President's Column
Read archives from AAN Past President Orly Avitzur, MD, MBA, FAAN, who served from May 2021 to April 2023.
January 2022
New Year's Well Wishes
According to numerologists, the year 2022 portends harmony and balance. As I reflect on the events of the past two years, I sincerely hope that proves to be true. In 2020, unimaginable stressors subjected health care professionals to feeling off-kilter at best and to severe emotional distress at worst. And this past year was fraught with new, unanticipated challenges as the pandemic ploughed on, vaccines became politicized, and employees quit their jobs in record-breaking numbers. The Great Resignation is affecting every sector of the health care workforce1 and is adding to our overburdened workloads. Neurologists, already saddled in pre-pandemic times with one of the highest burnout rates of all specialties2, are now working with fewer staff and colleagues3 and face waning resilience.
While research in the field of physician wellness has evolved over the past decade and awareness has improved, my conversations with neurologists across the country belie those efforts. New priorities borne of COVID-19 have muted the outcry for change and left best intentions broadly neglected. Instead, I have been told of a pressing emphasis on productivity for those with clinical obligations and inadequate time for educational and research responsibilities for those with hybrid roles. While some neurologists are leaving their positions for non-clinical jobs, others are seeking work that offers more flexibility or part-time employment. The exodus is worrisome—not just for its present consequences—but for its potential impact on our neurologist pipeline.
According to Tait Shanafelt, MD, who pioneered the physician well-being movement, now is the time for action4. He urges organizations to embrace wellness as a core value and the profession, leaders, organizations, and individuals to commit to change. Here at the AAN, we have created a Wellness Subcommittee, recruited wide expertise in its membership, and will be reaching out to you over time with new and expanded resources and initiatives for your consideration. Jennifer Bickel, MD, FAAN, FAHS, its chair, aims to develop multiple endeavors that promote self-care and continue to improve the environment in which neurologists work. The subcommittee hopes to go beyond reducing burnout to determining how it can assist all members to thrive at work.
Dr. Bickel, who serves as chief wellness officer at the Moffitt Cancer Center in Tampa, also points out that sustainable wellness achievements depend on leadership support and buy-in. Toward that end, an AAN-sponsored Neurology Department Chairs Summit held in March of 2022 will focus on challenges and opportunities in academic neurology in a post-pandemic world, including faculty and trainee wellness. The chairs will also discuss building and supporting a diverse workforce, mentoring, and using leadership platforms to embrace new care models and academic innovations, said S. Andrew Josephson, MD, FAAN, who leads the AAN Department Chair Subcommittee.
Under the guidance of the Wellness Subcommittee, the 2022 Annual Meeting in Seattle will continue to provide education and resources for self-care and community while expanding to include the challenging topics that can detract from our joy in practicing medicine. In future years, the Wellness Subcommittee will provide neurology leaders with guidance on how to best incorporate wellness into the workplace and also provide individuals with advice on how to determine if their workplace is doing what is necessary to improve the opportunity for professional well-being.
At the individual level, Shanafelt describes the transition to Wellbeing 2.0 as one which will require a mindful consideration of how to incorporate self-compassion, set boundaries, and impose self-care alongside other professional values. He encourages us to lean on each other and create not only connection, but also a community of shared experience, mutual support, and care.
Recently, I have begun to hear more colleagues speak of intentionally ridding themselves of perfectionism, incorporating mindfulness, and spending time “off-the-grid.” The pandemic has led to widespread introspection about work-life balance and a renewed commitment to the practice of self-kindness. There has been a focus on family, time away from work, avocations, and other activities that feed the soul. I hope this becomes a movement as culture change is necessary, not only for our individual survival during a multiyear pandemic, but for the preservation of our profession.
Some say that 2022 also means ‘Hope is Ahead,’ and as I contemplate the coming year, I hope it brings health, harmony, and balance to all of you. In that spirit, I have asked several colleagues to share their tips and New Year’s resolutions focused on wellness. May their words inspire you as they have me.
My best wishes to all of you for happiness and well-being in the new year.
Orly Avitzur, MD, MBA, FAAN
President, AAN
@OrlyA on Twitter
You are more empowered than you might think. Consider your practice's pain points and ask yourself, 'Do I have to do things this way?' Chances are some of these sources of friction come about from habit and assumption. If you step back and ponder a bit, you may come up with better workflows. Here's an example: revising your outpatient EHR documentation processes to reflect the streamlined 2021 outpatient CPT guidelines.
Neil A. Busis, MD, FAAN
Half of the time, my New Year's resolutions fail. Instead, I'm doing a lifestyle change by having a mindful minute before I start my day, and doing a gratitude exercise before I hit the hay.
M. Cristina C. Victorio, MD, FAHS
My advice is to always take a walk in the middle of the day, cold or hot, rainy or sunny. It can be for as little as 15 minutes. It refreshes the brain and allows one to think about things other than work. I think that it is best to do it alone! No matter how busy my days may be, I always find that 15 minutes.
Daniel M. Feinberg, MD, FAAN
My advice to my peers facing the intense pressures of our current work environment is to remember about the importance of balance and listen to the advice we give our own patients: make time to exercise, to practice mindfulness, and feed our own souls. There will always be more notes to finish and Epic requests to reply to, so we need to consciously pick a time every day to step back and take care of you.
Drew Falcolner, MD
1Avitzur O. For Some Neurologists, COVID-19 Has Prompted an ‘Existential Crisis,’ Now They've Revamped How and Where They Work. Neurology Today.
2021;1(12):1-30.
2Busis N, Shanafelt TD, Keran CM, et al. Burnout, career satisfaction, and well-being among US neurologists in 2016. Neurology 2017;88:797–808.
3Avitzur O. The Great Resignation: The Workforce Exodus Hits Neurology Practice and Research. Neurology Today. 2021;1(12):1-30.
4Shanafelt TD. Physician Well-being 2.0: Where Are We and Where Are We Going? Mayo Clinic Proceedings October 2021:96(10)2682-2693.