Curated Resources to Cultivate Wellness in the Professional and Personal Lives of ACG Members
The ACG Professionalism Committee and its collaborators created ACG Wellness Central, hoping to bring about a significant positive impact on ACG members by providing specific resources to improve wellness. See below for multimedia resources designed to provide general burnout information, recommendations for things you can do at home to promote wellness, recommendations for things you can do at work to promote wellness, and resources for organizations seeking to improve wellness.
Life
Creating work-life balance is one mechanism to avoiding or combating burnout. Work-life balance is creating a lifestyle that both achieves goals but allows one to enjoy life, both at work and with family, friends, and self. If provides a platform to gain pride, satisfaction, happiness, celebration, and well-being. Creating work-life balance is individualized and varies over time. Addressing burnout requires systemic and process changes, as it is not necessarily a deficit in individual resiliency, but a process that must be addressed with changes to programs, practices, institutions, and organizations as a whole.
MEDITATION
Meditation and mindfulness are associated with a decrease in burnout, depression, anxiety, stress, and sleep disturbance among healthcare workers. Many resources exist to facilitate practicing mindfulness, including websites and apps. Be aware of our emotions, thoughts, and maintaining a positive outlook can have a multitude of health and wellness benefits including better sleep, greater compassion and empathy, and stronger immune function. Below are links to several apps and websites that can help facilitate practicing mindfulness and/or meditation.
MINDFULNESS
Mindfulness is bringing complete attention to the present experience on a moment-to-moment basis and being nonjudgmental and consciously aware during every day activity. We cannot eliminate stress but we can determine how to handle it. Strategies include walking meditation; Yoga Nidra; Boday scan meditation; Mindfulness activities; Mind-body exercise such as yoga; tai chi and qigong; mantra repetition; sound healing; mindful eating; and breath work. Mindfulness interventions have been shown to be helpful in learning new techniques such as endoscopy.
VACATION
Why do you need to take a vacation? Physical activity melts away stress, novel experiences can give your brain dopamine hit, awesome moments improve decision making and critical thinking, and time with loved ones can cause a surge of oxytocin.
SLEEP
Restorative sleep is necessary for good health and critical to ensure attentiveness, improve cognition, assist in learning, and decrease errors. A chronically-fatigued practitioner will find it difficult to be mentally and spiritually present at home and at work. The CDC recommends 7 hours of sleep daily, but the fast-paced nature of our work, overnight call responsibilities, inbox taskings, and the constant stress of making important decisions is unconducive to always meeting this goal. Driven individuals will often justify the sacrifice of sleep to accomplish additional tasks. We must acknowledge a paradigm shift in how we think about and treat our sleep hygiene. Chronic fatigue is not a badge of honor! We must advocate for ourselves and our colleagues to create an atmosphere that treats sleep as a necessary component of our well-being, not a luxury. Create a consistent sleep/wake schedule and stick to this schedule until it becomes a habit. Incorporate a buffer-period before bed to decompress from the day and discontinue tasks – avoid blue light and screens and encourage a quiet, non-stimulating environment. Lastly, if you find yourself unable to sleep due to ruminating on thoughts and having difficulty ‘turning off your brain,’ you may benefit from talking with your doctor or therapist about cognitive behavioral techniques that can help identify and reduce stressors in your life.
- Do’s: consistent bedtime, sleep ritual, daily relaxation practices, encourage natural morning light
- Don’ts: avoid exercise 30 minutes before bed, avoid large meals 2-3 hours before bed, avoid caffeine and alcohol after noon, avoid blue light after sunset
NUTRITION
Be intentional—plan your snacks and meals. Make sure to cook your own food as much as possible. When you are eating, put away your electronics, sit down and breath, center and give gratitude. Develop a mealtime ritual and connect using all your senses.
ACG Publications
EXERCISE
Exercise is a fundamental element of our mental, physical and spiritual health. Sadly, in the face of increasing demands on our time, most of us do not prioritize our own health and exercise is often overlooked. However, in a procedure-heavy specialty, a healthy body is necessary to avoid injuries to ensure a long and fulfilling career. The CDC recommends at least 150 minutes of moderate aerobic activity or at least 75 minutes of vigorous activity plus strength training > 2 days/week. Just as we should schedule sleep to build a routine, creating an exercise regimen that incorporates some aerobic activity with some strength training is necessary to build a habit. Find what activities you enjoy and do as much of that as your schedule will allow, especially outdoors.
