A photo of a male physician leaning against a wall.

The National Academy of Medicine publishes a plan to improve the well-being of health workers

WASHINGTON — The National Academy of Medicine launched its National Health Workforce Wellness Plan Monday to address the growing challenges of burnout among health care workers, at an event hosted by the Association. of American Medical Colleges (AAMC).

Their report, a response to longstanding concerns about burnout exacerbated by the COVID-19 pandemic (60% of physicians reported burnout in a 2022 survey), underscored the need for broad cultural change , investments in research and efforts to de-stigmatize mental health. .

Darrell Kirch, MD, president emeritus of the AAMC and former dean of two medical schools, noted that at least two or three of his former students died by suicide and “none of them asked for help. Obviously, in retrospect, they were depressed, [but] they were afraid to admit the distress they were in.”

A key priority area, according to the report, is to focus on reducing mental health stigma. Kirch pointed out that credentialing and licensing applications contribute to this stigma by asking clinicians if they have ever had a mental health problem.

More than half of state medical boards continue to ask such questions in applications, said Christine Sinsky, MD, vice president of career satisfaction at the American Medical Association, citing a map found on the board’s website. Dr. Lorna Breen Heroes Foundation.

“What a grossly inappropriate question. The [right] question is, ‘Are you medically fit to practice?’ Full stop,” Kirch said.

The National Academy of Medicine’s plan also aims to make mental health care more accessible. The report recommends increasing telemedicine options for mental health, as well as extending hours of availability, as many healthcare providers work long hours, and some in remote areas. He also recommends debt forgiveness programs to encourage greater interest in careers in mental health care.

While the action plan is about concrete programs and policies, it’s also about creating a positive culture, said US Surgeon General Vivek Murthy, MD, MBA. “It’s about changing the way we think about the people who are there to provide care and keep our communities safe. It’s about seeing them as whole people and not just skill sets. “

Clinicians like to talk about seeing “the whole patient,” he noted, but it’s just as important to see “the whole health worker…and we don’t do that.”

“We tell our health workers that their strength is defined primarily by the number of articles they can publish and the number of facts they can remember, the number of hours they can stay awake and the strength that they can work with without complaining. It’s just a shadow of what real real strength is,” he added.

To foster a culture of well-being, the report recommends setting “reasonable productivity expectations”, offering mentorship programs, ensuring work breaks are “expected and routine, not exceptional” and develop clear protocols for reporting and addressing discriminatory behavior.

Another priority area, according to the report, is investing in research and evaluation with the aim of developing response strategies to improve well-being. Significant national funding and effort has helped track the mental health of the general population, Kirch noted, and the same approach should be applied to clinicians. These tools should measure not only the number of workers suffering from burnout, but also “the degree of burnout and their associated mental health status,” he said.

Burnout is an occupational health issue, Kirch continued, but the path from burnout to a “true mental disorder” is short.

While the federal government can help, all institutions have a responsibility to invest in their workers, and “in a nearly $4 trillion-a-year health care system, there should be money available to invest in the welfare of workers,” he said. argued.

In conversations with wellness managers, one phrase Kirch said he hears often is “all burnout is local.” He learned that there can be two healthcare teams performing similar tasks, but only one is exhausted.

These issues can be tracked by individual institutions using diagnostic tools, including “hot-spotting” – more commonly used to track issues among a particular set of patients, such as “super-users” .

Once a problem has been identified, the next step is to implement a “rapid response” protocol to determine which “corrosive elements” are responsible, such as staff shortages, a toxic work environment or a lack of “social cohesion”, Kirch explained. . After determining root causes, institutions can work “with mutuality and support” to address them.

The 6-year journey of this plan stems from the efforts of dozens of people from the private and public sectors, including representatives from CMS, CDC, Veterans Affairs, and the Agency for Healthcare Quality and Research. .

That work isn’t done yet, said Victor Dzau, MD, president of the National Academy of Medicine. The next step is to actually implement these policies and strategies.

More than 30 medical, nursing and pharmacy organizations have endorsed the plan, and Dzau called on all members and partners to adopt and implement its recommendations.

If you or someone you know is having suicidal thoughts, please call or text Suicide & Crisis Lifeline at 988.

  • Shannon Firth has reported on health policy as MedPage Today’s Washington correspondent since 2014. She is also a member of the site’s Enterprise & Investigative Reporting team. Follow

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