Physician well-being in allergy and immunology: Creating a culture of wellness

Growing up with allergies: Transitioning from adolescence to adulthood

Allergic disease management for adolescents and young adults requires consideration of unique psychosocial challenges and opportunities. Erik Erikson's model for the Stages of Psychosocial Development is a useful lens through which we can understand adolescent and young adult experiences with allergic and immunologic disease, particularly with regard to identity and relationship development. It is important to provide anticipatory guidance for patients who are transitioning environments (eg, home to college), with attention to the anxiety-provoking demands for increased responsibility on top of new stressors such as academic and vocational demands. It is critical that health care professionals use an empathetic, shared decision-making approach regarding the emotional impact of allergy on a patient's social engagement. A patient's ability to develop positive lifelong habits is also shaped by their environment's "culture of wellness," and clinicians can encourage habits to promote healthy choices and effective disease management. Social media provides opportunities and challenges as a conduit for both social connection and possible misinformation. Overall, allergic disease management in adolescents and young adults is a "high-risk, high-reward" period of time-and with awareness, anticipation, and proactive action, health care professionals can better serve patients by leveraging this transitional period to promote positive approaches to management of allergies and asthma, trusting relationships, and personal responsibility.

Women in Allergy and Immunology: The Future Is Female, Let Us Soar!

Despite increases in the number of female physicians in the past 50 years, women remain underrepresented in key areas of medicine, such as practice owners and partners, professional society leaders, principal investigators, full professors, chairs, and deans. Women are paid less, oftentimes for more work. Allergy and Immunology (AI), as a specialty, lacks substantial workforce research, but trends across specialties are consistent. We review what is currently known about women in AI and consider barriers to practice, advancement, and contribution. Through a new inquiry, we find that the challenges women in AI encounter can be summarized through 6 themes: work-life balance, professional advancement, salary equity, mentorship and sponsorship, bias, and sexual harassment and misconduct. Together, we must address these challenges head-on and provide an equitable environment for women in AI to thrive, especially those affected by intersectionality. To do so, we suggest targeted, tangible actions to promote opportunities, offer institutional support, and advance reporting and culture change outlets across AI settings.

Allergy and Immunology Physician and Patient (Un)Wellness During COVID-19 and Beyond: Lessons for the Future

The COVID-19 pandemic increased stress and reduced wellness for patients and physicians alike. The uncertainty, frequent changes, fear of illness and death, and supply chain issues taxed an already broken health care system. The pandemic undermined the factors that allow for a healthy workplace: control, predictability, and certainty. During this time, rates of depression, suicidality, and anxiety all increased among physicians and the community at large. These challenges were aggravated by disagreements regarding masking and vaccinations. These factors, as well as the degree to which people felt valued or not also contributed to burnout. Some changes such as the transition to telemedicine, although initially stressful, led to patient satisfaction and allowed clinical care to continue. Other changes, such as trying to homeschool, or watching young children while also trying to work were less desirable. Patients and physicians did their best to combat isolation, fear, anxiety, and the numerous societal changes. Burnout fluctuated throughout the pandemic related to local and systemic factors such as rates of infection, vaccination, supply chain issues, and individual support. The pandemic highlighted problems with our health care system, including structural racism, health care disparities, and how easily the system can be overwhelmed. Physicians may have been thrown into roles they did not feel comfortable filling and may have had insufficient staff to practice in the way they wanted. These factors led to frustration among patients and physicians alike. The National Plan for Health Workforce Well-Being outlines the need for health care reform to allow for effective and safe health care while protecting clinicians from burnout.

Evolution of a physician wellness, engagement and excellence strategy: lessons learnt in a mental health setting

OBJECTIVE

This study aims to evaluate the impact of several organisational initiatives implemented as part of a physician engagement, wellness and excellence strategy at a large mental health hospital. Interventions that were examined include: communities of practice, peer support programme, mentorship programme and leadership and management programme for physicians.

METHODS

A cross-sectional study, guided by the Reach, Effectiveness/Efficacy, Adoption, Implementation and Maintenance evaluation framework, was conducted with physicians at a large academic mental health hospital in Toronto, Canada. Physicians were invited to complete an online survey in April 2021, which composed of questions on the awareness, use and perceived impact of the organisational wellness initiatives and the two-item Maslach Burnout Inventory tool. The survey was analysed using descriptive statistics and a thematic analysis.

