Hello again, friends, I have missed you!  It’s been an exciting and exhausting month of travel, nature, speaking, and learning.  My brain and heart are both so full I can hardly stand it, and all I want to do is write and talk about it!  Last week I attended yet another phenomenal meeting!  I feel another quantum leap coming on, both professionally and personally.  Below is the spontaneous post I wrote over lunch on Tuesday, and I wish I had published at the time.  I would have made my own deadline and… well whatever, it’s all about learning to put myself out there with less fear and judgment.  *sigh*

Now I have some time to synthesize and process…  Here’s hoping I can articulate and share effectively! 🙂  Thank you for reading, and please share your thoughts! –Cathy

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Tuesday, October 20, 2015

Hello from Washington, DC! I submit this report from Day 2 of the CENTILE Conference, 2015, the International Conference to Promote Resilience, Empathy, and Well-Being in Health Care Professions.  I am in symposium heaven—it’s a veritable love fest of like-minded and like-souled physicians, nurses, educators, scientists and others, all here to share what we’re doing to make medical practice and practitioners healthier!

In the spirit of sharing and collaboration, I present in this post the highlights of the conference so far, and invite you all to reply and share how they resonate with you. Let’s explore how we can make not only medicine more humane, but life on Earth, and all of our relationships, too!

Caveat: My own thoughts will appear in [brackets]. The other ideas come from my handwritten notes, and I make no claims of content accuracy.  They are what resonate with me personally, experienced through my existing filters…  I hope they move you, as well.

• ‘Burnout’ may be an obsolete term, fixing our gaze on what’s wrong. It may benefit us all more, rather, to shift our attention to wellness, in all its forms and layers. [“Energy flows where attention goes.”]
• Six areas of job-person fit or mismatch:
  • Workload
  • Control (choice, discretion, voice)
  • Reward (compensation, recognition, acknowledgement –[“I see you.”])
  • Community (workplace RELATIONSHIPS!!!)
  • Fairness (promotions, etc. [!gender bias])
  • Values ([Your WHY—does it align with the organization? Does the organization walk its talk? Does it allow or hinder you to walk yours?])
• There are mountains of burnout data, and only molehills for interventions and their outcomes—now we know what to study!
• Individual strategies are not enough, the system/context also needs to change in order for providers to be well and do their best work—the data is sparse, but that which exists suggests that this is the more effective approach—we need BOTH.
• Workplace civility: Our words and body language matter, more than we know! When we act meanly or kindly, it does not just affect the other person, it affects everybody. Thus we can choose, in everything we say and do, to contribute to a more loving or a more toxic work environment.
• We need to change our culture. This will not happen overnight—”there is no antibiotic!” We need to think of it more as sustained lifestyle change—[diet and] exercise!
• There is now a growing consortium of pediatrics residencies, all collecting data on baseline wellness, innovating and implementing strategies for improvement, and reporting outcomes! Wooooooooo hooooooooooo!!
• More and more medical schools are changing the traditional teaching models and including resilience training, with amazing results. At St. Louis University School of medicine, by making the first two years pass/fail, decreasing curriculum time by 10%, and offering longitudinal electives, the depression rates among first and second year medical students dropped from 25-35% to 8-21%, and for anxiety from 54-61% to 14-47%, respectively. Holy cow!
• [I’ve been saying this for a while:] Physicians are [tribal] leaders, like it or not. But they should not be compared to the captain of the ship; rather, they are the coach of a high school soccer team from which no player gets cut and all must participate.
• You can calculate fiscal ROI for wellness interventions! At one large academic institution, Resilience training for faculty and staff decreased employee healthcare costs by $450 per person for year over 5 years [I’m pretty sure I got that number right…].
• Partnering health sciences students with a peer health coach during their training improves their subjective well-being, their biometric measurements, as well as their own confidence in advising patients on lifestyle change.  In addition, the peer coaches also benefited similarly.  [ IT’S ALWAYS A WIN-WIN WHEN WE HELP ONE ANOTHER, HOOOOOORRAAAAAAAAYYY!!]
• Stress is not all bad!
  • “Threat” stress can be—fight or flight—cortisol, vasoconstriction
  • “Challenge” stress can be good—rise to the occasion—DHEA, testosterone, vasodilation
  • “Tend to a friend” stress can be very good—evokes caring behaviors that help the tribe thrive—increases oxytocin, the hormone of love.
  • Generally we see that people with increased stress die earlier, but it’s actually the subset of those who believe that stress is all bad who do this; those who believe that stress is not all bad actually live longer!

Resilience can be learned. It’s proven!  Let’s get started now!!