Recently a photo of an emergency room doctor visibly grieving the loss of his 19-year-old patient went viral. Many social media sites and bloggers opined on this tragic vision, but one theme stood out; doctors are affected by loss and are often not given the tools and the support they need in difficult situations. In fact in the instance of this emergency room physician, as is often the case, he returns to work to finish his shift, with a stoic face to treat his next patient.
Numerous studies document that doctors experience high levels of stress leading to physical, psychological and emotional harm and eventually burn out. (1) It is well known that physician’s experience burnout at higher rates than most professions, with some studies quoting rates as high as 40-50%. The stress on a physician can be magnified if there is a potential medical error involved, and the physician’s action or lack of action caused patient harm. The effects create a dangerous cycle, as studies show distressed providers make more medical errors, display less empathy and their patients are less satisfied, less compliant and more litigious. (2)
In a 2007 JACHO publication, over 3000 physicians were surveyed, and less than 10% felt supported by their organization when they encounter difficult situations. (3) A survey created by Stanford Committee of Professional Satisfaction and Support (SCPPS) was given to our combined medical staffs (Stanford Health Care and Stanford Children’s Health). It concluded those physicians reporting a sense of greater support and appreciation experienced more professional fulfillment and less burnout. The question then becomes, how can we best support our providers through difficult situations?
Peer Support Programs
Dr. Jo Shapiro and her colleagues at Brigham and Women’s Hospital found physicians underutilize established mechanisms for support, such as EAP, physician health services, and GME. Instead, they reported a greater likelihood of seeking support from physician colleagues (2).
With the findings from the Stanford Health Care survey coupled with Dr. Shapiro’s report and consultation, Stanford Health Care developed a peer support program. SCPPS, in partnership with The Risk Authority – Stanford, the GME and Medical Staff Leadership, now offers routine peer support for our providers involved in critical events. The program has been very well received, and we are expanding to include support for providers involved in any difficult clinical event as well as litigation and medical board complaints.
“Few situations are more stressful to clinicians than experiencing an event that has resulted in harm to the patient,” stated Jeffrey Driver, JD, MBA, ARM, DFASHRAM, CEO of The Risk Authority – Stanford and Chief Risk Officer for Stanford Health Care and Stanford Children’s Health. “Unfortunately, clinicians seldom make use of traditional support services when these events occur. Peer support programs that reach out and provide 1:1 support are gaining attention as a way to help these clinicians when they are under this severe stress.”
The Risk Authority – Stanford will host a panel discussion on the subject of clinician peer support programs and their effectiveness following adverse patient outcomes. The live video webcast will air on Wednesday, May 6, 2015, 11:00 a.m. to 12:00 p.m. PDT (2:00 p.m. to 3:00 p.m. EDT) and is presented in partnership with Aon Risk Solutions, Lockton UK and MedPro Group.
The Risk Authority – Stanford will moderate this conversation with the leading authority in the field, Dr. Jo Shapiro of Brigham and Women’s Hospital and Harvard Medical School, along with Dr. Bryan Bohman, physician leader of Stanford Medicine’s Peer Support Program.
The webcast will explore the following questions:
- What is motivating leading institutions to establish Peer Support Programs?
- How do Peer Support Programs work? How do they differ from existing support services?
- How effective are they? What do the data say?
- What best practices have emerged?
- What challenges need to be overcome?
Registration for this free event is available at www.riskauthority3.wpengine.com. A replay of the webcast will be available through The Risk Authority – Stanford’s website www.riskauthority3.wpengine.com approximately two weeks following the live event. Previous webcasts on innovative healthcare risk management topics are also available on the site.
I hope you will join us to learn more about clinician peer support programs.
Dana Welle has more than 16 years of clinical experience as an obstetrician-gynecologist. After completing her residency in a large tertiary academic medical center, she began private practice where she continued to manage high risk obstetric cases as well as perform complicated gynecological surgery. She is a fellow in the American College of Obstetrics and Gynecology (ACOG) and also a fellow in the American College of Surgeons (ACS). Although she is no longer directly involved in patient care, she continues her pursuit of medical knowledge and remains active in both ACOG and ACS. Dana currently serves as teh Chief Medical Officer of The Risk Authority – Stanford, and as the physician risk consultant for Stanford Health Care and Stanford Children’s Health.
- Linzer M, Visser MRM, Oort FJ, Smets EMA, McMurray JE, de Haes. Predicting and preventing physician burnout: results from the United States and the Netherlands. Am J Med 2001; 111: 170-5
- Hu Y, Fix M, Hevelone N, Lipsitz S, Greenberg C, Weissman J, Shapiro J. Physicians’ Needs in Coping With Emotional Stressors
- JACHO study/Watterman