How did SGIM help launch professional society programming to improve physician well-being?

In 2015, SGIM’s Association of Chiefs and Leaders in General Internal Medicine (ACLGIM) created the Work Life & Wellness Program. Led by Dr. Mark Linzer, ACLGIM surveyed divisions of general internal medicine (GIM) to assess physician burnout levels in GIM. Many divisions used the survey data to make changes. With data in hand, divisions were able to ask institutional leaders for help in improving the work life of their faculty. ACLGIM learned that leaders were hungry for expertise on how to lead such change.

ACLGIM launched the Wellness Engaged Longitudinal Leaders Program in 2017 to build a community of wellness champions in GIM. The year-long program covered the mechanisms of stress, favorable and unfavorable work conditions, ways to measure work conditions, challenges related to use of the electronic health record (EHR), system-level interventions for changing the work environment, and examples of resilience training. The resulting cohorts of wellness champions had the knowledge and skills to effectively advocate for better work conditions at their institutions.

ACLGIM also created an online community using GIM Connect to facilitate regular discussion of physician wellness and burnout. The discussions generated a library of articles, surveys, and tools.

What is the ACP doing to improve physician well-being?

Since 2017, the ACP has been taking action to address clinician burnout and provide guidance and resources that foster communities of well-being for internists to best serve patients and optimize professional fulfillment. ACP has integrated clinician well-being and professional fulfillment into its mission and core values, creating a standing Physician Well-being and Professional Fulfillment Committee, encouraging interdisciplinary efforts, and deploying resources to promote the well-
being of internists and their teams.

The ACP developed a multipronged approach and a comprehensive set of resources to support just-in-time and long-term needs,¹ including:

1)    Improving the practice and organizational environment by giving members high-quality information, resources, tools, and support to help their practices thrive in the growing value-based payment environment;

2)    Fostering local communities of well-being with over 150 ACP Well-being Champions who support ACP chapter members, practices, and organizations in combating burnout;

3)    Promoting individual well-being by offering online resources and educational courses at ACP’s Internal Medicine Meeting and chapter meetings;

4)    Advocating for system changes with policy recommendations through ACP’s Patients Before Paperwork Initiative.²

As individual and system needs converge along with mental health consequences of the COVID-19 pandemic, ACP develops products and services to meet members where they are. In March, ACP launched the I.M. Emotional Support Hub with publicly available confidential peer-support, counseling, crisis links, and well-being resources.¹ To facilitate culture change and improve the well-being of the next generation of internists, ACP launched the Resident Well-being Learning Series.¹ Aligned with new requirements for resident training, these online modules are free to ACP members ($25 for non-members) and may be completed individually or in facilitated groups using a flipped classroom model.

What else is SGIM doing to address problems that contribute to physician burnout?

SGIM encourages members to support the efforts of the ACP and SGIM to address fundamental problems that contribute to physician burnout. One of the most important problems is inadequate investment of the health system in the essential care given by general internists. SGIM’s Health Policy Committee will continue to advocate forcefully for physician payment reform that recognizes the value of cognitive care.³ In December 2020, SGIM joined the ACP and other primary care organizations in issuing a unified statement calling for fundamental change in the financing of primary care.⁴ SGIM and ACP also were sponsors of the report from the National Academy of Sciences, Engineering, and Medicine on implementing high quality primary care.⁵ SGIM is collaborating with the ACP and other organizations to advocate for action on those recommendations.

When SGIM’s Council reviewed the plans of SGIM’s committees and commissions for the coming year, a recurring theme was a strong desire to address challenges related to use of telemedicine in GIM practice. General internists are feeling the brunt of stresses from the huge increase in use of telemedicine, further aggravated by problems with EHR systems. Council has asked the Clinical Practice Committee to collaborate with the Health Policy Committee, Education Committee, Health Equity Commission, and Geriatrics Commission on helping members adapt to the new role of telemedicine. In addition, ACLGIM will focus on what needs to be done to transform EHR systems to better support the care that general internists aspire to give their patients. Such efforts are critical to improving professional fulfillment and the well-being of our patients.