Psychiatrists as Chief Wellness Officers

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

As we continually hope for reduction of the physician burnout epidemic, a chief wellness officer (CWO) is one of the possible methods, as discussed in my last column, “Chief Wellness Officers in Unifying Medical Systems and Physicians.” In many ways, this new leadership position is in a promising trial and error process. One of the uncertainties was which medical specialty, if any, is best for that role. Psychiatrists, as advocated in our edited book on physician burnout, is one of them.¹

Fortunately, more information is emerging in regard to the actual experiences of psychiatrists in that role. One is Kirk Brower, MD, at the University of Michigan Medical School. He became a CWO there about a year before the pandemic. That enabled him and other CWOs at the time to find cracks and strengths that already existed in their wellness systems before the extreme stress of the pandemic on the system and workers.² The physician burnout epidemic was also in existence nationwide and already impinging on the mental health of physicians and patient care outcomes.

The new position of CWO has generally been dedicated to making staff and student well-being central to the organizational culture and strategies. Statements of appreciation are inadequate without actions that demonstrated sincerity.

Even as we move on and try to prematurely forget the ravages of the pandemic, CWOs can recognize the leftover mental health repercussions. Staff often went from heroes to villains. The organization had to recover from financial losses, including letting valued pandemic staff go. Soul-searching became necessary for leadership, and posttraumatic symptoms emerged after some delay.

Dr Brower and his CWO colleagues ended up recognizing that so many of the traditional strengths of psychiatrists were important and translatable: adequate communication, understanding the continuum of mental well-being to diagnosable disorders, how to apply psychological first aid, and how to move to posttraumatic strength and resilience.

As the pandemic wound down, Dr Brower was interviewed for an episode of the AMA STEPS Forward.³ He mentioned how his subspecialty in addictions in psychiatry prepared him well for working with individuals who did not want to change, and the interviewer confirmed that such a background was not rare among CWOs. Both patients, especially psychiatric ones, and organizations are often resistant to change. He recognized the need to measure not only burnout, but work/home flexibility, feeling valued, psychological safety, leadership connection, and professional fulfillment, all of which hopefully increase.

In contrast to Dr Brower’s relatively long experience in being a CWO, another psychiatrist just began in February at a different sort of large institution. This is Jessica “Jessi” Gold, MD, MS, at the University of Tennessee System.⁴ Here the priority is on mental health care for students and faculty, more obviously a traditional psychiatrist role. She feels that her clinical experiences and lived experiences of being a psychiatric patient herself are critical to success. She, too, recognizes the need for understanding the spectrum of mental health.

I will endeavor to also cover CWOs from other medical specialties but, all other variables considered and seemingly equivalent, psychiatrists like these 2 seem to offer extra value for the position of CWO.

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.

References

1. LoboPrabhu, S, Summers R, Moffic HS. Combating Physician Burnout: A Guide for Psychiatrists. American Psychiatric Pulblishing; 2019.

2. Brower K, Brazeau CMLR, Kiely SC, et al. The evolving role of the chief wellness officer in the management of crises by health care systems: lessons from the Covid-19 pandemic. NEJM Catal Innov Care Deliv. 2021;2(5).

3. How a chief wellness officer manages his own burnout. AMA Steps Forward Podcast. September 14, 2022. Accessed February 27, 2024. https://www.ama-assn.org/practice-management/physician-health/how-chief-wellness-officer-manages-his-own-burnout 

4. Thomas K. University of Tennessee’s first chief wellness officer: mental health should be ‘almost boring.’ Knoxville News Sentinel. January 14, 2024. Accessed February 27, 2024. https://www.knoxnews.com/story/news/education/2024/01/14/university-tennessee-chief-wellness-officer-prioritizes-mental-health-students/72105212007/