The stresses of working on the frontlines of the medical profession are legend, and data shows that physicians are at greater risk of depression and depressive symptoms than the general population and
double the average suicide rate.
Just a few years ago, Kevin Sowti, MD, MBA, was experiencing these troubling symptoms of burnout. Fortunately, Sowti, the medical director of Chester County Hospital’s Hospitalist Group and section chief of Hospital Medicine, recognized his symptoms, which enabled him to take action to treat them — including some leadership training so that he could help support the physicians he leads through similar struggles.
In 2019, Sowti’s role with the hospital’s wellness and entertainment committee took on a new identity and focus thanks to a collaboration with colleague Aneesha Dhargalkar, MD, who had already begun her own initiative among colleagues spurred on by her own deepening exhaustion.
A Lesson in Vulnerability
For much of its existence, the committee had staged regular social gatherings in an effort to keep the hospital’s growing medical staff connected. Unknown to Sowti at the time, Dhargalkar, an emergency medicine physician at Chester County Hospital, had also begun formally assessing the mental and emotional health of her colleagues — an idea inspired by her participation in the wellness committee at her children’s school district. “I started to wonder whether some of the issues and initiatives they discussed were applicable to my work environment,” she said.
After sharing her findings about burnout, resiliency, and the value of wellness programs with her fellow doctors and advanced practice providers in the emergency department, she began asking them to complete a survey about how they are feeling every six months. The results enabled her to see and respond to a widespread interest in getting together outside of work.
What she noticed from the surveys was “an improvement in how people were feeling,” Dhargalkar said. “I mean, it wasn’t drastic, but there was mild improvement in how people were feeling about burnout. People seemed to feel less emotionally exhausted, and have a greater sense of personal accomplishment in what they’re doing. The bigger change, I think, was an openness to discuss burnout among the group. Now we’re having conversations one-on-one or among three or four of us about what we’re feeling and the issues that we’re facing. If nothing else, it’s fostered a better sense of camaraderie.”
Dhargalkar has since moved to part-time, helping alleviate a lot of her own concerns, and leading her to collaborate with Sowti on the wellness and entertainment committee, now known as the Chester County Hospital Wellness Committee. Dhargalkar said its mission is “to eliminate burnout, reduce suffering, and promote a culture of wellness for our community by raising awareness, improving understanding, and creating and implementing programs and initiatives.”
To enact any sort of change, burnout needs to be discussed more openly and honestly, Dhargalkar said. To that end, she and Sowti began attending departmental meetings across the hospital, not only to hear their colleagues’ ideas but also to underscore the urgency and need of such a committee.
Michael J. Duncan, the hospital’s president and CEO, has been very supportive of the committee’s efforts, which is integral to affecting meaningful transformation, Sowti said.
Burnout Amid a Pandemic
In March 2020, the spread of COVID-19 went from a few isolated cases in the region to a full-on oubreak in just a few days. The pandemic spurred a renewed energy and vitality within providers, reconnecting them to the reason they chose the medical field – to take care of patients.
“I feel like it’s been much more than a year that we’ve been going through this,” Dhargalkar said. “It’s been a whirlwind.”
Fortunately, the seeds that the committee was able to plant in the months prior to the pandemic seem to have given way to a more open and accepting culture at the hospital, which put many in a better position to endure the chaos that no one could have seen coming.
Gradually, Dhargalkar and the wellness committee found specific ways to engage the hospital’s physicians and advance practice providers to help them cope with the pandemic while still focusing on their initial goal of reducing widespread burnout. In honor of National Doctors’ Day on March 30, 2020, the committee hosted a virtual observation in which about 50 people participated. “That was a great way for us to maintain social connectedness, which, I think, was a big piece that was missing from our personal and professional lives during the first couple of months of COVID,” Dhargalkar said.
The committee also created a weekly wellness e-newsletter that was distributed among the hospital’s medical staff. Each issue had a theme. One explored the different facets of grief and loss. Another detailed the importance of interacting amid social isolation restrictions. The newsletter became monthly in June, and now it’s oriented more toward general wellness insights.
A pre-recorded webinar was also presented to the group that described ways health care providers could be resilient in the face of the specific challenges they’re facing during the pandemic. A live session, titled “Self-Compassion for the Health Care Provider,” followed.
That same month, the committee launched an employee assistance program (EAP) that’s designed to address individual, work-related emotional and mental health concerns. A Penn Medicine Behavioral Health EAP was already in place at the hospital, but Chester County Hospital is also home to a number of physicians and advanced practice providers who aren’t specifically employed by Penn Medicine. This new, separate service is available to everyone who isn’t eligible for the Penn Medicine program.
Dhargalkar also participates in Penn Medicine’s Workforce Wellness Committee, which includes representatives from all the hospitals in the Health System. One of its initiatives includes PennMedicineTogether, a website the committee launched in April specifically for the Penn Medicine community. Here, staff from across the Health System can access a wide variety of resources and links to help them take care of their physical health, life necessities, and their families. Peer support and access to therapists is also provided at no cost.
“Most providers consider this to be a vocation for which they’re willing to sacrifice a lot,” Sowti said. “But we need to empower them to have a say in their daily lives and recognize that we can do a lot, but we can’t do everything. That gets lost at times.”
“I think the staff know this is something Dr. Sowti and I care very much about and we’re working to address, even in the middle of a pandemic. We want to be there to support everyone,” Dhargalkar said. “Over the last several months, people have reached out to me and asked for advice and resources. I’ve also been able to better help colleagues who’ve told me they’re feeling stressed or burned out. So, I do think it’s making a difference.”