Safeguarding Physician Wellbeing: Using Checklists for Personal, Professional, and Psychological Safety

As many of us are beginning to understand, the United States is currently facing an epidemic of physician burnout. This growing, difficult challenge has been accelerating throughout the COVID-19 pandemic as more and more physicians experience the signs of an anticipated serious national shortage of physicians within the current decade.

Obviously not only is this bleak trend bad for physicians, it is bad for patients as well especially as the US population grows older and increasingly sicker. The Washington Post, The New York Times, and numerous other publications large and small have been sounding the alarm on this issue for a long time now. Yet despite increasing media coverage, published data, and identification of system-based factors that erode physician wellbeing, no standardized systematic solutions have been introduced across all practice settings for all specialties and subspecialties of physicians.

Patient safety is impossible without physician safety. Ensuring physician personal, professional, and psychological safety is of paramount importance. In other words, it is critical, not just for all practicing physicians and trainees themselves, but society at large, that an actionable, standardized, and relevant burnout prevention and remedy for all practicing physicians and trainees be found ... and soon.

"The patients--and only the patients--matter" is ingrained in physicians and surgeons from the time they begin their training. While noble, this fundamental belief makes physicians more susceptible to pushing themselves to the point of danger. Burned-out physicians are often left with no other option but to leave the profession entirely due to the physical and/or mental health struggles that make their continuing practice untenable. Physicians and surgeons are forced to dissociate their own emotions, distress, and human needs against unrelenting productivity pressures, metrics, continual yet toss of autonomy, and secondary traumatic stress as unavoidable occupational hazard. The risks physicians face are thus ubiquitous in all areas of life: personal, professional, and psychological. Naming the problem is one thing
effectively addressing the problem is another.

Regulatory agencies, aviation industry, and businesses have adopted use of checklists as described by Dr. Atul Gawande. Hospitals, health systems, and the culture of healthcare have readily adopted the use of such checklists by physicians to improve patient safety, minimize medical errors and related deaths and morbidities. However, there are currently no applications of "checklists" as a standardized solution for physician burnout.
This book offers a novel framework that utilizes various checklists to optimize physician wellbeing in all dimensions and support career longevity. By employing a "physician safety checklist," physicians across the entire spectrum of their career (including during training) can achieve personal, professional, and psychological protection, career satisfaction and longevity, and mitigate their risk of suicide. This framework as a proposed unique "solution" to positively impact the crisis of physician burnout will hopefully save many physician lives, and thus protect a unique and critical workforce for society. Vignettes are included in the book to highlight personal stories of burnout and despair as well as resilience through professional connections in various forms and settings in the practice and education of medicine. While the author focuses primarily on physicians, many of the ideas and solutions she presents are applicable to nurses, physician assistants and other professionals who are stressed and burned out.