Keynote and plenary speakers at the recent AAP Leadership Conference highlighted the importance of members’ well-being. In addition, the top resolution called for development and promotion of a confidential resource for pediatricians experiencing stress, threats of violence and/or public attacks and to expedite connection to AAP, peer and local resources.
Building on this momentum is an updated AAP clinical report on physician wellness written with three primary goals:
- to highlight new research providing insight into the complexity of burnout and its relevance to pediatricians across specialties,
- to present a broad look at progress in the field, with emphasis on culture change and burnout prevention, and
- to emphasize the need to take a proactive, mindful and deliberate approach to one’s own well-being through each stage of training and practice.
The report Physician Health and Wellness, from the Section on Integrative Medicine, is available at https://doi.org/10.1542/peds.2022-059665 and will be published in the November issue of Pediatrics.
The report covers burnout prevalence and diagnosis; national progress in physician wellness; AAP physician wellness initiatives; pediatrician-specific burnout and well-being; organizational and individual drivers of burnout; the intersection of race, ethnicity, gender and burnout; and protective factors and components of wellness for organizations and individuals.
The clinical report was shaped by the COVID-19 pandemic and its related physical, mental and logistical challenges, which revealed important gaps in health care systems. The staggering impact to both patients and health care professionals is ongoing.
The report offers approaches to improve organizational support of physicians and reviews the vocabulary of trauma-impacted practice, including moral distress, compassion fatigue, secondary trauma, vicarious traumatization and ethical dilemma.
Greater burden on women
Important trends are the disproportionate burnout experienced by female physicians in general and the shift in ratio of male to female pediatricians, with women now comprising a majority of those in training and practice. Gender, therefore, has a particular relevance in the consideration of pediatrician burnout, and the field has a unique opportunity to further national research.
Pediatricians can help lead change in the disproportionate impact of stressors experienced by women in practice, which include pay discrepancies, disparity in academic advancement, sexual harassment and imbalance of domestic responsibilities.
Components of wellness
The report explores cultivation of protective factors and discusses components of organizational and personal well-being. It emphasizes resources and evidence-based skills that can be used by individuals and teams, including the following:
- Pay consistent attention to healthy lifestyle fundamentals such as nutrition, physical activity, sleep and stress management.
- Plan and take regular time off and vacation.
- Develop a hobby outside of medical practice.
- Cultivate a gratitude practice.
- Consciously build and maintain a supportive social/family network.
- Create a personal mission statement. What brings you joy in medicine? Why did you choose the field? How will you thrive?
- Explore and practice mind-body approaches such as mindfulness and compassion practices that harness emerging research from centers such as the Emory-Tibet Partnership at the Emory University Center for Contemplative Science and Compassion-Based Ethics and the Stanford Center for Compassion and Altruism Research and Education.
The clinical report update was undertaken with optimism for the future of AAP members and the organizations they serve. Pediatricians have many inherent strengths, including a strong sense of purpose and commitment to community, altruism and compassion.
Continued progress will depend on maintaining a sense of urgency, leaning into grit and manifesting the desire to shape the field of pediatrics so it is healthier, safer and more satisfying for future trainees and practitioners. All of this is possible if pediatricians continue to pull together for change.
Dr. McClafferty is a lead author of the clinical report and a former chair of the AAP Section on Integrative Medicine Executive Committee.
The clinical report at https://doi.org/10.1542/peds.2022-059665 includes multiple resource links and data.