RESULTS

103 survey responses (40.9% response rate) were gathered from physicians, with 39.8% of respondents reporting experiences of burn-out. Overall, there was variable reach and suboptimal use of the organisational interventions reported by physicians. Themes emerging from open-ended questions included the importance of addressing: workload and resource related factors; leadership and culture related factors; and factors related to the electronic medical record and virtual care.

CONCLUSIONS

Organisational strategies to address physician burn-out and support physician wellness require repeated evaluation of the impact and relevance of initiatives with physicians, taking into account organisational culture, external variables, emerging barriers to access and participation, and physician needs and interest over time. These findings will be embedded as part of ongoing review of our organisational framework to guide changes to our physician engagement, wellness and excellence strategy.

The "Bayés Spirit" as a guide for new generations: How to combine one's personal life and friendships with science and profession

Recent studies suggest that up to a quarter of physicians in training suffer from burnout and psychological disorders. Scientist-physicians, cardiologists, cardiology residents, and first-year medical residents seem to be more prone to developing varying degrees of emotional distress. Concerned about the new generations of clinicians and researchers, the authors aim to provide guidelines for reconciling professional success with a fulfilling and satisfying personal life. The figure of Antonio Bayés de Luna (cardiology and electrocardiology guru) is used as the ideal example to learn how to combine one's personal life, family, and friendships with science and their professional career. This can be done in a healthy and balanced way, prioritizing the former while continuing to have an intense dedication to the latter.

How does organizational culture affect employees' mental health during COVID-19? The mediating role of transparent communication

BACKGROUND

Over the years, the workplace landscape has significantly evolved, demanding an optimal psychological approach to establish an environment that values individual work and health. A firm's culture inspires it to adopt business practices that enable its employees to live healthier lives.

OBJECTIVE

The study aims to measure the mediating relationship of transparent communication between organizational culture and mental health in the Pakistani healthcare industry. The study also explores the relationship between organizational culture and mental health.

METHODS

The study collected primary data via purposive sampling from the healthcare employees of Pakistan between March and May 2022. The study's sample size consists of 509 respondents from the healthcare industry sector, and the research used Smart PLS software to measure the relationship through bootstrapping and algorithms.

RESULTS

Organizational culture has a positive effect on the employee's mental health. The study has found significant positive mediation of transparent communication and moderation of organizational trust between organizational culture and mental health.

CONCLUSION

The COVID-19 pandemic has deteriorated workers' mental health, causing considerable changes in the healthcare sector. Positive mental health at work is a critical factor that improves the working environment. As such, this study highlights the importance of mental health in the workplace setting. It extends the literature in the context of the healthcare industry, thus supporting employees' well-being. The findings suggest a significant relationship between an organization's culture and mental health. This study suggests the theoretical and practical implications for policymakers' and researchers' perspectives concerning employees and organizational culture.

Physician Flow at Work: Examining Work Absorption, Clinical Flow, Work Fulfillment, and Flow Thieves

BACKGROUND

The experience of "flow" at work correlates with positive job outputs and work-related attitudes. Very little current literature describes flow at work in physicians, who experience significant barriers to optimal work outputs, also known as flow thieves (e.g., case interruptions, documenting care). This study aimed to develop a measurement for physician flow (P-Flow) at work and examine the association of P-Flow with physician burnout, job satisfaction, and well-being.

METHODS

A pilot instrument was tested with items measuring P-Flow at work. After the pilot administration, a 14-item physician flow (P-Flow-14) scale was administered to physicians. In addition to the P-Flow-14 scale, physician respondents completed items measuring burnout, job satisfaction, and well-being.

RESULTS

This study specifies initial psychometric evidence of P-Flow-14 and 7-item P-Flow instruments for researchers interested in studying flow at work in physicians. For each P-Flow instrument, higher levels of the flow experience correlated with superior levels of well-being (p < .01) and job satisfaction (p < .01), and less burnout (p < .001). Results showed initial psychometric evidence of derived subscales (work absorption, clinical flow, flow thieves, work fulfillment) for application in future research. Results showed associations between flow experience by age group and physician specialty.

CONCLUSIONS/APPLICATION TO PRACTICE

To enhance well-being and job satisfaction, physicians should aim for concentration and immersion in clinical duties while reducing unnecessary distractions. These findings can be applied by employers and can guide further research on work interruptions and patient safety. Future research can validate the P-Flow scales and subscales to assess interventions aimed to improve the physician work environment.