133737
133737
com
https://ebookmeta.com/product/safeguarding-physician-
wellbeing-using-checklists-for-personal-professional-and-
psychological-safety-1st-edition-julie-l-wei/
OR CLICK HERE
DOWLOAD NOW
https://ebookmeta.com/product/safety-metrics-for-the-modern-safety-
professional-1st-edition-c-gary-lopez/
ebookmeta.com
https://ebookmeta.com/product/tourist-health-safety-and-wellbeing-in-
the-new-normal/
ebookmeta.com
https://ebookmeta.com/product/respiratory-care-assessment-and-
management-2nd-edition-deborah-duncan/
ebookmeta.com
Separation Anxiety in Adulthood How to Address it in
Clinical Practice 1st Edition Stefano Pini Barbara Milrod
https://ebookmeta.com/product/separation-anxiety-in-adulthood-how-to-
address-it-in-clinical-practice-1st-edition-stefano-pini-barbara-
milrod/
ebookmeta.com
https://ebookmeta.com/product/studies-in-the-horror-film-tobe-hooper-
s-salem-s-lot-1st-edition-tony-earnshaw/
ebookmeta.com
https://ebookmeta.com/product/tress-of-the-emerald-sea-brandon-
sanderson/
ebookmeta.com
https://ebookmeta.com/product/quantum-mechanics-a-mathematical-
introduction-instructor-solutions-manual-1st-edition-andrew-j-
larkoski/
ebookmeta.com
“Dr. Wei masterfully confronts the overlooked crisis of physician burnout with
a practical approach for reclaiming wellbeing. This is more than a book, it’s a
movement that transforms a daunting and complex challenge into actionable
steps ensuring the wellbeing of healthcare’s most vital resource: its physicians.”
– Kari Granger, CEO of The Granger Network, Executive Advisory
“This book is long overdue and no one is better qualified to write it than Julie. As
an exemplar physician and surgeon, she hits the mark with brilliance.”
– Jim Loehr, EdD, Renowned Performance Psychologist and Co-Founder of the
Human Performance Institute
“Dr. Julie Wei is a champion. Her commitment to the wellbeing of others knows
no bounds. This is the ultimate playbook for physicians and those in training to
‘win’ and achieve incredible wellbeing in their life and careers.”
– Lou Holtz, Legendary Hall of Fame football coach, motivational speaker,
author, TV analyst, and philanthropist
“Dr. Julie Wei is an important and brilliant and compassionate physician voice.
We encourage everyone to read this book.”
– Scott Becker, Becker’s Healthcare
“Are you one of the many physicians I know who are annoyed by admonitions
from others to become more resilient? Truth be told, the physicians I know are
already the most resilient professionals I know! If you are committed to your own
well-being (as are most resilient persons), then this book is for you. Checklists
used in clinical practice have been systematically developed based on best evidence
and consensus. They are familiar tools in clinical practice. Dr. Wei developed this
approach to offer physicians standardized and achievable solutions in a set of
checklists designed to mitigate physician burnout and increase physician
wellbeing. If you are a medical student, resident, or fellow, these checklists will be
invaluable as you launch your career as a physician. Dr. Wei shares many of her
own experiences that bring to life the need for a more systematic approach for
fostering personal, professional, and psychological safety.”
– R. Kevin Grigsby, Co-author: Grigsby RK, Mallon WT. Thriving: New Perspectives
and Approaches for Personal and Organizational Success. AAMC Successful Medical
School Department Chairs Series. Washington, DC: AAMC, 2020.
“Dr. Wei has provided us with practical and meaningful strategies to approach
these important issues. This book itself warrants its own place on a very important
checklist!”
