President's Message: P. Bradley Hall, MD, Spring 2018

Thursday, April 5, 2018

Burnout and the FSPHP: A Paradox for Success
P. Bradley Hall, MD, DABAM, DFASAM

The term burnout itself is a paradox of sorts—almost a “pejorative blessing.” Initially indicating a condition of the individual physician, burnout garnered a preponderance of attention from the house of medicine at the individual level all the way to national organizations representing or serving those individuals experiencing burnout. As result, it is now recognized more accurately as a cause for concern that goes well beyond the problem “within” the individual physician. It is now known to include “systems” within which physicians work today; therefore, the solutions must include this shared responsibility of system redesigns and individual wellness. This buzzword of burnout has resulted in the FSPHP being involved in an unprecedented multitude of projects and collaborations with other organizations and in partnership at the national level. The recognition of the benefits and success of the PHP model we have all known has shifted the perspective of others to see our membership—and the FSPHP itself—as having a significant role in primary prevention of burnout and the expanding awareness of issues facing physician health and well-being.

In recent years, the FSPHP has been involved in the 2016 World Medical Association Physician Well-Being Policy and the AMA Model Physician Health Program Act (a 1985 policy revision) [www.fsphp.org/sites/default/files/pdfs/ama_physicians_health_programs_act_-_2016.pdf]. Your leadership has attended the ACGME Symposium on Physician Well-Being and the National Academy of Medicine’s “Action Collaborative on Clinician Well-Being and Resilience” [https://nam.edu/initiatives/clinicianresilience- and-well-being]. We are currently involved in the Federation of State Medical Boards’ Physician Wellness and Burnout Workgroup, a joint FSPHP/FSMB survey of PHPs and will continue our combined education session at the FSPHP annual conference. We’ve had additional educational opportunities at the Coalition of Physician Enhancement (CPE), American Osteopathic Association (AOA), Coalition of Physician Education (COPE), and the Organization of State Medical Association Presidents (OSMAP), and we will be presenting “Improving Addiction Outcomes: Lessons from the Physician Health Program Model” at the National Rx Drug Abuse & Heroin Summit [https://vendome.swoogo.com/2018-rx-summit].

The FSPHP has also had direct interactions with ABMS member boards as they navigate their own processes. Many of our members were involved in the writing of the recent textbook, Physician Mental Health and Well-Being: Research and Practice. Meanwhile, Dr. Earley was involved in writing the revision of the chapter on PHPs and Physician Addiction in the ASAM textbook: Principles of Addiction Medicine. Dan Perlin, MD, presented at the International Health Facility Diversion Association (IHFDA), representing his commitment to physician health and well-being. We were also instrumental in assisting the American Board of Obstetrics and Gynecology in updating their MOC application relative to PHP participants. Without the support of our membership and individuals like yourselves, these and other important works would not have been accomplished.

Board members continue the important work in overseeing the accomplishments within each of the four strategic goals and associated objectives related to our workgroups:

  • Revenue
  • Accountability, Consistency, and Excellence (ACE)
  • Education, Media, and Research
  • Organizational and Membership Development

The FSPHP committees have been hard at work accomplishing the much-needed groundwork for the many FSPHP projects, both within and beyond the organization. The program planning committee, under the leadership of Martha Brown, MD, and Doris Gundersen, MD, have continued to improve the quality of education and attendee experience for members and nonmembers alike at our annual conference. The work of committee members has been exemplary and now includes the addition of the silent auction in support of the funding workgroup goals.

The publication committee, under the leadership of Sarah Early, PsyD, and Amanda Kimmel, continues to produce an exemplary FSPHP newsletter of the highest caliber, while guiding ongoing work of the website and ListServe. The finance committee, Robin McCown, chair, continues to guide the board in its fiscal responsibilities of carrying out our transition to organizational independence with sound financial management. Recently, one of our most valuable assets, the past-presidents committee, Luis Sanchez, MD, chair, has been doing a groundbreaking compilation of references toward a future publication representing years of expertise, experience, and passion. Having a “white-paper–type” publication by our mentors and “lions in the field” is exciting. The medical student and resident committee, under the leadership of chairs Martha Brown, MD, and Joyce Davidson, LSW, has been quite busy in producing a medical school survey related to PHP awareness and utilization. The research committee chair, Paul Earley, MD, has been very productive in the development of potential FSPHP research and projects that will collaborate with outside organizations. Dr. Goldberg and the task force on education developed guidelines that resulted in the recent launch of the FSPHP membership portal and library of presentations. Kelley Long, chair of the funding development committee, is working in tandem with the board members involved in the Revenue Workgroup, providing incredible expertise and guidance in the FSPHP fundraising plan. Our intensely dedicated FSPHP ACE Committee has been and continues to participate in an impressive consensus-building process updating the FSPHP Guidelines. These guidelines will be utilized in the development of our performance, enhancement, and effectiveness review process to be made available for all PHP programs, inclusive of a treatment center review process.

FSPHP STRATEGIC GOAL WORKGROUPS

    • Revenue: Develop revenue sources to support budget neutrality to ensure the financial sustainability of the FSPHP.
    • Accountability, Consistency, and Excellence (ACE): Improve accountability, consistency, and excellence by utilizing and implementing an FSPHP-endorsed review process for PHPs and treatment centers.
    • Education, Media, and Research: Provide ongoing education about the value of PHPs via education, media relations, and research.
    • Organizational and Membership Development: Maintain and continue to grow an organizational structure and membership services that will help achieve our mission, vision, and strategic goals.

As you can see, the years of hard work by the forefathers of the FSPHP, the PHP model success, the devotion of our membership, and the current state of affairs relative to burnout, physician health, and well-being have made the importance of our work highly respected. The gold standard of care provided by the PHP model and the work we do are exemplified by the current activities and those yet to come benefiting the PHP model and the participants we serve.

I would be remiss not to recognize Linda Bresnahan, our Executive Director, for her expertise, passion, and leadership, which is demonstrated in all that the FSPHP has accomplished and continues to improve upon today. The medical association management assistance from Julie Robarge is greatly appreciated as well. With our current staffing and committed membership, “we” have created more understanding of the value of the PHP model and, therefore, expanding opportunities ahead for PHPs, including greater visibility of the successes and importance of our work.

As your president, in writing my last “President’s Message,” I am in awe. Words are inadequate in describing the experience. Since beginning this work in 2005, the maturation, devotion, expertise, and accomplishments of the FSPHP are ineffable. I remain and have been honored to be a “humble servant” among many to the effectiveness of the FSPHP and enhancement of physician health and well-being