President’s Message

A Message from the President

by Clifford Wang, MD

SCCMA President

Rest and Recovery

Greetings and it is an honor to be your 135th president of the Santa Clara County Medical Association (SCCMA). We have a long and distinguished history of pursuing our mission to extend medical knowledge and advance medical science, to elevate the standards of medical practice, to enlighten the public on matters pertaining to public health, to promote the excellence in the provision of quality ethical healthcare, and to promote the betterment of the medical profession. I hope this year we will add to this legacy.

As we turn the page on two years of a pandemic and begin a new year, it is useful to take time to acknowledge what we have been through. We are coming out of our fourth surge with Omicron and over 5 million deaths worldwide. We witnessed rapid change in medicine from vaccine development to new medications, fear and uncertainty of each new variant, mixed messages from various sources, loss revenue from declining patient encounters or elective surgeries, and increased video meetings but less direct human connection. As physicians, we stepped up to care for patients in the face of danger but sometimes at the cost of not being available for our families or the worry that we would infect our loved ones. Dr. Gail Wright, a physician wellness leader, posed these questions at a recent wellness session: What would you like to forget about this pandemic, what is something amazing that you would want to tell your grandchildren you witnessed or were a part of with this pandemic, and what is something we learned out of all the difficulties that will propel us forward? I encourage you to take time to reflect and answer what this might be for you. We hope that we are moving from a pandemic period to and endemic period with SARS-CoV-2, but I have learned to not underestimate this virus.

Burnout

We know that prior to the pandemic, physicians were already experiencing burnout at high levels, but the pandemic propelled us into survival mode to help wherever we could. It gave us the additional purpose, energy, and endurance to keep hospitals and clinics open, to use telemedicine to reach our patients, and to adapt to new guidelines, policies and mandates. However, the hidden toll from this maybe even more burnout as we come out of the pandemic. Dr. Christina Maslach, former professor of psychology at the University of California, Berkley, pioneered research on job burnout. She describes job burnout as an experience of response to chronic job stressors that have not been successfully managed with three components: exhaustion, negativism or cynicism, and professional inefficacy. The six areas that influence these dimensions include workload, control, reward, community, fairness, and values. I like her analogy of these chronic job stressors being like pebbles in your shoe that will not get better unless they are managed. In 2019, the World Health Organization recognized burnout as an occupational phenomenon which can have health implications and the National

Academy of Medicine published Taking Action Against Clinician Burnout and the importance of a systematic approach to this issue. It is important to recognize that burnout is not a disease, and that burnout inventories or indices should not be used to label individuals. I have spoken to many physicians who are experiencing these symptoms, and there is a need to engage our profession in addressing it. Jonathan Malesic, who wrote “The End of Burnout: Why Work Drains Us and How to Build Better Lives,” notes that individuals generally are not the cause of their own burnout. The causes of burnout are not a problem within the individual but a larger systemic problem of organizations and a culture of productivity with an emphasis on greater efficiency without recovery. It will take a concerted effort to change the organizational issues but there are steps we can take. At SCCMA, we are committed to helping physicians improve their wellness through our Resilient MD program that began last year. In our first session, we learned from Dr. Seema Sidhu the 3 spheres of control and had the chance in break-out sessions to share with colleagues our strategies, challenges, and experiences with wellness. In our second session, Dr. Thom Mayer, NFL Hall of Fame inductee, taught us to take a page from athletes who perform at the highest levels but incorporate rest and recovery. Our latest speaker, Dr. BJ Wells focused on what binds us as human beings underneath our roles and how grief can re-frame our experience. These are all available for review on our website, but I encourage you to join colleagues real-time from different practices and health systems at these sessions throughout the year. Most importantly give yourself some self-compassion and find ways to recover.

MICRA

This year there is a ballot measure called the Fairness for Injured Patients Act or Changes to Medical Malpractice Lawsuits Cap Initiative which is being led by trial lawyers again to challenge the Medical Injury Compensation Reform Act (MICRA) that has kept medical malpractice liability reasonable in California. This new initiative would create a new category of injury with no

cap and is much broader in its application that could allow huge payouts and encourage more lawsuits at a time when we already are being challenged from the pandemic and the cost of medical care. Kerry Hydash of the Family Healthcare Network noted that increased costs related to this measure could have a trickle-down effect that could result in community clinics closing their doors, essential health services being slashed and health care providers having to limit new patients. Hundreds of organizations are working together to defeat this initiative, but it will require a huge effort by local medical associations and the California Medical Association. We will continue to keep you informed and let you know how you can get involved.

DEI

We want to continue the dialogue and education that started last year regarding diversity, equity, and inclusion. We know there is much work to do to end structural racism and inequity in healthcare and we will be setting up a task force to help guide us. We will continue to At SCCMA, we are committed to helping provide education such physicians improve their wellness through as our webinar series last year that is still available our Resilient MD program under the resources tab at SCCMA.org but also want to take action. One way we hope to increase diversity in medicine is offering young students in underserved and low-income communities the opportunity to participate in a STEM program to learn from Stanford medical students and SCCMA physicians. It is great chance for them to learn some science but also to interact with those who are in training and in practice and possibly inspire them towards a career in medicine. There are many other opportunities to participate at SCCMA through our committees and programs from legislative advocacy, environmental health, bioethics, membership services, and physician wellness. If you would like to get involved, please email me at cliffordwangmd.sccma@gmail.com Finally, if COVID-19 conditions improve, we hope to have opportunities for in person meetings to reaffirm our connection with one another as physicians.

References: WHO COVID-19 Dashboard, February 12, 2022, https://covid19.who.int Schaufeli WB, Leiter MP, Maslach C. Burnout: 35 years of research and practice. Career Development International, 2009;14, 204–220. doi:10.1108/13620430910966406 Maslach C, Leiter MP, How to measure burnout accurately and ethically, Harvard Business Review, March 19, 2021, https://hbr.org/2021/03/ how-to-measure-burnout-accurately-and-ethically National Academies of Sciences, Engineering, and Medicine. 2019. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Washington, DC: The National Academies Press. https://doi.org/10/17226/25521 Malesic J, (2022) The end of burnout: Why work drains us and how to build better lives, (1st ed.), University of California Press Hydash, K. Medical Malpractice Ballot Measure Would Benefit Lawyers, CalMatters, February 7, 2022, https://calmatters.org/ commentary/2022/02/medical-malpractice-ballot-measure-would-benefit-lawyers/