– Jennifer Shin, MD, SM, Department of Otolaryngology-Head and Neck Surgery,
Department of Surgery, Office for Faculty Affairs, Harvard Medical School
Author Bio.................................................................................................. xi
Foreword................................................................................................... xiii
Preface........................................................................................................xv
Introduction....................................................................................... 1
1 My Journey......................................................................................... 5
2 Physician Safety................................................................................ 11
3 Data on Physician Burnout and WHY.............................................. 16
4 Professional Protection Checklist..................................................... 24
5 Coaching for Physicians (by Physician and by Non-Physician
Coaches)........................................................................................... 44
6 Personal Checklist............................................................................. 56
7 Financial Checklist........................................................................... 65
8 Physical and Mental Health Checklist.............................................. 71
9 Relationship Checklist...................................................................... 80
10 Checklist for Career Longevity.......................................................... 84
11 Checklists for Ergonomics, Disability, and Recovery........................ 89
12 Delaying Pregnancy, Miscarriage, and Infertility.............................. 95
13 How to “Off-Ramp”, “On-Ramp”, or Exit Your Clinical
Career – Safely................................................................................ 102
ix
x ◾ Contents
xi
xii ◾ Author Bio
long-term medical leave. In February 2022, she made the difficult decision to
take a “PAUSE” in clinical and surgical practice to pursue total healing without
surgical intervention, while living with uncertainty about her career in surgery.
During her time away from practice, Dr. Wei devoted unprecedented time to
her body, undergoing scheduled chiropractic care, cervical and lumbar decom-
pression therapy, physiotherapy/massages, and routine work out with strength
training to reverse the completely atrophic right rotator cuff muscles due to fro-
zen shoulder. Grieving and processing the trauma associated with her disability
also fueled her passion to increase awareness in surgeons on surgical ergonomics,
WRMSD, and permission to seek help through writing and speaking on her
journey from injury to recovery. At the ASPO annual meeting in May 2023,
Dr. Wei moderated a panel on surgical ergonomics to highlight prevalence in her
subspecialty, risk factors, and preventive measures. Dr. Wei has spent 2 decades
helping children and families avoid unnecessary medications and surgical pro-
cedures through nutrition and health literacy and eliminating ENT symptoms
through healthier dietary habits. She has also been a champion of supporting
mental health for surgeons, by addressing the stigma and lack of support for
surgeons who invariably experience PTSD.
Dr. Wei has authored two books on how dietary habits in children can cause
acid reflux, ENT symptoms, and subsequent misdiagnosis and over treatment
with use of medications. She is a TEDx speaker and her talk, “The Hidden
Dangers of the Milk and Cookie Disease” has been viewed over 408,000 times
since 2015. Dr. Wei has created online courses on her website on treating ENT
symptoms through dietary modification. She has published over 49 peer-reviewed
articles, 13 invited articles, and 12 book chapters.
Foreword
I first met Julie when she was a student in the Master of Medical Management
program at Carnegie Mellon University. I previously had been a student there
and credit the program to opening my eyes to possibilities I had never consid-
ered. Because of the tremendous impact the program had on my own career,
I have been teaching there ever since. Julie and I had many conversations about
the impact of burnout on physicians and her assignments were always incredibly
insightful. Several years have passed since then and the importance of physician
wellness couldn’t be more important to physicians and society in general. I was
excited to review this book because of the critical nature of addressing physician
well-being and its use of the checklist approach. As a pediatric critical care doctor
for almost 30 years, I remember the introduction of checklists into standard use
and the reluctance many of us had in using them. As Julie mentions, to-do lists
were used by all the pediatric residents I trained with, and we felt like we never
got to the end of the list. The use of checklists is quite different as they are specific
to a task and ensure accurate and timely completion of that task. They are now
in routine use throughout healthcare and have been written about including the
well-known The Checklist Manifesto by Atul Gawande.
Before reading this book, I wouldn’t have thought of using checklists to help
with physician well-being, much less writing a book on the topic. As I read the
first few chapters, I got more excited about the approach. I am an avid reader and
run a monthly book club at my own organization (Cincinnati Children’s). At the
end of many of the books, some will comment “that was interesting, but there
were very few actionable steps to take that the book provided.” That couldn’t be
further from the truth with this book. Each chapter has actionable, easy-to-use
checklists that are specific, action-oriented, and can easily be finished. Some are
general and applicable to many professionals and others are more specifically
oriented to physicians. As I read the chapter on financial checklists, it was like a
highlight reel of many of the financial mistakes I made coming out of training.
