Survival 101:
Work Life Integration & Wellness
Jason Liebzeit, MD
Assistant Professor
Sheryl L. Heron, MD, MPH
Associate Professor/Associate Residency Director
Assistant Dean Medical Education & Student Affairs – Grady Campus
Department of Emergency Medicine
Emory University School of Medicine
SAEM: Chief Resident Forum – 6/2011
Disclosures
No commercial financial
relationships to disclose
Objectives

Learners will:
Describe the concept of work-life integration
 Recognize burnout and describe strategies
to combat it
 Formulate a personal plan for self-care
during time as a Chief Resident
 Discuss time management techniques

Overview

What is work/life integration?

What’s next?

Career Demands

Relationship Demands

Attention to Self

The Big Picture
Work-Life Balance Integration
Work
Life/Family
The End of the Road (or the
Beginning)

What’s Next? It’s good to be the Chief

Academic

Community

Fellowship

Locum Tenems
http://www.nytimes.com/2011/04/02/health/02resident.html
Burnout

Elevated levels of burnout exist among a
substantial percentage of surveyed Emergency
Physicians

Classified broadly in terms of negative
perceptions of self, negative practice habits
and attitudes, and unhealthy lifestyle.

Goldberg et al: Acad Emed 1996 - , Vol 3, 1156-1164
Burnout

Self- recognition of burnout

Lack of job involvement

Negative self- assessment of
productivity

Dissatisfaction with career
Goldberg et al: Acad Emed 1996 - , Vol 3, 1156-1164
Burnout Correlates

Sleep disturbances

Intent to leave the practice within 10
years

Higher levels of alcohol consumption

Lower levels of exercise
Goldberg et al: Acad Emed 1996 - , Vol 3, 1156-1164
Work-Life Culture

What exists?

Is it valued?

Are there policies?
ACEP: Wellness
Institution

Emory University Department of
Emergency Medicine


Wellness & Well-Being Committee
Emory University

Work Life Initiative


Strengthen work-life culture for individual and
families
FSAP
My Wellness
Family
Financial
Spiritual
Social
Professional
Physical
Mental
Relationship Demands

You’re almost done, it’s my time now

Prime age to begin/expand families

Sandwich generation
Realities of Life

Residency Training & Pregnancy

Personal & Family illness

Impairment

Sleep Hygiene
Time Management

Enhances Work-Life Integration by:

More Control of your life

Improved Relationships

Increased Productivity
Attention to Self

Organization
Organization
Organization

Prioritization

Resources


Creating a Schedule

Prioritization


Yearly, Monthly, Weekly, Daily
Family/Non-negotiables

Vacations, Reunions – 1st priority

Fill in the Blanks

Utilize your Resources
Resources

Family

Colleagues

Community

Administrative Support

You
Institutional Resources

Human Resources?

Dual Career Programs?

Family Medical Leave?

Mentoring Programs

Faculty Staff Assistance Program
The Big Picture

Keeping the Balls in Motion

Monitoring the Balls

Dropping the Balls
What Keeps You Well?

Identify what keeps you grounded

Articulate clearly and often

Share them with your family and
friends

Tap into them
Benefits of Work-Life
Integration
To the organization:

Measured increases in individual
productivity, accountability and
commitment

Better teamwork and communication
Benefits of Work-Life
Integration
To the Organization:

Improved morale

Less negative organizational stress
Benefits of Work-Life
Integration
To the individual:

More value in your daily life

Increased productivity

Improved relationships

Reduced stress
http://www.worklifebalance.com/5steps.html
What about us?

Survey of 193 ED Physicians (ACEP
members)

Validated measures of career satisfaction,
tolerance for uncertainty, and burnout

High level of career burnout


No demographic variables were associated with
burnout status
High anxiety caused by concern for bad
outcomes (odds ratio=6.35) was the strongest
predictor of burnout
Kuhn et al: Annals EM: Feb 09
What about us?

32.1%, exhibited Emotional Exhaustion
core symptom of burnout
 not related to age or type of practice


Physicians did not feel anxiety because
of:

general uncertainty, difficulty in disclosing
uncertainty to patients, or admitting errors to
other physicians.
Kuhn et al: Annals EM: Feb 09
The Good News
Despite exhibiting emotional
exhaustion, the majority of
respondents are satisfied with the
career of emergency medicine
Kuhn et al: Annals EM: Feb 09
The Good News

Random sampling of 1008 Emergency
Physicians

2004 - 65.4% EPs reported high career
satisfaction, while 12.4% EPs reported
low career satisfaction (n = 515)
Cydulka & Korte; 2008 – Acad. EMED – June 2008
Career Satisfaction

Higher career satisfaction was associated:


Teaching settings, research, publication,
leadership positions, belonging to medical
organizations/medical politics
1/3rd of respondents (33% in 1994, 32% in
1999, 31% in 2004) reported that burnout
was a significant problem.
Cydulka & Korte; 2007 – Acad. EMED - Abstract
Changing the Conversation



Burnout
Well-Being/Resiliency
Develop a shared definition of
physician wellness
Culture Change
More positive Educational Environment
 Raising awareness of burnout and stigma
 Enabling prevention strategies

Ecklberry-Hunt et al: JGME: Dec 2009
Changing the Conversation
Heron et al. Does a curriculum on wellness affect burnout in an
Emergency Medicine Training Program (CORD 2011, SAEM 2011)
Heron-Liebzeit Protocol

Keep a calendar & honor it

Learn to say “No”

It’s okay to be away

There are 24 hours in each day
Heron-Liebzeit Protocol

Get rid of clutter

Monitor the balance


Self-check
Empower others

Honor who & what keeps you well

Use your resources
Summary

Work/life integration is realistic and
attainable

Burnout is a reality, but you are wellequipped to combat it

Prioritize your time

Utilize your resources
Conclusion

Good luck

Remember the Big Picture

Congratulations