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    Health & Fitness

    MedPEP

    The first season of MedPEP, the Medical Professionals Empowerment Program, stars Dr. Marie Curious, a physician, physician’s wife and mother of toddlers, who is attempting to douse the flames of physician burnout. Listen as Marie and her guide, Dr. Les Schwab, interact with experts with the wisdom and experience to help anyone who is overwhelmed by the stresses and pressures of a nearly impossible job. After you have listened, take our free CME: https://www.medpep.org/cme

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    Latest Episodes:
    Episode 11: Peer Support – Jo Shapiro, MD Jul 24, 2018
    Show notes

    Following up on her conversation with Marie on conflict management, a second conversation with Dr. Jo Shapiro focuses on her hospital’s model peer-support program. There, clinicians facing emotionally stressful situations such as safety events, trauma and traumatic losses, malpractice suits, and medical board complaints are offered the opportunity to meet with trained peers, who help them to express and normalize the complex feelings that arise in these situations. Jo demonstrated the Brigham’s peer support paradigm by asking Marie to talk about an adverse outcome that continues to weigh on her. Marie, Dr. Schwab and Dr. Shapiro proceed to have a moving conversation about the so-called “ghosts” who from time-to-time haunt the memories of many, if not most, practicing physicians. The discussion clarifies the essential differences between informal and formal peer support, and between peer support and psychotherapy. As Marie talks freely about one of her “ghosts,” the relief she experiences in doing so is palpable. Dr. Shapiro asserts that peer support can actually make a physician more resilient after a stressful event, diminishing the psychological wear and tear that may lead to burnout and depression. She shares her conviction that the medical profession should universalize programs of this sort to meet the human needs of dedicated professionals who frequently face significant occupational stresses.

    Disclosure Information
    None of the individuals in a position to control the content of this CME activity, and/or their spouse/partner, have any relevant financial relationships with commercial interests to disclose.

    Episode 11: Peer Support – Jo Shapiro, MD MedPEP Download
    Episode 10: Conflict Management — Jo Shapiro, MD Jul 17, 2018
    Show notes

    Marie and professionalism expert Jo Shapiro, MD, have a deep conversation about resolving interpersonal conflicts that come up on medical teams and at different levels of health care organizations. Dr. Shapiro, a surgeon at the Brigham and Women’s Hospital, directs the Center for Professionalism and Peer Support there. She believes that conflict in medical settings is inevitable and may be healthy when it allows for a respectful synthesis of multiple perspectives. Dr. Shapiro helps Marie unpack and process her negative feelings about a colleague who at times comes across as overly demanding. They consider this situation from the perspective of both Marie and her colleague, and they embrace the assumption that all team members are trying to do their best. They discuss providing colleagues with behavioral feedback that is both positive and critical, and how tricky it is when others are not aware of how they come across. A careful approach that is helpful, respectful, and tactful is called for. Such discussions should center on observational data, whenever possible, and antagonism should be avoided. When such attempts to iron out interpersonal complexity do not go well, one should promptly obtain help from those with the skill to ameliorate situations of this kind.

    Disclosure Information
    None of the individuals in a position to control the content of this CME activity, and/or their spouse/partner, have any relevant financial relationships with commercial interests to disclose.

    Episode 10: Conflict Management — Jo Shapiro, MD MedPEP Download
    Episode 9: Medicine is a Team Sport — Alan Morse, PhD Jul 10, 2018
    Show notes

    Psychologist and Coach Alan Morse focuses on assessing and addressing physicians’ problems from individual, team, and organizational perspectives. He suggests that the same analytical skills that physicians utilize to assess patients’ conditions may be applied to one’s self and one’s practice. Understanding organizational culture is a must, and solutions should be viewed through the lens of the team. Hierarchical differences between team members take a back seat to the good of the patients and the harmonious functioning of the team, and these typically align. Sticking points may necessitate that leaders weigh in on potential solutions, as well as modification of policies. Dr. Curious is somewhat skeptical about her ability to implement this approach in her particular practice situation, which is busy and seems hopelessly hierarchical at times. However, she is willing to start addressing her day-to-day frustrations more openly and seems to be gaining comfort with a more active and assertive problem-solving stance. She is encouraged to stay the course in solving problems at the practice level and is beginning to integrate the perspective of organizational management with her own.

    Disclosure Information
    None of the individuals in a position to control the content of this CME activity, and/or their spouse/partner, have any relevant financial relationships with commercial interests to disclose.

