers.
     Our second Speak-Up luncheon will be held on October 9 as soon after noon as we can begin. We are seeking a room for this meeting. We would like at least one resident or fellow from each training program to attend. In addition, any trainee who wants an opportunity to speak up about an issue where they have a positive suggestion to improve our wellness is welcome to attend. We will have lunches available for the first 25 attendees. Room announcement to follow.

     - Submitted by Paul Lessem, MD


September 11, 2018: Speak-Up luncheon

     The first Speak-Up Luncheon was held on Tuesday September 11th in the Simulation Center classroom at Ascension Providence Hospital, Southfield campus. All residents and fellows were invited. The House Officers Association was asked to have representatives from all training programs attend. The 19 attendees included representatives of several programs, Dr. Basim Dubaybo, the wellness physicians and the administrative staff of medical education. Dr. Dubaybo welcomed all students, residents and fellows as coworkers and partners in education, recognized the difficult paths that they have chosen and promised that we will do everything that we can to help them to succeed. They were welcomed to share concerns and ideas for strengthening our community and Dr. Dubaybo expressed the wish that they would join our hospital committees that maintain and work to improve all aspects of our functioning as a hospital and an educational community. A list of these committees will be made available where medical trainee membership, ideas and energy would be greatly appreciated. Dr. Dubaybo stressed that collectively we can figure out ways to be more efficient and effective.
     Gains have been made in several areas since the Speak-Up Forum. Utilization of our many wellness services has improved and been extended to more members of our community. All residents will soon have stickers on their meal cards informing them of resources that they can call for assistance and to report situations where improvements are needed. The creation of this blog and website will speed communication regarding health and wellness issues. The website will have an up-to-date list of important contacts. The blog will focus on new developments, events and critical health and wellness information. The program coordinators will electronically contact all members of their programs when there is something of immediate significance to be read on the blog. The resource library will be a repository of wellness information and offer opportunities for self-assessment to be perused at one’s leisure.
     There are many monitoring opportunities now available to all levels of trainees as the programs have implemented their wellness plans. We are working on wellness programming of mutual interest with other disciplines, notably nursing. The resident gym is being well utilized.
     Several residents mentioned the need for more feedback regarding their suggestions. Dr. Dubaybo cited gains that have recently been made in reporting and feedback regarding problem areas.
     It was mentioned that colleague’s stories of how they have managed the stressors of career development and day-to-day functioning have been helpful. Development of a conference with this as a focus might be useful.
     The tone of this first meeting was very positive. All attendees seemed enthusiastic and friendly. Our next meeting is scheduled for October 9 (most likely in the same location). Check the blog for further developments.

     - Submitted by Paul Lessem, MD