How Ochsner Health created a culture to support physician wellness

Pressing “send” on a letter sent to 34,000 colleagues can never be a stress-free moment, especially if the letter shares very personal thoughts about his own mental health.

But AMA member Nigel Girgrah, MD, PhD, has no regrets sending the letter two summers ago, especially after it received an overwhelmingly positive response and helped drive engagement. with co-workers on the value of self-care and asking for help when needed.

“I had no idea what was going to happen,” said Dr. Girgrah, a hepatologist transplantologist and wellness manager at Ochsner Health, based in New Orleans, a member of the AMA Health System program.

“I didn’t know if the state licensing board would come knocking on my door,” he added. “It was a bit risky. But I think it was the right thing to do, certainly at that time and for our employees.

Dr. Girgrah, who is also Medical Director of the Liver Transplant Program at Ochsner, shared his story during “Creating a Culture that Supports Wellness” (Apple Podcasts | Spotify), an AMA STEPS Forward® podcast.

New Orleans, one of the nation’s earliest pandemic hotspots, had been going through another surge of COVID-19 and Dr. Girgrah was dwelling on the anniversary of losing her son to cancer. Due to travel restrictions and a knee injury, he was unable to use his normal coping mechanisms – traveling to see friends and family in Canada or exercising.

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This led to the letter in which he admitted to asking for help. The response to the letter led to a realization.

“My ‘ah!’ moment was that everyone had their side of this story,” Dr. Girgrah said. “Historically, this letter, which we refer to as the ‘Welfare Director’s Message’, was a somewhat sterile report of things we were doing in the office.

“But I shared a bit about myself and then spoke more broadly about the issue of mental health in the healthcare sector and the response was overwhelming,” he added. “It was the most open executive letter with many lengthy responses and people saying they will now ask for help.”

Dr. Girgrah recalls that although he had received support from key members of the leadership team on the topic of the message in advance, he was always a bit worried about a negative reaction from the management of Ochsner. Instead, it led to these leaders adopting a “more vulnerable but authentic” communication style and speaking “more intentionally about mental health.”

Reducing physician burnout is a critical part of the AMA’s recovery plan for American physicians. You took care of the nation. It’s time for the nation to take care of you. It’s time to rebuild. And WADA is ready.

Far too many American physicians suffer from burnout. That’s why the AMA is developing resources that put wellness first and highlight workflow changes so physicians can focus on what matters: patient care.

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Four-pronged approach

In the podcast, Dr. Girgrah described how Ochsner took steps to address and maintain the mental health of his doctors, medical professionals and staff.

Measure the state of mental health of staff. Ochsner conducts an “organizational biopsy” through the use of an expanded Mini Z Wellbeing Index – a 10-point Zero Burnout Program survey – to identify drivers of professional growth and assess issues such as depression or post-traumatic stress disorder at granular department and service line levels. With the help of the AMA, Dr. Girgrah said, this has led to annual measurement of burnout levels for doctors and other staff with the ability to compare Ochsner to other systems.

Education and awareness. That includes talking about mental health “more broadly,” Dr. Girgrah said. Ochsner also has a Professional Wellness Office that is “committed to helping our workforce and employees find the resources they need to avoid disengagement, rediscover joy, and find harmony.” Physicians and staff have access to personal and professional wellness webinars, including 90-minute sessions on resilience, nutrition, mindfulness, and post-traumatic growth.

Destigmatize mental health. Internally, that means system leaders are more open and sharing what they’re going through when it comes to mental health, which “creates a more permissive environment for employees to seek help sooner,” the CEO said. Dr. Girgrah.

Find out why healthcare system leaders need to be open and authentic about burnout.

Look upstream to resolve burnout. There was a need to go beyond being reactive and developing crisis coping mechanisms and reducing the frequency and severity of stressors. Additionally, a resource group was formed where female physicians could come together to talk about the unique stressors they face. Dr. Girgrah noted that Ochsner is willing to take an experimental approach in this area and uses the plan-do-study-act process to scale up interventions that work and phase out those that don’t.

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