Transcription:
Providing Physician Support During COVID-19

Melanie Cole (Host):  Welcome to Better Edge, a Northwestern Medicine podcast for physicians. I’m Melanie Cole and today, we’re discussing the P2P Network, it’s a physician peer support network created to help physicians after experiencing adverse events. Joining me is Dr. Angela Chaudhari. She’s an Associate Professor in the Department of Obstetrics and Gynecology, Minimally Invasive Gynecologic Surgery and she’s the Director of the P2P Network. She’s here to talk to us about the importance of peer support and how the program has shifted to help physicians during the COVID-19 pandemic. Dr. Chaudhari, it’s such a pleasure to have you with us and what an important topic. Tell us about the P2P physician support group and why you created it. Tell us about the importance of peer support.

Angela Chaudhari, MD (Guest):  Of course. Well thank you so much for having me today. I’m very excited to tell you about our fairly new program call the P2P Network. This is a program that was created as a physician peer support program designed to help physicians cope after adverse events. We know both from evidence as well as our own personal experience as physicians, that after an adverse event, some physicians may feel sadness, guilt, anger, loss of self-confidence. All of these symptoms left untreated, can actually end up leading to physician burn out. And the goal of our program is really to support our physicians who experience these symptoms after an adverse event when it occurs. We hope this can build our community of physician support and help prevent more long term issues with physician burn out in our workforce.

Host:  So important what you’re doing Dr. Chaudhari. So, how is P2P providing support during this pandemic and how has the program shifted to help physicians in these unprecedented times?

Dr. Chaudhari:  Well you know, we’re actually a very new program at Northwestern. We just started the program earlier this year. It was actually the brainchild of a program called the Scholars of Wellness here at Northwestern that was created by Dr. Joan Anzia and our current Director of Physician Wellbeing Dr. Gaurava Agarwal. Through their guidance, and with the help of that program team, I was actually able to develop a physician peer support network within my own department of Obstetrics and Gynecology. And once it was established there, they actually asked me to run it and begin it here at Northwestern. And so, really, we went live with all of this programing just in February of this year. So, just prior to the start of COVID pandemic. And we were quickly seen with the decrease in elective surgeries and admissions at the hospital that actually we were getting less adverse events reported to us through our risk management system. But we also began to see a number of physicians start experiencing different types of difficulties in their coping such as fear of COVID exposure for both themselves and their families, difficulties in quarantine, discomfort with lack of knowledge about the disease and the treatment options available.

So, we quickly made a pivot to try to support our colleagues experiencing these new types of adverse events. Different than what we’d started with but coming from the same perspective of how they make us feel as physicians.

Host:  Wow, it’s so important and so interesting. Tell us a little bit about why mental health support for providers is so important at all the times. As you said, you started this before the pandemic but especially now and you mentioned some things that really, really affected me when you said their fear of COVID exposure and for their families. Tell us a little bit about the mental health services that you offer and why it’s so important.

Dr. Chaudhari:  Yeah, so our physicians – it’s pretty amazing. I work with such an amazing and resilient group of physician workforce at my institution. I’m always impressed by how much they deal with and can cope with on an everyday basis. But we know that adverse events create feelings of decreased self-worth, feelings of decrease in self-confidence and we know that those things can then perpetuate, and impact patient care down the road. I’d like to say really that most of the physicians as they go through this pandemic feel much like the rest of the community at large. They are worried about their personal health, their family health, their finances, job security, the economy, home schooling, even toilet paper. But as physicians, we also see the personal health of our patients impacted by this pandemic. And that personal impact on our patients really affects the physicians in different ways. Some people actually find that all of the new work that we’re doing around the pandemic, the new treatments that we’re developing, the ability to get people well when we didn’t think we could before; they are quite invigorated by creating all those new protocols.

And other physicians feel like they are floundering. They are frustrated that they don’t know how to help their patients, they feel as though they have constant fear of not doing enough at work and also bringing things home. And those sorts of feelings can just perpetuate and make people feel less and less sure of themselves. So, knowing that, we know that the mental health of physicians impacts the way they treat patients and we know that by kind of nipping it in the bud, before it turns into a major burnout problem, that we really can help physicians learn to cope better with these adverse events so they’re something that they can learn from and thrive afterwards rather than just surviving and moving forward.

Host:  Well then tell us some of the tools and strategies that physicians can use to stay well during the pandemic and as you said, with burnout and the stress of being a healthcare provider now and all the time, really. Give us some tools and strategies that you are using with the peer support network.

