Hope, Direction and Solutions: Personal Journeys in the Desert

AAPL’s first “Beyond Burnout & Resilience” workshop “far exceeded my expectations,” one attendee says, summarizing the group sentiment.

Three days in the Arizona desert never promised to solve physical and mental fatigue associated with burnout — not by itself, or at least not overnight — but as 33 physicians learned during a reflective and transformational workshop in early November, it can be a catalytic leap toward restoring joy to their personal and professional lives.

The American Association for Physician Leadership held its first “Beyond Burnout & Resilience: Enduring Solutions for Transformation” workshop in and near Scottsdale, Arizona, in the hopes that it would “provide hope for physicians who felt trapped in their circumstances, that they could feel equipped to improve that circumstance,” says Dian Ginsberg, AAPL’s director of career services and one of the organizers of the event.

The program included group exercises on addressing organizational issues and decision-making under pressure, in addition to excursions into the Arizona desert and to a botanical garden. | AAPL

That was a lofty goal for a first-time program, and yet it “far exceeded my expectations,” one attendee says, summarizing the group sentiment. Making that possible was a mix of subject-expert facilitators and perspective-shifting experiences that extended far beyond the walls of a classroom setting — an experience AAPL President and CEO Peter Angood, MD, FRCS(C), FACS, MCCM, describes as “hugely transformative.”

The workshop was designed to help physicians find balance, well-being and synergy by increasing self- and professional awareness, as well as clarity surrounding the complexity of the organizations in which they work and the health care industry in general.

“The success of this AAPL initiative will become the foundation for a social movement that is very much needed in order for broad-based and sustained successes to occur,” Angood says of the workshop. “Physicians are highly motivated, and it’s highly frustrating for them to not be able to deliver what they came into this profession for, and we have a decreasing morale in that workforce. Something’s not right.”

Beyond Burnout & Resilience addressed those issues while taking a holistic, solutions-based approach toward two primary objectives:

Equipping individual physicians to better cope with burnout treatment and avoidance.

Equipping individuals with the tools to assume leadership roles and help others deal with burnout.

Achieving those objectives begins with open, honest and meaningful discussions about a condition Chip Souba, MD, MBA, ScD, calls “a mountain with no top.” Souba, former dean of the Geisel School of Medicine at Dartmouth University, was among four prominent workshop faculty members. Others:

Dan Friedland, MD, president and CEO of Super SmartHealth and an expert in transforming burn-out into resilience. He addressed the psychology of burnout and how to lead from within.

Dan Diamond, MD, a family medicine physician and 30-year veteran of disaster relief. He was director of a medical triage unit in New Orleans, Louisiana, after Hurricane Katrina, where he identified the at-tributes of those thriving under high pressure and applied those attributes to the work environment to combat burnout.

Don Kennedy, DO, a family and geriatric medicine physician, founder and CEO of The Surfer’s Journey. He led a self-discovery excursion into the desert.

“Each one [of the faculty] had their own area of expertise and how it all fit into becoming a leader and working within the system to make change for burnout,” says Rick Holland, MD, an emergency specialist from Grand Rapids, Michigan. “And the great thing about it was that each was very authentic about what they were teaching. … You could tell that this is their passion and this is what they did.”

Holland, an emergency physician for 18 years, says years of enduring burnout symptoms, including fatigue, unhappiness with his job, diminished compassion and a sense of being overwhelmed, inspired him to become an advocate for change by forming a burnout committee at work, which, in turn, inspired him to attend the workshop.

That inspiration was shared by Mario Victoria, MD, CPE, FAAPL, MMM, who, as chief medical officer at Samaritan Medical Center in Syracuse, New York, is starting a program to address burnout at his organization.

“I went there looking for interventions that I could bring back home — things that I could do here to either change the environment or somehow help physicians to avoid or recover from burnout,” Victoria says. “There’s a lot of literature out there about burnout and a lot of people talking about it, but what made this event different was the quality of the faculty. They were top-notch. Their presentations were well-researched and well-delivered and their stories kept me engaged throughout the workshop. I left with a sense of excitement and empowerment.”

The program included group exercises on addressing organizational issues and decision-making under pressure, in addition to excursions into the Arizona desert and to a botanical garden. These were presented as opportunities to discuss, reflect, face vulnerabilities, symbolically burn troubles, and separate each person’s personal and professional identities.

The takeaway was that although burnout can lead to an overwhelming sense of inescapable futility, it also can stimulate growth and transformation essential to preserving physician well-being.

“The only way to make lasting change is to restore the right mindset, then engage in the work, invest in others, and reconstruct a better environment,” Diamond says. “How do we do that? By starting with the ‘thriver's mind-set‘ that says, ‘I have the power to make a difference, and it's not all about me.’ It's hard to ‘do no harm’ when working in a harmful environment, [and] it's tempting to blame the organization for everything, but that doesn't work either.”

Beyond Burnout & Resilience was designed to enable physician leadership to function at its highest and most-effective level, Souba says, describing it as “a force multiplier that will begin to move this initiative forward, and ultimately spread like a virus. Once you commit to something that’s bigger than your own personal agenda, watch out. People will step up to the plate and really good things happen.”

Adds Holland: “I thought it was a fantastic program. It may been one of the best conferences I’ve ever been to. All the people that were there were there for their own reasons, but the group melded really well together. I thought, man, I could probably go to that again sometime, because there was so much benefit as far as looking at making changes.”