Thank you to all Sharp HealthCare CME Committee Members
Sharp Community Medical Group CME Committee
Gregg Garner, DO - Pulmonology (Chair), Jeffrey Dysart, MD - Family Medicine, Noah Johnson, MD – Family Medicine, Bernard Michlin, MD – Internal Medicine, Lynne Milgram, MD, MBA – Internal Medicine, Jerome Stenehjem, MD – Physical Medicine/Rehab, Michele Bautista-Meredith, PharmD, Manager, Pharmacy Services
Sharp Grossmont Hospital CME Committee
Rokay Kamyar, MD – Gastroenterology (Chair), James Cary, MD – Pathology, Yangheng Fu, MD – Hospitalist/Intensivist, Anitha Garlapati, MD – Hospitalist/Intensivist, Fadi Haddad, MD – Infectious Disease, Sathya Pokala, MD – Hospitalist/Intensivist, Suhail Zavaro, MD – Cardiology, Nancy Greengold, MD – CMO
Sharp Rees-Stealy Medical Group CME Committee
James Lin, MD – Internal Medicine (Chair), Brian Barmettler, MD - Internal Medicine, Cheryl Wright, MD - Rheumatology, Cyril Light, MD – Family Medicine, Diana Rowell, MD – Internal Medicine, Douglas Schulz, MD – Family Medicine, Eric Mair, MD - Otolaryngology, James Wolosin, MD – Gastroenterology, Kim Allen, PharmD – Director, Pharmacy Services, Miranda Sonneborn, MD – Family Medicine, Pamela Lee, MD - Colon and Rectal Surgery
What’s New in CME
SRS Dementia Guidelines Update – Implementation
In FY 2019, the CME Department developed a comprehensive needs assessment demonstrating the need for dementia training aimed at primary care providers. The CME Department collaborated with community organizations, including Champions for Health and the Alzheimer’s Project Clinical Roundtable, to develop education focused on addressing dementia in San Diego County. This concerted effort reached over 300 clinicians and led to countless additional non-CME educational strategy meetings with internal and external stakeholders, and important conversations regarding dementia at Sharp HealthCare.
The Department provided four hours in live and online CME activities for San Diego health care providers including more than 50 hours of planning and development with providers. This included a panel discussion at the Sharp Community Medical Group's (SCMG) annual conference and grand rounds at both Sharp Grossmont and Sharp Coronado. The Alzheimer’s Project Clinical Roundtable Physician Guidelines were converted into an online CME activity. These guidelines can be accessed by visiting, https://sharp.cloud-cme.com/dementia/. Additionally, the Alzheimer's Project Clinical Roundtable exhibited and promoted the Round Table’s clinical guidelines at the SCMG conference.
Results from post-evaluation surveys collected from these CME-accredited events showed markedly increased confidence is treating patients with Alzheimer and other related dementias. There was a self-reported increase confidence of 27% across all participants in our educational efforts. Nearly 100% of participants stated that the activities met their educational needs and 91% of those participants stated that the provided education was immediately applicable to their practice.
Additionally, Sharp Rees-Stealy’s (SRS) Clinical Guidelines committee updated their management of cognitive impairment and dementia guidelines on June 2019. This update is based in part because of the collaborative efforts of San Diego’s Alzheimer’s project clinical roundtable, the CME department, and SRS’s Population Health Department and their clinical guidelines committee. The guidelines are designed to assist clinicians in the evaluation and treatment of the more common medical problem as well as provide a resource list to support patients and their families. The updated clinical guidelines can be accessed through SRS’s EHR.
Q&A with Ashraf Kasto, DO Emergency Medicine, Sharp Grossmont Hospital Emergency Department
Please tell us a little bit about yourself and your affiliation with Sharp HealthCare.
Hello, I am Dr. Ashraf Kasto, DO Emergency Medicine, Sharp Grossmont Emergency Department. I Graduated Med School in 2002, and did my residency at Henry Ford Health System-Michigan in 2007
Could you define Physician burnout?