- Create a weekly plan and set small, achievable goals
- Balance cardio and strength exercises
- Be intentional about incorporating movement into your day
Work/Organization
Prior studies evaluating burnout among gastroenterologists have shown that inefficiencies and time spent in electronic health records, lack of flexibility in schedules, clerical burden all increase burnout. Conversely, doing procedures, receptive leadership, and good clinical support all reduce the prevalence of burnout.
In 2022, over 48% of gastroenterologists including trainees experience burnout. Although some factors linked to a higher rate of burnout are personal and must be individualized, there are actions within institutions, practices, and training programs that could be easily incorporated to try and mitigate burnout.
SCHEDULES
Flexibility in schedules and allowing breaks such as Lunch breaks can be very helpful. Providers have indicated significantly less burnout if they can consume lunch on at least 50% of their workdays. Also it is very important to consider parental and family leave strategies to prevent clinician burnout.
ACG Publications
AJG Articles
EMR WORKFLOWS
Improving efficiency in the electronic medical record can be very helpful to enhance daily workflows. Clinicians who spend more time in the EHR experience high rates of dissatisfaction. Small changes in workflows can lead to large changes in decreasing the number of clicks and time in front of the computer.
ACG Online Presentations/Videos
ERGONOMICS
Ergonomics in endoscopy is extremely important to prevent endoscopy-related injury and allow for healthier and longer careers. There are increasing resources to available to help gastroenterologist ensure appropriate endoscopic techniques to prevent injury.
ACG Publications
ACG Online Presentations/Videos
Other Journal Articles & Publications
PROCEDURAL EXPOSURE FOR TRAINEES
In a recent survey of gastroenterology/hepatology trainees, the ability to perform procedures significantly improves well-being. Providing maximal exposure to procedures and having faculty who are willing to mentor and coach fellows could combat burnout. on best practices for a diversity of procedural competencies. For programs with reduced exposure to sub-specialty procedures, providing access to training sessions, especially in-person demonstrations or using models to provide a diverse training experience could also mitigate trainee burnout and enhance educational satisfaction. Both Boston Scientific and Olympus have a variety of learning and training options available:
PROFESSIONAL DEVELOPMENT
Career and professional development is important to help clinicians sustain long and fulfilling careers. Understanding how to build a successful career is important as well as building tools to help in difficult work situations.
ACG Online Presentations/Videos
TEAM BASED CARE
Increasingly, team based care is important to help gastroenterologists take care of all patient needs. Social, nutritional, mental health support teams allow each team member to contribute in their area of expertise. Patients benefit from more time and focused care from these teams.
SOCIAL ENGAGEMENT
Social functions and frequent meetings have also been highlighted as indicators for wellness and stable work environment. Organizations, program directors, and leaders can help incorporate these types of events into programs to enhance the well-being of employees and fellows.
ACG PRACTICE MANAGEMENT TOOLBOX
The Toolbox is a series of short articles, written by practicing gastroenterologists, that provide members with easily accessible information to improve their practices, personal lives, and ability to provide care to patients. A new edition of the Toolbox is released each month.
Visit the ToolboxGeneral Burnout
Burnout is a state of mental and emotional exhaustion, related to professional work. It is characterized by a low sense of personal accomplishment and depersonalization, defined by increased cynicism and a lack of compassion for others. Burnout has a significant impact on medical professionals. On a personal level, it leads providers to leave the profession early, increases rates of substance use, depression, and poor health outcomes including suicide. For practices, it lowers satisfaction scores, increases the rate of medical errors and unprofessional behavior, and decreases workplace morale.
MENTAL HEALTH RESOURCES
Physicians are often concerned that seeking help may have a negative impact on their career. Fostering an environment that acknowledges mental health and its consequences including but not limited to burnout, depression, substance abuse, and provides resources is essential.
Schedule a telehealth visit with a mental health provider:
www.ableto.com
Find a Provider near you:
www.psychologytoday.com/us/therapists
24/7 Crisis Line:
1.800.273.TALK (8255), or contact the Crisis Text Line by texting TALK to 741741
PUBLICATIONS & ADDITIONAL RESOURCES
ACG Publications
AJG Articles
Other Journal Articles & Publications