Before The Well Runs Dry: Promoting Wellness on Interdisciplinary C-L Teams

VIRTUAL CONTENT

Location: NA

CE: 1 CME

Lead Speaker(s)

Liliya Gershengoren, MD, FAPA

Clinical Associate Professor of Psychiatry
New York University
Cresskill, New Jersey

Speaker(s)

Molly Howland, MD (she/her/hers)

Staff Psychiatrist
Cleveland Clinic
Lakewood, Ohio
Paulo Marcelo Gondim Sales, MD, MS

Psychiatrist
River Region Psychiatry Associates
Birmingham, Alabama

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Rachna Raisinghani, MD, FAPA, FACLP

Medical Director- Division of Consultation Psychiatry at Sheppard Pratt
Sheppard Pratt Health System
Baltimore, Maryland

Abstract: Chronic work stress and decreasing autonomy due to the corporatization of medicine have led to an increasing prevalence of physician burnout and moral injury (Clark et al., 2018; Sales et al., 2021). Discussions about physician wellness have become commonplace as awareness about physician burnout has increased. Consultation-Liaison (C-L) psychiatrists are frequently asked to formally or informally address issues of wellness and burnout in their interdisciplinary colleagues.

Previous workshops and symposia focused on downstream interventions that C-L psychiatrists organized for distressed healthcare workers. There has been less focus on the well-being of C-L psychiatrists themselves, C-L trainees, and their interdisciplinary C-L colleagues (e.g., social workers, nurse practitioners, rotating trainees of other specialties, etc.). The tasks of consulting and liaising present unique wellness challenges, which the COVID-19 pandemic has exacerbated.

This symposium explores psychodynamic and team-related contributors to burnout in C-L psychiatrists, trainees, and interdisciplinary C-L team members. We discuss upstream micro- and macro-level wellness interventions that educators in C-L psychiatry can implement to enhance physician wellness and strategies for removing potential barriers.

Dr. Gershengoren will moderate the symposium and introduce wellness challenges and opportunities from a team dynamics standpoint during crises and beyond. She will discuss micro- and macro-level wellness interventions for interdisciplinary C-L team members.

Dr. Sales will discuss wellness in C-L trainees and physicians using a psychodynamic framework by exploring the psychological challenges unique to the pillars of C-L practice: consultation and liaison work. He will also expand on the interaction between individual- and corporate-level factors influencing wellness, including corporate responses to individuals experiencing burnout or moral injury that were accentuated by the COVID-19 pandemic.

Dr. Howland will present approaches for self-care for C-L trainees, including trainees from interdisciplinary specialties. She will explore the leadership role of the chief resident and C-L fellow in modeling self-care, preventing burnout, and advocating for changes to interdisciplinary stakeholders to promote the wellness of trainees on C-L rotations.

Dr. Raisinghani will expand on organization-level interventions to promote the wellness of physicians and interdisciplinary colleagues. She will consider C-L psychiatrists’ role in implementing these interventions in creating an ideal workplace culture. She will discuss barriers and facilitators to operationalizing these interventions, including stakeholders and strategies for measuring and monitoring progress.

References:

Clark, S. (2018). The impact of the Hippocratic Oath in 2018: The conflict of the ideal of the physician, the knowledgeable humanitarian versus the corporate medical allegiance to financial models contributes to burnout. Cureus, 10(7), e3076. https://doi.org/10.7759/cureus.3076

Sales, P., Arshed, A., Cosmo, C., Li, P., Garrett, M., & Cohen, M. A. (2021). Burnout and moral injury among consultation-liaison psychiatry trainees. Psychodynamic Psychiatry, 49(4), 543–561. https://doi.org/10.1521/pdps.2021.49.4.543
Learning Objectives:
Identify individual-, team-, and organization-level risk factors associated with burnout/moral injury on interdisciplinary CL teams along with their psychodynamic underpinnings
Apply micro- to macro-level wellness interventions on CL teams
Describe CL psychiatrists’ role in addressing barriers to implementation of wellness interventions and creating a wellness-promoting workplace culture