It is even more critical that physicians entering residency training take steps to
protect their financial well-being. According to the Medscape Physician Wealth
xiii
xiv ◾ Foreword
and Debt report in 2023, the average graduating medical student has a com-
bined debt of 251,000 dollars. Most then train for a minimum of three years at
lower wages and many train at least twice that long. Every medical student in the
United States would likely benefit from the succinct financial advice provided
within.
One other area worth addressing is the approach of having a specific physician
wellness program. Burnout is ever in the healthcare setting, was exacerbated by
the pandemic, and is an issue for almost all who work in this environment. Many
organizations now have employee wellness programs that target all employees
with varying degrees of success. Others have specific physician programs, and
now some are providing unique programs for physicians with a different program
for others. Certainly, any effort to improve the well-being of those working in
the complex and ever-changing healthcare environment is worthy. I believe this
book makes a good case for the importance of an approach that is tied to the
unique pressures facing physicians today. The checklist approach will feel familiar
to today’s physicians, be actionable, and can be used as a reference at different
times both as a whole and individual chapters.
THE hall clock was just striking three on Thursday afternoon when
Murray stopped before the room occupied jointly by Mrs. Hall and
Vera and rapped smartly on the closed door. It was opened by Vera.
“You are wanted at the telephone, miss,” the footman announced,
and she stepped into the hall.
“Who wants me, Murray?”
“The party wouldn’t give his name.”
“Oh!” Vera’s footsteps lagged. “Did you recognize the voice?”
“No, miss. Shouldn’t wonder if it’s another ’tec,” he added gloomily.
Two whole days had passed and Mrs. Porter had not inquired for his
state of health, and even Vera had failed him as a confidante for his
latest symptoms; truly his world was out of joint. “I asked him for
his message and he said he had to speak to you personally.”
A second “Oh!” slipped from Vera, then she went downstairs in
thoughtful silence and was proceeding toward the library when
Murray, of whose presence she had grown oblivious, addressed her.
“I hopes, miss, you don’t hold yesterday’s doings in Mr. Brainard’s
room against me,” he said earnestly. “I feel very badly about it—
very.”
“I realize that you were not to blame,” answered Vera. “But the
others—” Her small hand clenched. “I’d rather forget the scene,
Murray; some day, perhaps, I’ll get square with those men for the
fright they gave me.”
“I hope you will, miss.” Murray threw open the library door. “I’m
wishing Mrs. Porter would give orders not to admit them. Me and
Selby are waiting our chance.” And he smiled significantly.
“Perhaps she will.” And Vera glanced earnestly at the footman. “You
are not looking very well today, Murray; have you tried that tonic Dr.
Noyes advised?”
The footman brightened. “I have, miss, but it don’t agree with me,
and the neuralgia’s getting worse.”
“That’s too bad. Come upstairs later and I will give you a tube of
Baume Analgésique Bengué.” As the French name tripped off her
tongue Murray regarded her with respectful admiration.
“It sounds great, miss; I’d like to use it, thank you.” And he departed
for his pantry, his manner almost cheerful.
Left to herself Vera closed the library door and approached the
telephone with some hesitancy; she could think of no friend who
would have a reason for not giving his name to the footman and
concluded Murray was right in imagining the “party” to be a
detective. Her interview with Mitchell the day before was still fresh in
her mind and she resented the idea of further impertinence. It
occurred to her, as she toyed with the receiver, that it was a simple
matter to ring off if she found it was Mitchell at the other end of the
wire; then a thought stayed her—suppose it was Dr. Beverly Thorne
waiting to speak to her? Her expression hardened, and her voice
sounded clear and cold as she called into the mouthpiece:
“Well?”
An unknown voice replied: “Is this Nurse Vera Deane?”
Vera’s expression altered. “Yes, what is it?”