Dr. Chaudhari:  So, I think most of the tools that we’re usually using to cope at difficult times are the same as what we’re using now, really. Healthy eating, exercise, trying to find balance between home and work, though I feel like that’s more challenging when many people are working at home. Spending time with family and friends even though now we need to do that in a more socially distanced or virtual manner. I really think though, utilizing your colleagues and your community at work to discuss events at both work and home can be very beneficial. Many physicians tell me that they feel like many of their friends and even their family members can’t really understand how they feel. Coming to work, coming back to work, changing in the garage, showering and scrubbing everything down prior to coming into their homes to avoid sort of exposing their families. We know that that support of your community and your physicians around you is really important. And for our Northwestern physicians, we hope that they’ll begin utilizing P2P even more as a source of peer support if you don’t feel like you can talk to your direct colleagues about it. We have physicians from across the institution that are really here to give you nonjudgmental support.

Host:  Well what an amazing program. So, for physicians who are listening, who might be interested in starting a program at their own hospital; share examples of how both organizations and individuals can create an environment that supports this wellness for physicians.

Dr. Chaudhari:  That’s a difficult one Melanie. I think peer support is really of utmost importance to create community and engagement amongst physician teams. I really think it belies organizations to create structures so peer support is feasible, so that it’s not really taking time away from physicians that they would usually be spending at home with their families. Because that alters our worklife balance even more. It shouldn’t be an institutional requirement. It should be an offering that’s available to people. I also think that organizations need to be supportive to ensure that these discussions are confidential, non-reportable, non-discoverable. Physicians won’t feel comfortable talking about their feelings, talking about how they are coping with some of these difficulties if there’s a constant fear of retribution. And finally, I can’t stress enough, the importance of if developing a program, training the supporters to really help with coping. Even my most senior peer supporters that have been in long-term mentorship roles and debriefing roles found that the basis of peer support was very different than what they had been doing for their colleagues. Details of the event are far less important than actually how they are coping with those events and how they’re looking to move forward in their work after that.

Host:  Dr. Chaudhari, do you have some red flags that other physicians would recognize in their workmates that would alert them that this particular person is experiencing some of these things and possibly mental health issues? As you said, some people are reluctant to seek help because they think maybe it’s going to go on their record or change their work environment. Are there some red flags that you think people should be noticing that might say, you know join the network, get involved, we can help?

Dr. Chaudhari:  You know I think it’s always – we as physicians, it really needs to be on us to look at our other physicians and to check in with them to see how they are doing. It is very easy in the elevator to see someone with tears in their eyes or with an angry expression on their face and to turn the other direction. And I really think as physicians, we need to be together to support one another. If you see that your colleagues seem to be more frustrated at work, seem to be pulling away from work, seem to be less engaged with their patients than they previously were; those can always be very subtle signs that they’re having some difficulties with coping. And sometimes, it’s peer support that they need and sometimes they need even more intervention, sometimes meetings with a therapist or a psychologist to really talk through some of the issues that they are having. But I think it’s very, very important that we just start paying attention. We are so good at paying attention to those small factors in our patients looking for disease processes. But sometimes in our colleagues, we shy away from addressing them for fear that they will be embarrassed, or you’ll be embarrassed. And we really need to stop being embarrassed and start approaching our mental health and our wellbeing head on.

Host:  What a great point and such a great program. As we wrap up, is there anything else you’d like physicians to know about the program and the resources that are available through the P2P Network at Northwestern Medicine and how physicians feeling this extra stretch can reach out to you?

Dr. Chaudhari:  You know I really call on all physicians at my institution to utilize peer support as they feel they need. P2P is available all the time. We can be reached by email at peersupport.central@nmw.org. You can also reach it through NMI Interactive through physician wellbeing page. You can call in for yourself. You can also call in for a colleague. And it can be anonymous, or we can give your name, whatever you prefer. This is not a program that creates any retribution. There’s no follow up at a larger scale with the institution. It’s really just physicians helping physicians. For physicians that might be listening from other institutions, peer support can really be invaluable for a struggling colleague. If someone looks like they are struggling, ask how they are doing rather than turning away. And finally, at an organizational standpoint, I really think resources spent on ensuring your physician workforce is well are invaluable. We know that burnout in physicians can lead to poor patient outcomes and medical errors and by addressing issues with coping after adverse events such as this peer support program along with addressing many other systems problems that can lead to physician burnout; we can really improve the overall health and wellbeing of the workforce and therefore of our patients.

Host:  Great information Dr. Chaudhari. Thank you so much for coming on. What an important aspect of wellness that you’re working on for other physicians. Thank you again. And that concludes this episode of Better Edge, a Northwestern Medicine podcast for physicians. To refer your patient please visit our website at www.nm.org. Please also remember to subscribe, rate and review this podcast and all the other Northwestern Medicine podcasts. I’m Melanie Cole.