I would define physician burnout as long-term unresolved job stress that leads to emotional exhaustion, feeling overwhelmed, cynical, depersonalization (detached from the job), and lacking of sense of personal accomplishment.
Tell us about the Physician Wellness Project, your role, and some of the goals or objectives for the project.
I am one of the committee members that meets monthly to help discuss future plans for reducing physician burnout at Sharp HealthCare Hospitals. Our goals are to brainstorm ways to reduce stress at work, improve physician recognition system wide, as well as help physicians recognize, acknowledge, and treat symptoms of burnout early on.
Earlier this year the 2019 Medscape National Physician Burnout, Depression and Suicide Report was published. One of the recommendation this report makes, is for physicians to ask themselves two questions in order to identify and address burnout in themselves. (1) How am I feeling right now? (2) What am I going to do about it?
What are your thoughts on these questions? Is this something you do or is there something else that works for you?
I would like to start of by saying that these two questions are very simplified, it is important to recognize that physician burnout is multifactorial and looking at physician burnout requires more thought. That being said, asking these two questions may help with identifying or understating some of the frustrations we encounter in our day to day lives. I find that asking myself these questions help re-focus me back to my goal of what makes me love what I do. I find that working on fixing issues that cause me frustration leads to a sense of accomplishment which helps reduce any job stress overall. Some of the things I find help reduce feelings of frustration are: attending Sharp CME event, attending meetings for physician wellness and working with staff at Sharp Grossmont to improve our physician experience. Also, keeping a balance between work and home life is very important to reducing job stress. Overall these two questions aren't enough to address physician burnout but it's a good starting point.
What are some of the resources currently available with in Sharp to address physician burnout?
I know that we have Happiness Committee events schedule regularly at Sharp Grossmont which have included chess tournaments, fishing trips, padres baseball event, currently coming up breakfast at father Joe's, Holiday parties and events to promote physician comradely. I find that these activities help reduce stress and allows us to enjoy each-others company outside of a stressful work environment. Within our own ER department, we organize meetings and get together at a physician's house, hang out, talk and not deal with work. It's been a great way to get to know my colleagues in a non-work setting and let our hair down as they say.
What does the literature say about physician wellness/ burnout?
Based on some of the literature that I have read, I've learned that some specialties such as Urology(54%), Neurology(53%), Internal Medicine(49%) and Emergency Medicine(48%) seem to have the highest rate of burnout. Women are more reported to be "burned out" than men, but this could be that men are less likely to admit to psychological problems or seek help. Some of the most common contributing factors are: charting & EMR, too many hours at work, which equates to higher rates of burnout, and lack of respect or recognition from administration/colleagues/staff.
Some of the most common ways to cope with physician burnout are exercise and talking to close friends/family.
The most concerning part is that some of these physicians experiencing burnout may also suffer from depression or other underlying issues that are not discussed for one reason or another and they don't seek help. Physician burnout is a very serious concern because in some cases has lead to physicians taking their own lives.
The 2019 Medscape National Physician Burnout, Depression and Suicide Report states that there are 6 domains of wellness: Physical, Emotional, Spiritual, Intellectual, Environmental, and social. - Can you share whit us something you do to address one or some of these domains?
- Physical: I enjoy doubles tennis regularly and enjoy fishing and photography
- Emotional: I enjoy taking monthly 2-3 days off to specifically relax and unwind from everything
- Spiritual: I enjoy attending Sunday mass at church with my lovely wife
- Intellectual: I attend CME events and lectures as often as possible to rejuvenate the reasons why I choose medicine as my profession
- Environmental: Practice my photography while on hikes & walks to mentally resolve any frustrations from work.
- Social: I like to attend hospital events such as fundraisers, CME, holiday parties, and fishing trips.
What would you say to a physician going through burnout and is not sure what to do?
I would suggest that they talk to a colleague, family member or friend. Try to focus on the positives and avoid fixating on the negative. The most important thing is to talk to someone and get help.
Online Learning Spotlight