“This is Police Headquarters,” went on the voice crisply, and Vera
started. “Inspector North speaking. Have you lost anything, Miss
Deane?”
“I? No.”
“Are you sure you have not lost your handbag?”
“My handbag!” Vera’s raised accents testified to her astonishment.
“No, certainly not.”
“Quite sure, Miss Deane?” insisted the inspector.
“Yes; but as a matter of form I’ll run upstairs and look. Hold the
telephone, please.” And Vera dashed up to her room and unlocked
her trunk; there lay her handbag, and pulling it open she found its
contents intact.
She was out of breath when she again reached the telephone, and
had to pause a second before speaking to the inspector.
“My handbag is upstairs, safe and sound,” she called.
“Thank you.” The inspector cleared his voice. “I called you up, Miss
Deane, because we found a handbag in a Mt. Pleasant car yesterday
afternoon containing your visiting-card, and we located you through
the Central Directory for Graduate Nurses.”
“My visiting-card?” echoed Vera, astonished. “Are you sure it was
mine?”
“Oh, yes, Miss Deane, your name is engraved in full on a black-
edged card. Good afternoon.” And he rang off.
A black-edged visiting-card? Vera sat clinging to the telephone
receiver in bewilderment—it had been fully five years since she had
had a black-edged visiting-card! Suddenly her ear detected the click
of a receiver being hung up, and the faintness of the sound aroused
her. Who had been listening in on the branch telephone in Mrs.
Porter’s boudoir?
Vera went straight to the boudoir, but before she reached it Millicent
walking down the hall paused in the act of entering her own room
and called her name softly.
“Mother is lying down,” she said as Vera drew nearer. “Dorothy and I
have just left the boudoir. Come and join us in my room.” And she
held out her hand with a little affectionate gesture which was
characteristic of her. Vera smiled, and under sudden impulse kissed
her; there was something very winsome about Millicent, mere child
as she was.
“Thanks, Millicent, I’ll come and sit with you later; but first I must
take my ‘constitutional’—I haven’t had a walk for several days, and I
need the fresh air.”
Millicent stroked her cheek with tender fingers. “Perhaps the wind
will put color there,” she said. “You are not getting proper rest, Vera;
for your pallor and heavy eyes tell the story.”
Vera shook her head in dissent. “I only need fresh air; don’t let that
foolish sister of mine put ideas into your head.” She stopped abruptly
as Hugh Wyndham stepped out of his aunt’s bedroom and joined
them.
“Good afternoon, Miss Deane,” he commenced cordially, but she
returned his greeting so perfunctorily that Millicent’s eyes opened
wide in surprise, and, reddening, Wyndham turned to his cousin.
“Are you going to motor in to Washington with us, Millicent? Better
come; you don’t have to leave the car or talk to anyone,” guessing
the cause of her hesitancy.
“True—” but still Millicent paused.
“I think you had better go,” put in Vera quietly, and barely glancing
at Wyndham she went to her own room.
Wyndham smiled reassuringly as he caught Millicent’s puzzled frown.
“Vera’s nerves are on edge,” he said. “I quite understand her
seeming rudeness.”
“Well, I don’t,” confessed Millicent. “Dorothy has a much sweeter
disposition than her sister, and on her account I overlook Vera’s
occasional tempers. Go and get the limousine, Hugh; Dorothy and I
will be ready in ten minutes.”
However, it was less than the prescribed ten minutes when Millicent
and Dorothy stood waiting in the lower hall for the arrival of the car,
and the latter, going into the library to collect some notes she had
left there, encountered her sister on her way out of the side
entrance to Dewdrop Inn.
“I wish you were going with us, Vera,” she exclaimed impulsively.
“Do come, there’s plenty of room in the limousine.”
“Not today, dear.” And Vera tempered the refusal with a kiss. She
glanced at the yellow copy paper Dorothy was busy stuffing inside
her muff. “Did you use the telephone in Mrs. Porter’s boudoir about
fifteen minutes ago?”
