Physician Wellness in Academic Cardiovascular Medicine: Key Points

Bradley EA, Winchester D, Alfonso CE, et al., on behalf of the American Heart Association Fellows in Training and Early Career Committee of the Council on Clinical Cardiology; Council on Cardiovascular Surgery and Anesthesia; Council on Lifelong Congenital Heart Disease and Heart Health in the Young; and Stroke Council.
Physician Wellness in Academic Cardiovascular Medicine: A Scientific Statement From the American Heart Association. Circulation 2022;146:e229-e241.

The following are key points to remember about this scientific statement from the American Heart Association on physician wellness in academic cardiovascular medicine:

  1. Academic medicine as a practice model provides unique benefits to society. Clinical care remains an important part of the academic mission; however, equally important are the educational and research missions. Support for the current and emerging cardiovascular academic workforce is critically important in the United States because future discovery and advancing science rely heavily on this group.
  2. More specifically, the sustainability of health care in the United States relies on an educated and expertly trained physician workforce directly provided by academic medicine models.
  3. Furthermore, the research charge to deliver innovation and discovery to improve health care and to cure disease is key to academic missions. Therefore, to support and promote the growth and sustainability of academic medicine, attracting and engaging top talent from fellows in training and early career faculty is of vital importance.
  4. As the health care needs of the nation have risen, clinicians have experienced unprecedented demand, and individual wellness and burnout have been examined more closely. The consequences of burnout are not insignificant and include lower-quality patient care, higher rates of medical error, decreased productivity, and reduced patient satisfaction. Disruptive behavior and loss of professionalism may manifest, and health care system cost escalates as a result of decreased clinical productivity and increased turnover.
  5. Current academic positions can drive stress, and eventually burnout, in ways that are unique and include: a) productivity-driven compensation models that force competition for time between clinical care and academics, b) the requirement for promotion in systems that have not evolved to consider combined clinical and academic expectations, and c) distinct expectations based on faculty pathway (e.g.‚ grant funding, publications etc.).
  6. Creating efficiency in the workplace is a key intervention that can help build a manageable schedule, reduce the likelihood of burnout, and support the goal of creating a fulfilling academic career.
  7. Time protection is one of the most important tenets to consider when building an academic career. Early career academicians should strive to protect their time, to enhance efficiency, and to focus on top-priority tasks that are aligned with their career goals. Declining low-priority tasks is important but needs to be done tactfully, with awareness of the departmental mission.
  8. To enhance academic career success, it is highly advisable that early career cardiovascular professionals build individualized strategies to combat fatigue and to promote wellness, focusing on self-care and healthy habits (adequate sleep, healthy nutrition, exercise, outside interests, meaningful social relationships).
  9. An important premise of early career success and burnout mitigation is choosing the right position, particularly with respect to organizational culture and alignment with individual values. Those who find themselves working in a toxic environment (i.e., lack of trust/support, unhealthy rivalry, no mentorship, existence of in-groups/out-groups) should attempt to improve their environment.
  10. Exhaustion and burnout uniquely threaten future and early career academic physicians. However, with appropriate mentorship, goal planning, strategic practice efficiency skill sets, and negotiation for specific tools related to the academic phenotype (clinical, education, research), young academicians can look forward to a fulfilling and long career in academic cardiovascular medicine.

Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Prevention, Diet, Stress, Sleep Apnea

Keywords: Burnout, Psychological, Diet, Healthy, Faculty, Medical, Fatigue, Medical Errors, Mentors, Motivation, Negotiating, Organizational Culture, Patient Care, Phenotype, Physicians, Patient Satisfaction, Professionalism, Secondary Prevention, Self Care, Sleep Deprivation, Workforce, Workplace

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