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Preparing for Grad School/Residency Wellness

#51 – Provider Wellness with Christine Hein, MD

This is one of my favorite podcasts that I’v recorded. If you’ve had the privilege of working with or getting to know Dr Christine Hein, MD, – or once you listen to this podcast – you’ll know why!

Christine Hein, MD is an emergency medicine physician and the Chief Wellness Officer at Maine Medical Center, Maine’s only level 1 trauma center and academic teaching hospital.

We recorded this episode in August of 2017 when Dr Hein was developing the Provider Well-being and Peer Support program at MMC. Since that time, the well-being program has grown substantially with continued support from the medical center and numerous volunteers. Maine Medical Center made a substantial statement of supporting provider wellness by establishing the Chief Wellness Officer position and Dr Hein was selected to serve as the first Chief Wellness Officer.

She’s in the trenches as an emergency medicine physician and actively engaged in resident education. She’s an absolute master at all things related to provider wellness, a wife and mother of 5 kids and an elite distance runner. She has somehow found a way in her professional life to maintain a since of joy & optimism that is truly authentic and infectious. It’s like she walks around just spilling joy everywhere; she’s like an overflowing glass of water just sloshing a refreshing positive vibe wherever she goes, leaving the rest of us better off for having interacted with her. Yet that vibe is not some shallow surface level corporate smile campaign. With Christine, it’s actually rooted deep in a career as an emergency medicine provider and as a proficient healthcare leader & administrator. She’s someone who’s been in the arena, with her face mared by dust & sweat & blood*, to borrow from Theodore Roosevelt’s speech. And it’s from her personal story as an emergency medicine physician and from some dark places in her personal life – which she talks about in this episode – that she’s developed this deep desire to improve the lives of other healthcare providers around her through her work on provider wellness.

So all that comes through in this episode. That’s who were talking to today. You’re going to love it. And not only that, but we also had the immense pleasure of being joined for this discussion by Dr Hein’s daughter, Ms Abby Irish. This is the first time that a guest has brought one of their children along to a podcast recording and that, again, speaks to how important this topic is to Dr Hein and one of the reasons why I love this episode. At the time of this recording Abby was an 8th grader who was interested in becoming a physician. She had just finished surgery summer camp in Boston and talks about her experience at the start of the show.

We run the gamut of provider wellness in this conversation. We discuss burnout, wellness, resiliency, organizational drivers of burnout and ways hospitals, med schools & anesthesia programs can build structural components to eliminate burnout and foster well-being. We talk about peer support & how that’s different than professional counseling. We touch on substance abuse, suicide and the stigma of mental health concerns and getting help & support. We share personal stories from our careers and those of others that bring these concepts to life and give them real traction. As healthcare providers, we spend an incredible amount of time, energy and money becoming highly qualified in our fields yet rarely create space for deliberately developing a sense of well-being in our professional and personal lives. We should remember that as health is more than the absence of disease, joy in work is more than the absence of burnout. We owe it to ourselves, our colleagues and our patients to be whole people, grounded in a deep sense of well-being. This show explains why doing that matters and gives actionable steps we can take to minimize burnout and foster joy in our work.

One more thing before I introduce you to Dr Hein and Abby: we discuss a shocking statistic that 300-400 physicians commit suicide each year in the United States. That’s 1 to 2 medical school classes of physicians each year. It’s remarkable. I had a classmate in anesthesia school who took her own life and last year a SRNA reached out to talk after her roommate and classmate took her life just months before the end of their program. Research shows that upwards of 21% of SRNAs experience suicidal ideation during their training. If that’s you, or someone you know, I want you to know that you’re not alone and there’s a wealth of resources created by people who understand what you’re going through and who care deeply about your wellbeing and safety. I’ve got links in the show notes to people you can call or even text. The Crisis Text Line is 741741. You can text any message to the number 741741 and a trained volunteer will respond to you anytime of day or night. It’s a free service. That number is 741-741. Put it in your phone. Post it in your break rooms & locker rooms. And don’t hesitate to text the number. Help is available – just a text message away.

And with that, let’s get to the show…

Quotes:

“As health is more than the absence of disease, joy in work is more than the absence of burnout.” – Jon Lowrance

“300-400 physicians each year in the United States commit suicide… essentially two medical school classes of physicians each year.”  Christine Hein, MD

“I think that it has professionally been probably the most satisfying experience of my career – to be involved in [Provider Wellness].”  Christine Hein, MD

“[Resilience is] the capability of a strained body to recover its size and shape after deformation caused especially by compressive forces.”  Christine Hein, MD

Dr Hein completed Dr Hein completed medical school at Dartmouth in 2001 followed by her residency in emergency medicine at Maine Medical Center where she was Chief Resident in her final year. At the time of this recording, she served as the Associate Medical Director for the Department of Emergency Medicine and the Director of Provider Well-being and Peer Support at Maine Medical Center as well as the Director of Emergency Medicine for MaineHealth.  She is an Associate Professor of Emergency Medicine at Tufts University School of Medicine and is well-respected as a medical educator, receiving in 2009 the American College of Emergency Physicians National Teacher of the Year award.  Her research interests include burnout, resiliency, critical care and women’s issues in medicine.  Outside of work, Dr Hein is married, has five children and is an avid marathoner, completing over 23 marathons including posting highly competitive times in the Boston Marathon.

*”It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.” – Theodore Roosevelt

Resources:

AANA Health & Wellness and Peer Assistance Website

Attending:  medicine, mindfulness and humanity Ronald Epstein, MD

TEDTalk:  Everything you think you know about addiction is wrong by Johann Hari

Epstein, R. M., & Krasner, M. S. (2013). Physician resilience: what it means, why it matters, and how to promote it. Academic Medicine88(3), 301-303.Raj, K. S. (2016). Well-being in residency: a systematic review. Journal of graduate medical education8(5), 674-684.

Swensen, S. J., & Shanafelt, T. (2017). An Organizational Framework to Reduce Professional Burnout and Bring Back Joy in Practice. The Joint Commission Journal on Quality and Patient Safety43(6), 308-313.

By Jon Lowrance

Jon Lowrance, MSN, CRNA is the producer of Anesthesia Guidebook, the go-to guide for anesthesia providers.