Dorothy shook her head. “No, but Mrs. Porter and then Hugh tried to
get Central.” Her sister’s reference to the boudoir recalled a recent
conversation, and she added briskly: “Vera, why are you so stand-
offish with the Porters? They are fond of you, yet you never spend
any time with them, and I think they feel it.”
Vera drew back from Dorothy’s detaining clasp. “I am here in my
professional capacity, Dorothy, and I don’t wish to intrude upon
them,” she said gently. “Better that they think me ‘stand-offish’ than
say I take advantage of ‘auld lang syne’ and push myself forward.”
“What nonsense! I declare, Vera, you are downright provoking, not
to say morbid,” protested Dorothy. “It’s the result of never getting
away from the atmosphere of the sick room. I don’t see how you
stand it; the mere sight of suffering drives me wild, and to think of
poor Craig Porter, whom I used to dance with, lying there inert—I
just could not go to his room today when Mrs. Porter asked me to do
so,” she wound up. “His changed appearance would break me down
completely. How can you watch him night after night?”
“You and Craig were great friends, whereas I never knew him in
those days.” Vera lowered her voice. “Let me see, did you first meet
him when we were in mourning?”
“No, before that, when Millicent and I were at Catonsville together.
We were great chums.” And she smiled, then winked away a sudden
rush of tears. “Poor Craig!”
“Don’t call him ‘poor’—he is rich in accomplishment,” rapped out
Vera. “Think what he has done for the Allies; get Mrs. Porter to tell
you of the honors paid Craig by the gallant Frenchmen, and never
call him poor again.”
“I wasn’t alluding to his past, but his present,” explained Dorothy,
somewhat startled by the gleam in her sister’s eyes. “I understand
he can’t utter a sound or move a muscle.”
“He can’t.” She paused as Millicent’s voice echoed down the hall.
“Go, dear, they are calling you.”
But Dorothy lingered. “Have you any errands I can attend to for you
in town?”
“N-no—wait.” Vera spoke hurriedly as steps approached. “See if you
can find my package of visiting-cards—”
“I told you months ago, Vera, that you hadn’t any left,” interrupted
Dorothy.
“Perhaps you can find an old one, even if it’s black-edged, in my
desk—”
Dorothy shook her head violently. “I can’t; I looked there at
Christmas and could not find any kind of a card. Coming right away,
Murray,” as the footman appeared. “Do you wish me to order some
cards struck off?”
“Yes,” called Vera. “Pay for it with the money I gave you yesterday.”
And Dorothy disappeared with Murray in attendance.
Vera waited until convinced that the limousine must have driven off,
then, tossing the blue cape with its small picturesque red cross
about her shoulders, she opened the side door and, skirting the back
of the house, walked swiftly past the garage. Passing down a lane
she crossed a field and went up a path leading to the “side hill,” as
that part of the Porter plantation was called.
The cold and wind of the preceding day had abated, and Vera took
deep breaths of the delicious, invigorating air, as, deserting the path,
she made her way among the trees and dead underbrush to a
clearing high up on the hillside, which, except from above, was
invisible from the path she had quitted some moments before. A
huge mica rock, known locally as Diamond Rock, occupied most of
the clearing, and Vera exclaimed with pleasure as she caught the
rainbow effects produced by the winter sunshine on its surface.
Stepping in clefts in the rock she slowly mounted to the top and
made herself comfortable. Once settled on her perch, she turned her
attention to the panoramic view of the Potomac River far below her
and the surrounding countryside.
But she barely saw the landscape, her thoughts being concentrated
upon the Porter limousine and its occupants. Too late she regretted
that she had not accompanied Millicent and Dorothy to Washington.
But when her sister had asked her, a feeling of abhorrence had
swept over her at the prospect of being inclosed in a small space
and listening to their chatter. Her desire to be out in the open and by
herself had gained the mastery; for an hour at least she could
wrestle with her problems and decide on the future. She resolutely
determined to put all thought of the past out of her mind, but it was
a greater task than she had imagined—the past would not bury its
dead!
