Out of Committee: Patient Safety and Quality Improvement | Fostering Wellness through Intentionality and Community

Sarah N. Bowe, MD, MEd, and Matthew M. Smith, MD

During the past year, many of us have experienced reduced clinical and surgical volume, decreased income, change in job roles/titles, adverse health conditions, loss of loved ones— and the list goes on and on. While we would like for the year 2020 to disappear from the rearview mirror, 2021 is not off to the greatest start. A common sentiment that we both have heard around the hospital is, “I’m just trying to survive.”  While this mentality might serve well in a tournament setting—“survive and advance”—it tends to take a massive toll on our personal and professional lives when our bodies and minds never get a chance to reset. During this pandemic, the stress fractures in our lives, which occasionally caused pain but were often ignored, might now have broken, leaving us to try to pick up the pieces.

Be Intentional

Matthew M. Smith, MDMatt: As I reflected during the initial part of the pandemic on how to maintain my own health, I found myself reaching out to colleagues with a vast experience in wellness and mindfulness. While they had more information, they were also in the same position due to the pandemic, needing to make an intentional choice to take care of their individual health. As noted earlier this year by our AAO-HNS/F President Carol R. Bradford, MD, MS, you must first put on your own oxygen mask before helping others. As physicians we are committed to serving others and frequently neglect to care about ourselves. We need to be intentional with our health, which includes our bodies and our minds. During this time I realized that I had not seen a physician for a well visit since college. While we might think that we can diagnose and manage ourselves, or have a colleague write a prescription, we have to be intentional about our own physical health just as we implore our patients to do the same. 

Sarah N. Bowe, MD, MEdSarah: In order to focus on our health, it means we need to be intentional with our time, making room for the “tasks” that we know are important but in the moment never seem urgent. For that reason, we need to take time to exercise, meditate, and even just pause to breathe. At the AAO-HNSF 2019 Annual Meeting & OTO Experience, one of our colleagues, Sian Cotton, PhD, led Matt and me in a mindfulness exercise for five minutes—we just focused on breathing, briefly escaping our surroundings through meditation, and it was empowering. While we often don’t think about breathing, it is consistently available, providing an anchor for us to focus on throughout the day. Just 15 minutes of mindfulness or meditation per day has been shown to decrease stress, lower anxiety, and enhance concentration. To some, 15 minutes might sound like a lot, but taking roughly 1.5% of your time when you’re awake to commit to your mental health can have immense benefits. Again, we just have to be intentional.

Invest in Community

Matt: One of the hardest parts about this pandemic is the social distancing and not being able to see friends and family in the usual way. On the other hand, there have also been opportunities to engage or appreciate things differently. For instance, my wife and I have made intentional choices to prioritize weekly meetings with our closest friends. These three other couples were—and continue to be—an outlet to express joy and frustration, or we just play games virtually during these unprecedented times. In the past with our “normal” busy schedules, we would only see these friends together in a group about once a month. Now after the kids go to bed each Friday night, it’s parent check-in time. 

Sarah: Previously, there have been times when we could experience a “fear of missing out (aka FOMO)” on events, but now there is actually less happening. This provides a great opportunity to embrace the “joy of missing out (aka JOMO).” By flipping the perspective, the lack of other commitments can be a welcome change of pace. For example, I have enjoyed Friday Family Fun nights, which is generally code for pajamas, movies, popcorn, and cuddling. Thus, by being intentional with our time and flexible to our surrounding atmosphere, we have both cultivated deeper relationships with friends and family.

Professionally, another key point noted by Dr. Bradford was that “[w]e all need each other to get through these challenging times.” At both of our institutions, we have been able to participate in a program that supports physicians and other healthcare workers during hard times. Peer-to-peer support, a program popularized by Jo A. Shapiro, MD, at the Brigham and Women’s Center for Professionalism and Peer Support, was introduced with the goal of reaching out to physicians who have had a difficult clinical or personal situation and providing an opportunity for them to talk openly about the event. 

Matt: I found this program immensely beneficial during a time when one of my patients suffered a fatal cardiac complication. We especially need to invest in programs like this at a time when many physicians feel alone and isolated without the usual shoulder to lean on. By investing in other physicians around us, this reinforces the concept of community and allows us to feel supported in the job we perform.

Final Thoughts

It is critical for us as physicians to carry forward those changes in our lives or practices that have had a positive impact during the pandemic. In our opinion, the most important is taking care of ourselves. This is not selfish, but necessary in order to provide excellent care to our patients. Be an active participant in your health and wellness. Be intentional with your time and block your schedule for 15 minutes to start or participate in a form of mindfulness or meditation. Invest in friends, family, and other physicians around you and foster a community that lifts each other up. A curated set of resources that delve deeper into each of these topics is included below. Take care and be well! 

Resources

Articles

1. Achor S and Gielan M. Resilience is about how you recharge, not how you endure. Harv Bus Rev. 2016. https://hbr.org/2016/06/resilience-is-about-how-you-recharge-not-how-you-endure

2. Bradford CR. Put your oxygen mask on before helping others: the importance of wellness. AAO-HNSF Bull. 2020/2021;39:3. https://bulletin.entnet.org/article/put-your-oxygen-mask-on-before-helping-others-the-importance-of-wellness/

3. Shapiro J and Galowitz P. Peer support for clinicians: a programmatic approach. Acad Med. 2016;91:1200-1204. https://journals.lww.com/academicmedicine/Fulltext/2016/09000/Peer_Support_for_Clinicians__A_Programmatic.14.aspx

AAO-HNSF Annual Meeting Webcasts 2019

1. Mind-Body Medicine: Tools to Reduce Stress and Foster Resilience and Well-Being Part I and II. http://academyu.entnet.org/diweb/catalog/item?id=4656071

2. From Burnout to Wellness: A Description of Burnout and How to Maintain Wellness. http://academyu.entnet.org/diweb/catalog/item?id=4655365

AAO-HNSF Annual Meeting Webcasts 2020

1. Individual and Organizational Solutions to Increase Physician Wellbeing. http://academyu.entnet.org/diweb/catalog/item?id=6162982

2. Wellbeing: It's Time for a 360° Approach. http://academyu.entnet.org/diweb/catalog/item?id=6161056