FEATURE
The NAM’s Conceptual Model of Factors
Affecting Clinician Well-Being and Resilience
FIGURE
SIDEBAR 2
The Resilience Whiteboard Wall
At the 2017 ASH Annual Meeting, attendees were invited to visit the “ASH
Whiteboard Wall on Resilience,” where they were asked to answer the
following question: “As a hematologist, or as a trainee, how do you build
resilience and face factors that might contribute to professional burnout?”
Hundreds of attendees visited the whiteboard and shared their stories
with graphic artists who illustrated their words in real time. Below are a
few photos from the display.
physicians need support to remain en-
gaged and compassionate. She manages
regular meetings in which all members
of the health-care team can discuss
issues in a patient’s case that have
troubled them. 12
The alarmingly high rates of suicide
among doctors indicates a need for this
type of open, supportive environment –
replacing a culture where many physicians
feel they must “suffer in silence.” The level
of support can vary greatly among differ-
ent hospitals and departments, and shame
and stigma about seeking help for mental
health issues persist.
the licensing implications.
“There’s tremendous stigma,” Dr.
Lown said. “Students are afraid they’re
not going to get the residencies they
want if they fess up that they need help.
Physicians are afraid that they’re not going
to be sustained in their employment.”
In response to growing concerns about
the mental health of physicians and medi-
cal students, the AMA has adopted a new
policy to reduce the stigma associated
with medical professionals seeking mental
health care. 14
They are urging state medical licensure
boards to remove questions regarding
“Physicians have to play a role in
reorganizing care by reasserting
the values that are important to
us and looking at new ways ... to
address them.” —BETH LOWN, MD
“When one of our trainees needed a
break, people stepped up. People said, ‘I can
help. I can take your call, or I can take your
block for a couple of weeks to give you a
break,’” Dr. Singavi recalled. “All of us rec-
ognize we are vulnerable to stress, and we’re
willing to help get each other through it.”
Unfortunately, many doctors and
trainees hesitate to seek help, out of the
fear of appearing weak or decreasing their
chances for career advancement.
For some trainees, this is particularly
distressing; one-third of states include a
question on initial and renewal licens-
ing applications about applicants’ mental
health and whether they have ever
received treatment. 13 Forty percent of phy-
sicians in states where the questions were
used said they would be reluctant to seek
help for a mental health issue because of
ASHClinicalNews.org
mental health from licensing applica-
tions or to ask physicians only about
current mental or physical disabilities
that could affect the provider’s ability to
practice medicine in a competent, ethical,
and professional manner. The recom-
mendation would reduce the most severe
consequences for reporting or seeking
treatment, such as dismissal or suspension
of medical license.
The new policy is part of the AMA’s
Professional Satisfaction and Practice
Sustainability initiative, intended to im-
prove health care by focusing on the well-
being of physicians and their practices.
The AMA brought together physicians,
hospital administrators, business lead-
ers, and other stakeholders to discuss
processes for reducing physician burnout,
creating healthier educational practice
ASH Clinical News
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