Hitting “send” on a letter sent to 34,000 co-workers can never be a stress-free moment — especially if the letter shares highly personal reflections on one’s mental health.
But AMA member Nigel Girgrah, MD, PhD, has no regrets about sending the letter two summers ago, especially after it received an overwhelmingly positive response and helped spur engagement with his colleagues on the value of self-care and seeking help when needed.
“I didn’t know what was going to happen,” said Dr. Girgrah, a transplant hepatologist and director of wellness at New Orleans-based Ochsner Health and a member of the AMA Health System Program.
“I didn’t know if the state licensing board would come knocking on my door,” he added. “It felt a little risky. But I think it was the right thing to do – certainly at that time and for our employees.”
The Doctor. Girgrah, who is also the medical director of the Ochsner Liver Transplant Program, shared his story during “Creating a Culture that Supports Well-Being” (Apple Podcasts | Spotify), an AMA STEPS Forward® podcast.
New Orleans, one of the country’s first pandemic hotspots, was experiencing another outbreak of COVID-19 and Dr. Girgrah was celebrating the anniversary of the loss of her son to cancer. Due to travel restrictions and a knee injury, he was unable to use his normal coping mechanisms – traveling to see friends and family in Canada or exercising.
This led to the letter in which he acknowledged that he had sought help. The letter’s response led to a realization.
“My ‘aha!’ was that everyone has their version of this story,” Girgrah said. “Historically, this letter, which we call the ‘Message from the Chief of Welfare’, was a rather sterile report on things we were doing in the office.
“But I shared a little bit about myself and then I spoke more widely about the issue of mental health in the healthcare industry and the response was overwhelming,” he added. “It was the most open executive letter with a lot of lengthy responses and people saying they were now going to ask for help.”
Dr. Girgrah recalls that while he had received early support from key members of the executive team on the topic of the message, he was still a little concerned about a backlash from Ochsner’s leadership. Instead, it led these leaders to adopt a “more vulnerable but authentic” communication style and to speak “more intentionally about mental health.”
Reducing physician burnout is a critical component of the AMA’s Recovery Plan for Physicians of America. You took care of the nation. It’s time for the nation to take care of you. It’s time to rebuild. And the AMA is ready.
Many American doctors suffer from burnout. That’s why the AMA develops wellness-first resources and highlights workflow changes so clinicians can focus on what matters: patient care.
Four-pronged approach
On the podcast, Dr. Girgrah described how Ochsner has changed to treat and maintain the mental health of its doctors, healthcare professionals and employees. On the same subject : GA AIDE press release.
Measure the mental health status of the team. Ochsner performs an “organizational biopsy” using an expanded Mini Z wellness index – a 10-item Zero Burnout Program survey – to identify job fulfillment factors and assess issues such as depression or post-traumatic stress disorder. at granular department and service line levels. With the help of the AMA, said Dr. Girgrah, this has led to the annual measurement of burnout levels for doctors and other staff with the ability to compare Ochsner to other systems.
Education and awareness. That includes talking about mental health “more broadly,” Girgrah said. Ochsner also has a professional wellness office “determined to help our workforce and employees find the resources they need to avoid disengagement, regain joy and find harmony.” Doctors and staff have access to webinars on personal and professional wellness, including 90-minute sessions on resilience, nutrition, mindfulness and post-traumatic growth.
De-stigmatize mental health. Internally, that means system leaders are more open and sharing what they’re going through regarding mental health, which “creates a more permissive environment for employees to seek help sooner,” Girgrah said.
Find out why healthcare system leaders must be open and authentic about burnout.
Looking upstream to resolve burnout. There was a need to go beyond being reactive and develop crisis coping mechanisms and reduce the frequency and severity of stressors. In addition, a resource group was formed where doctors could come together to talk about the unique stressors they face. Dr. Girgrah noted that Ochsner is willing to take an experimental approach in this area and uses the plan-do-study-act process to scale interventions that work and eliminate those that don’t.