Great drops of perspiration beaded her forehead as incidents of the
past three days rose before her: her first glimpse of Bruce Brainard
in bed Monday night—the tragedy—the inquest—the detectives—
Vera plucked at her handkerchief and pressed it against her forehead
and her cheeks, rubbing the latter vigorously. She must not think of
the past; the future concerned her more intimately.
She must decide on a course of action before Detective Mitchell
devised other methods to trap her, and remembrance of the scene in
Brainard’s bedroom twenty-four hours before brought a hot flush of
resentment in its train. She would square accounts with the
detective before many days had passed, and her pretty teeth met
with a determined snap. What troubled her was Beverly Thorne. She
wished that she might dismiss him from her mind; then shivered
involuntarily as she grudgingly admitted to herself that she feared
his quick intelligence, his ever-searching eyes and cynical smile. It
was an evil fate that had thrown him across her path. As the thought
crossed her mind, she saw someone moving in and out among the
trees to her right. The newcomer was making his way down the
hillside, and she watched him idly.
The man kept a zigzag course and she was unable to get a good
look at his face as, with cap pulled down over his forehead and the
collar of his Norfolk jacket turned up, he seemed intently scanning
the ground, pausing now and then to watch a switch which he
carried loosely before him in both hands. Suddenly he stopped and,
facing in her direction looked up long and earnestly into the bare
branches of a tall tree. Vera’s breath forsook her as she recognized
Beverly Thorne. Had she conjured him to appear?
After testing a lower branch of the tree with his weight Thorne
transferred his attention to the cleft stick in his hand and strode
onward. He was within a few yards of Vera before he discovered her
presence. There followed a momentary hesitation on his part, then
he advanced to the rock and bowed gravely.
“You have caught me trespassing,” he began. “What is the forfeit?”
Vera pointed in the direction he had come where a wire fence could
be seen in the distance; she knew that placards placed at intervals
announced: “No trespassing under penalty of the law.”
“As a ‘J. P.’ you must be aware of the penalty exacted for trespass,”
she answered, preparing to rise.
He noticed her movement, and raised his hand. “Don’t let me drive
you away,” he begged, appreciating to the full the charming picture
she made perched on the rainbow-hued rock, her blue cape and its
red cross in striking contrast to the dull colors of the woods. “I am
going.”
His announcement, however, while it had the effect of inducing Vera
to remain where she was, proved a mere figure of speech, as he did
not move from his place by the rock. At the end of a long silence
Vera could not restrain her impatience, and he caught the
antagonism she strove but faintly to conceal.
“Miss Deane”—Thorne skirted the rock and came closer to her—“I
am afraid you harbor resentment against me. I assure you that I had
no hand in the trick played on you by Detective Mitchell yesterday.”
“Your presence with the detective in the spare bedroom leads me to
think otherwise,” she replied coldly.
“I can explain,” he began, but her raised hand stayed him.
“Why attempt an explanation, doctor?” she asked, and her disdain
showed so plainly that he colored with indignation.
“Because I desire to set myself right in your eyes,” he answered.
“With what object?”
His eyes did not fall before the challenge in hers, while a warm,
sunny smile lightened the severe lines of his stubborn chin and
determined mouth.
“Object—matrimony,” he retorted, and she detected the twinkle in
his eyes and the faint mockery discernible in his voice. Her resolve
was instantly taken; she would meet him on the ground he had
chosen—woman’s wit against man’s intelligence was a game old
when Methuselah was young. She rose and dropped Thorne a half
courtesy, balancing herself on the rock with graceful ease.
“On so short an acquaintance your jest is flattering, but ill-timed.”
She paused, then added, “I thank you—and decline.”
“Wait.” He laid down the switch of witch-hazel and drew nearer. “Our
acquaintance is not so short; it commenced six years ago in New
York.”
Vera stared at him intently. “I fail to recollect,” she began, and
paused uncertainly.
Instead of answering verbally he took out his leather wallet and,
searching among its contents, finally produced a black-edged
visiting-card. On the reverse side were traced the words:
February 14—In grateful remembrance.