    Episode 9: Medicine is a Team Sport – Alan Morse, PhD MedPEP Download
    Episode 8: When the Going Gets Tough — Recalibrate — Les Schwab, MD Jul 03, 2018
    Show notes

    Les and Marie take stock of their first 6 conversations with well-being experts, and they reflect on Marie’s ability to effectively incorporate the torrent of new information, skills and techniques into the everyday flow of a busy life at work and home. Marie acknowledges how difficult it is to translate knowledge into habit formation, and they discuss the importance of accountability, consistency and practice, all of which support positive behavior change. In a demonstration of mentorship and coaching, Les inspires Marie to attempt to make one consistent positive change, and to monitor her own progress just as she would monitor the progress of a patient. He models a client-centered, positive psychology approach that allows for experimentation and learning, alleviating the kind of self-criticism and pressure that many physicians inflict upon themselves. Les helps Marie identify a potentially helpful accountability partner at work. Les and Marie acknowledge that because physician burnout is a byproduct of factors beyond the control of individual physicians, many future MedPEP episodes will focus on interventions that are team-based, organizational or systemic. As an individual who aspires to become more empowered and personally effective, Marie is interested in applying what she is learning at the level of her team, work-group and organization.

    Disclosure Information
    None of the individuals in a position to control the content of this CME activity, and/or their spouse/partner, have any relevant financial relationships with commercial interests to disclose.

    Episode 8: When the Going Gets Tough — Recalibrate — Les Schwab, MD MedPEP Download
    Episode 7: Stop Running on Empty — Beth Frates, MD Jun 26, 2018
    Show notes

    In this episode Marie meets Beth Frates, MD. Trained as a physiatrist, Beth coaches people to adopt healthy lifestyles, with an emphasis on diet, sleep, stress resiliency and exercise. In this MedPEP episode, Beth focuses on nutrition and healthy eating patterns as critical factors to energize Marie over the course of rigorous days in the clinic. She describes the evidence-based Harvard Healthy Plate - half is comprised of vegetables and fruits, one quarter is whole grains, and the last quarter includes healthy proteins. Beth sings the praises of the health-promoting vitamins, minerals and antioxidants contained in vegetables, as well as the energy-sustaining fiber found in whole grains such as brown rice and quinoa. She underscores the importance of consuming healthy sources of protein such as beans, seeds, nuts, fish and unprocessed, lean meat, all of which sustain energy more effectively than simple carbo-hydrates. Beth engages with Marie in a collaborative and empowering way, enhancing her motivation to make health-promoting changes in her diet, despite her harried work schedule. Beth also introduces the idea of mindful and restful eating, and by the end of the podcast, Marie finds herself close to taking on the challenge of setting aside 15-20 minutes of clinic time to take a restorative lunch break. Marie continues to struggle with putting her own basic needs ahead of the daily demands of her medical practice.

    Disclosure Information
    The Massachusetts Medical Society (MMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) and must ensure independence, balance, and scientific rigor in its accredited continuing educational activities.

    All individuals in control of the content for an MMS accredited continuing education activity must disclose all financial relationships with ineligible companies.

    The following individual disclosed relevant relationships with ineligible companies:

    • Elizabeth Frates, MD, Scientific Advisory Board, Jenny Craig
      Medical Advisory Board, obVus Solutions
      Owner, Wellness Synergy, LLC

    All relevant financial relationships have been mitigated prior to the beginning of this activity in accordance with ACCME and MMS policies.

    Episode 7: Stop Running on Empty – Beth Frates, MD MedPEP Download
    Episode 6: Holding Your Own in Difficult Conversations — Cathy Lanteri, MD Jun 19, 2018
    Show notes

    Dr. Marie Curious reports back to Dr. Les Schwab that her arousal level is unacceptably high in the course of the work day, and he comments that difficult conversations in the clinic may be a contributing factor. He introduces her to Dr. Cathy Lanteri, a practicing psychiatrist and executive coach. Cathy explains that the current environment requires physicians to develop expertise in communication, conflict resolution and team building, and gives Marie pointers for effectively managing difficult conversations. One should take a step back, think about the primary goal, pay attention to one’s feelings, and consider how best to reach the other person. It is important to recognize how the brain responds emotionally when caught in a "limbic loop," and to short circuit that loop by thinking analytically. Cathy demonstrates the I-F-I-A-R (“if I am ready for resolution”) paradigm to help Marie navigate strained interactions more effectively. I-F-I-A-R focuses on factual, first-person communications to help us maintain our composure and “get to yes.” Marie and Les both find utility in this approach.

    Disclosure Information
    None of the individuals in a position to control the content of this CME activity, and/or their spouse/partner, have any relevant financial relationships with commercial interests to disclose.

    Episode 6: Holding Your Own in Difficult Conversations — Cathy Lanteri, MD MedPEP Download
    Episode 5: Managing Your Energy — Diana Dill, EdD Jun 12, 2018
    Show notes

    After Marie describes her experience with savoring the moment while drinking water — a follow-up activity from the meeting with Dr. Gazelle — Dr. Schwab introduces her to Diana Dill, EdD, who coaches physicians to prevent burnout from feeling stressed and overwhelmed due to unsustainable organizational changes. She points out that people have different stressors and everyone has to assess if they have enough energy to sustain through the day. In the stress management world, energy arousal is measured on a scale of zero to 100; and peak performance can be achieved for two to four hours at a stretch in the mid arousal levels of 40–60. Above 60, one begins to feel frazzled. And at yet higher levels, the body allows only automatic activities, e.g. fight or flight, required for addressing emergency situations. One can, however, modulate the level of arousal energy and bring it in the mid-range periodically with activities such as deep breathing, savoring a moment, etc. that provide a break from sustained high-energy activities. Diana advises Marie to monitor and map out her arousal levels during the course of a day and manage activities both personal and professional using such techniques, enabling herself to think and change the course of action, if and when needed.

