1. Donald Girard, M.D. Sydney Ey, Ph. D. Mark Kinzie, M.D., Ph.D. Mary Moffit, Ph.D., R.N. Our mission is to enhance the well-being of faculty with coaching and counseling services. OHSU Faculty Wellness Program was developed by Dr. Donald Girard and funded by Graduate Medical Education with the support of OHSU Hospital and Dr. Mark Richardson, Dean of Oregon Health and Science University.

2. Dr. Bill A very dedicated physician, he experienced an adverse outcome with a patient last week. Irritable, tense/on edge, he keeps replaying the event over and over in his head and is having nightmares. What might be happening with Dr. Bill?

3. Dr. Martha Was a “star” teacher/researcher last year. Is now bored with teaching and recently missed a grant deadline She is emotionally exhausted, losing confidence and thinking about leaving OHSU. What might be happening with Dr. Martha?

4. Dr. Jason Highly skilled in his specialty area. Very detail-oriented, critical of the slow pace of his clinic /research lab Multiple complaints from nursing staff: angry attitude when paged or questioned about decisions Students and residents are often bullied or demeaned while his department chair is treated with great respect and deference. What might be happening with Dr. Jason?

5. John Wayne- Still With Us? Burnout is especially hard for physicians who come from what Peter Moskowitz calls the “John Wayne School of Medicine”. “Because we are trained to solve problems ourselves, we…. believe it is a sign of weakness to ask for help. When physicians cannot tap into resources, they… think they have no alternative but to quit.” “The last human freedom is to choose your attitude in given circumstance” Victor Frankel

6. Prevalence of Burnout in Residents and Physicians in Practice Burnout rates of 30 to 76% seen across 15 studies of residents: multiple years, types of programs, US and International teaching hospitals represented (Thomas, 2004) Similar burnout rates among physicians in practice (Chopra et al., 2004) 46-80% moderate to high EE 22-93% moderate to high DP 16-79% moderate to low PA Lower rates of burnout among academic physicians (Tait, 2003) 37-47% burnout in academic physicians vs. 60% burnout in physicians in private practice

7. Resilience: A Common Phenomenon “Ability to bounce back” from adverse events and return to normal functioning (APA, 2004) Not unscathed but able to move on with life Estimated < 20% of people exposed to significant trauma develop PTSD Resilience is not just the opposite of depression, anxiety, neuroticism More like a set of internal resources that become critical when dealing with high levels of stress, adversity

8. What are your strengths? Remember a challenging time when you were growing up and managed to “bounce back” and possibly even “thrive”. What did you do to cope with the situation so well? What did you realize were your strengths in this situation? How might you use these strengths now—perhaps in a different way? Case Example: approaching a new challenge like a sports competition

9. Challenge Unhelpful Thoughts: Being a Better Coach to Yourself What is the worst that could happen and could I survive it? What is best outcome? Most likely? What would I tell a friend? What evidence is there to support or refute this prediction? How could I test out these negative predictions?

10. Connor-Davidson Resilience Scale (CD-RISC; Connor & Davidson, 2003) Reliable, valid measure, sensitive to interventions to increase well-being Used with general population, outpatient psychiatric and PCP settings Key factors measured are Hardiness “can deal with whatever comes” Persistence “can stay focused under pressure”

11. Faculty Wellness Program School of Medicine primary faculty (o.5 FTE) Coaching or Counseling Personal or Professional concerns Accessibility: Private location on the hill Time: Morning and evening appointments Cost: Our services are free

12. Faculty Wellness Program Confidentiality: No Epic/OHSU Medical record No insurance is billed for our services Future Disclosure: Wellness coaching/counseling— not reportable in Oregon However, if a physician appears to be impaired, we may refer to the Health Professionals Program No role in disciplinary or Fitness for Duty evaluations We offer referrals to community resources

13. “No restrictions are placed on a license if a physician is not impaired by his or her illness. The Board’s intention is to encourage physicians to seek treatment in a timely manner.” Kathleen Haley, JD, Executive Director of Oregon Board of Medical Examiners

14. OHSU Faculty Wellness Program To make an appointment: Contact Mary Moffit, Ph.D Email: moffitm@ohsu.edumoffitm@ohsu.edu Pager : 1-2047 Voice-mail: 4-1208 Urgent/ After Hours: (503) 330-7880 Other RWP Providers: Mark Kinzie, M.D., Ph.D. Email: kinziem@ohsu.edu pager: 1-4559kinziem@ohsu.edu Sydney Ey, Ph.D.: Email: eys@ohsu.edu pager : 1-1291eys@ohsu.edu http://www.ohsu.edu/faculty-wellness/

15. TEN STEPS TO RESILIENCE Make connections. Avoid seeing crises as insurmountable problems. Accept that change is a part of living. Move toward your goals. Take decisive actions. Look for opportunities for self-discovery. Nurture a positive view of yourself. Keep things in perspective. Maintain a hopeful outlook. Take care of yourself. American Psychological Association A a

16. Discussion of an Action Plan What is one change that you want to make to develop greater resiliency? How might you use this specific change on a daily basis to improve resiliency? What will increase the chances of you making this change? http://www.ohsu.edu/faculty-wellness/