Career and Life Planning Guidebook for Medical Residents

R E A D : Restoring Joy to the Practice of Medicine: Finding Meaning and Purpose in Your Work Donald Berwick and colleagues in 2008 developed a framework for the redesign of healthcare that highlighted a desire to transition to population health. The so-called Triple Aim emphasized the goals of reducing per capita health care costs, improving the patient care experience, as well as improving the health of populations. 35 In order to accomplish these goals, it is necessary to have a highly-efficient, effective healthcare organization. This will not happen without an engaged and productive workforce, which the Triple Aim did not explicitly acknowledge. Sikka, Morath and Leape proposed a modification of the Tripe Aim to include the experience of physicians and others in providing care to patients. 36 This so-called Quadruple Aim acknowledges the importance of physicians-indeed all employees-in finding both joy and meaning in the work they perform. The Institute for Healthcare Improvement argues that caring and healing are naturally joyful activities. The joy which is the natural consequence of these activities needs to be leveraged to mitigate against burnout. This strategy has an advantage in that it changes the focus in an organization away from avoiding burnout to pursuing joy and engagement as a process-related goal. Moreover, it is important to recognize and embrace the reality that joy in medicine is possible. “We have chosen a calling that invites people who are worried and suffering to share their stories and allow us to help. If any work ought to give spiritual satisfaction to the workers, this is it. “Joy,” not “burnout,” ought to rule the day.” 37 Effective organizations are efficient at identifying and removing the existent barriers, which impede the ability of the physician to experience the joy which should be inherent in this work. It is imperative that the physician pursue that work with compassion and gratitude, aware of the deeply personal intrinsic meaning and purpose immanent to it. A disciplined program of self-care will help to maintain an equanimity of spirit needed to remain healthy in a demanding, stressful but incredibly rewarding profession. As you’ll see in the following chapter, just as we work to provide preventative care for many of life’s often devastating diseases, the ounce of prevention is more than worth the pound of cure. Learning to be well, embracing the idea that self-care is a priority, and cultivating a toolkit of resources for wellness is indeed the “vaccine” that helps prevent the disease of burnout Physician Burnout 45 WWW.PHYSICIANCAREERPLANNING.COM