    Disclosure Information
    None of the individuals in a position to control the content of this CME activity, and/or their spouse/partner, have any relevant financial relationships with commercial interests to disclose.

    Episode 5: Managing Your Energy — Diana Dill, EdD MedPEP Download
    Episode 4: Mindful Medical Practice — Gail Gazelle, MD Jun 05, 2018
    Show notes

    Dr. Schwab introduces Marie to Gail Gazelle, MD, a practicing hospice physician and health professional coach, and they review multiple working definitions of mindfulness. She stresses the need for compassion, both for one’s patients as well as for oneself. Dr. Gazelle also emphasizes the importance of being in the present moment, staying focused on the reality in front of us. Marie comes to understand that focusing on the here and now allows one to put a distance between oneself and the downward spiral of negative thoughts that sometimes distract and preoccupy individuals who work in high stress professions. A benefit of practicing mindfulness and other related meditative techniques is that they enable us to effectively focus our attention where it belongs and to tune out the distractions. Another beneficial aspect of mindfulness is critical curiosity about one's own thought processes. By learning to focus on the task at hand, we are able to conserve energy that might otherwise be lost in negative thoughts. Drs. Gazelle and Schwab talk to Marie about incorporating a simple mindfulness practice into the course of her busy days in the office, and Marie agrees to give it a “college try.”

    Disclosure Information
    The Massachusetts Medical Society (MMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) and must ensure independence, balance, and scientific rigor in its accredited continuing educational activities.

    All individuals in control of the content for an MMS accredited continuing education activity must disclose all financial relationships with ineligible companies.

    The following individual disclosed relevant relationships with an ineligible company:

    • Gail Gazelle, MD, MCC, Owner, Gail Gazelle Coaching

    All relevant financial relationships have been mitigated prior to the beginning of this activity in accordance with ACCME and MMS policies.

    Episode 4: Mindful Medical Practice — Gail Gazelle, MD MedPEP Download
    Episode 3: Self-Care Is Not Selfish — Coach Margaret Moore, MBA May 29, 2018
    Show notes

    After reviewing Marie’s effort to take time for lunch, Dr. Schwab introduces her to Margaret Moore, MBA (a.k.a. Coach Meg), founder of the first health and wellness coaching school in the United States. Coach Meg points out that physicians are trained first and foremost to focus on their patients' well-being and often feel guilty when they pause to take care of themselves. "We’re not a healthy society, emotionally or physically. And it’s hard to imagine us getting that [patient care] done without the health care workforce also being well." Coach Meg presents multiple definitions of well-being and delineates the relationship between resilience and positive emotions. Maintaining an upbeat, open-minded, and flexible perspective may counteract the stress encountered during a busy clinic session. Coach Meg talks to Marie about coaching herself during the course of the work day. Short breaks, deep breaths, and glancing at a pleasant image may be helpful. Meg motivates Marie to take a high-level look at herself and her life, and to start re-examining the path forward and its sustainability. Coach Meg and Dr. Schwab inspire Marie to see if she can begin to locate her own personal “off switch” before the next episode.

    Disclosure Information
    None of the individuals in a position to control the content of this CME activity, and/or their spouse/partner, have any relevant financial relationships with commercial interests to disclose.

    Episode 3: Self-Care Is Not Selfish — Coach Margaret Moore, MBA MedPEP Download
    Episode 2: Let's Get Physical — Eddie Phillips, MD May 23, 2018
    Show notes

    In this episode, Dr. Curious meets physiatrist and lifestyle medicine guru Eddie Phillips, MD. Marie describes the draining of cognitive, emotional, and physical energy engendered by rapid multitasking and juggling in the clinic. In response, Dr. Phillips emphasizes the importance of physician self-care to counteract energy depletion. Health professionals should practice what they preach when it comes to a healthy lifestyle, stress management, nutrition, physical activity, and substance use. He then offers multiple tips on how to incorporate good lifestyle practices into one’s daily life. Marie is encouraged both to exercise while interacting with her young children, and to derive joy and pleasure from these healthy interactions. Another way to counter energy depletion is to focus on the joy one derives from helping patients. Finally, Dr. Phillips advises Marie to improve her lifestyle practices by making small changes, building and growing incrementally. Drs. Schwab and Phillips inspire Dr. Curious to test out a lifestyle improvement before the next episode.

    Disclosure Information
    None of the individuals in a position to control the content of this CME activity, and/or their spouse/partner, have any relevant financial relationships with commercial interests to disclose.

    Episode 2: Let's Get Physical — Eddie Phillips, MD MedPEP Download
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