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burnout and dissatisfaction was due to a lower number of workers available, which caused many medical professionals to work overtime and spend extended periods of time in stressful situations. With proper support and care available from hospitals and employers, it is possible that even with staffing shortages, physicians can avoid burnout.

Florida has become the seventh-fastest growing state in the U.S. with a 1.58 percent growth rate since 2011. By the end of the year, it is anticipated that Florida’s population will break 22 million people. With an influx in residents, there needs to be proper medical care available for individuals. The Florida Health Physician Workforce Annual Report asked physicians whether they had relocated to Florida in the last five years. Of those surveyed, 18.1 percent of physicians reported they had, mainly due to employment opportunities or employment after finishing their education. Several area hospitals are working to create programs and support services to assist doctors, nurses and medical professionals to lower the possibility of burnout as patient numbers increase.

Dr. Neil Finkler, chief clinical officer for the seven-county Central Florida Division of AdventHealth has discussed streamlining hospital processes with the Centers for Medicare & Medicaid Services (CMS) to improve physician experience while also reducing burnout. In an interview with the American Medical Association (AMA), Dr. Finkler discussed how important it is for leadership to consider the wellness of their physicians. “There are so many things that contribute to the physician experience that can eventually lead to burnout. I like to ask my CMOs, start thinking about what are the rocks in your physicians’ shoes.” Dr. Finkler continued, “I have a physician who is now the chief medical officer of the physician experience, and she is examining a whole host of opportunities to improve the physician experience across the board such as improving the communication process, creating processes to recognize fellow physician colleagues for excellence and developing mental health services to support our colleagues.” At AdventHealth’s Central Florida Division, Omayra Mansfield, MD, MHA, works as an emergency medicine physician and is the chief medical officer for both AdventHealth Apopka and Physician Experience at the Central Florida Division. In an interview, Mansfield discussed the importance of monitoring physicians and medical staff for any signs of burnout. “There are two relevant things that we trend and track over time,” stated Mansfield. “One is our SCOR survey, which is a safety survey that we take as an organization that allows us to benchmark against other organizations. Part of the SCOR survey looks to the questions of reflections of your burnout, reflections of team members’ burnout, and questions about personal resilience. The other marker we use is physician engagement surveys.” These two tools allow AdventHealth to provide proper support during stressful times. Orlando Health offers the Employee Assistance Program (EAP), a free, confidential counseling service provided for staff. This service is a great way for staff to talk about any stressors including job anxiety or other life challenges. “Orlando Health has several initiatives, some systemwide, to help frontline teams through the emotional process [of stress in the workplace]. The Serenity Room started before the pandemic, but really opened up in the past year. It’s a quiet place where staff can re-group and re-focus,” according to a recent article for Orlando Health. “We also have a lot of support from our chaplain services that have really built strong relationships with the team members that come around and really talk through the process with them,” said Christina McGuirk, Orlando Health chief nursing officer. AdventHealth also offers the AdventHealth Provider Well-Being website, which provides physicians with ways to manage stress and avoid burnout. Some internal resources on the website include relational initiatives, mental wellness and mission mentoring. In addition, there are external resources available through the American Medical Association, Champions of Wellness, Vital Work Life, the Coalition for Physician Well-Being and Mayo Clinic WellBeing Index. As programs become available for physicians and medical professionals through hospitals and online, it is possible to manage burnout and in turn, handle staffing shortages in a controlled manner. With support, it is possible to remind medical professionals why they are at their job every day–to help patients in need.

“With proper support and care available from hospitals and employers, it is possible that even with staffing shortages, physicians can avoid burnout.”

Photo by Laura James, courtesy of Pexels

Assessing Healthcare Equity

The last several years have shined a light on healthcare disparities in our community, most recently due to the pandemic. Since it has been quite relentless for many, some have experienced a lack of health equity more than others. With this, a push to improve health equity across healthcare is expanding throughout the country. “Health equity is the state in which everyone has a fair and just opportunity to attain their highest level of health. Achieving this requires focused and ongoing societal efforts to address historical and contemporary injustices; overcome economic, social, and other obstacles to health and healthcare; and eliminate preventable health disparities,” states the Centers for

Disease Control and Prevention (CDC). This includes the need for expanding and

removing social and economic obstacles that lead to inadequate health outcomes. Some barriers include unsafe or unhealthy environments, poor quality of housing, poverty, lack of access to jobs with health insurance, which can lead to a denial of needed healthcare for individuals. It has also been found that there is a lack of health equity for those with disabilities and for those who reside in rural communities.

“Many people face such barriers and are prevented from accessing the care, services and resources they need to live a healthy life, often leaving minorities in communities impacted by disinvestment. As a result, many minorities experience limited access to healthy foods, lower quality education, difficulty earning a living wage and unsafe environments,” said Dr. Kelli Tice, Florida Blue chief health equity officer, in an interview. Tice continues, “At Florida Blue, we are working to collect and analyze data about members’ challenges, which allows us to better meet their needs, identify resources and create programs that are tailored to them. COVID-19 shines a spotlight on health disparities that exist among minority populations. In communities across the United States, minorities faced higher rates of disease transmission and financial impacts associated with the pandemic. Minorities, while overrepresented in higher risk jobs, consistently have

decreased access to testing and vaccines.” In Orange County, Florida Health Charts reported that 86.8 percent of the civilian non-institutionalized population had health insurance. Osceola County had 86.8 percent and Seminole County had 90.6 percent of populations insured. This is versus the state percentage of 87.2. This comparison is fairly consistent over the different counties, but it highlights the fact that many are having health equity issues and need access to care, which can be hard to get when uninsured. Organizations throughout Florida have been working relentlessly to transform public health research and implementation to promote health equity efforts. Floridabased Voices Institute, launched by Selena Webster-Bass, MPH, is a consulting and research group focused on advancing and promoting health equity efforts that address physical, mental and emotional well-being needs in families, communities, organizations and systems. Voices Institute provides training and consulting including health equity professional learning, equity organizational assessments, equity plans, cultural humility, young development, organizational assessments and more. Some of the health education and promotion services include mental health literacy, racial literacy, health literacy, grief and loss support and COVID-19 vaccine hesitancy education. Health studies are also available with qualitative research, focus group facilitation and multicultural community engagement. In Central Florida, Orlando Health is working with United Way of Broward County and Moffitt Cancer Center to improve health equity throughout the area. “The three organizations, with support from a combined $2.5 million health equity grant awarded by the Florida Blue Foundation, will partner to train more than 3,000 healthcare professionals over a four-year period. The health equity grant was provided for development and implementation of a train-the-trainer program to ensure that families and community members have both access and opportunity to attain full health potential and are not disadvantaged due to environmental, economic, and/or social circumstance,” stated Orlando Health in a recent article. “We are excited about this partnership and the opportunity to address the existing biases and social determinants of health,” said Quibulah Graham, MSPH, BSN, corporate director, Diversity & Minority Business Development, Orlando Health. “Identifying community healthcare organizations and professional associations is key to building awareness, knowledge, and practice of health equity across the Central Florida region and later our state.” The Florida DOH has also enlisted the Project Public Health Ready, a section of the Emergency Preparedness and Response department. “This partnership program between the Florida Department of Health, the National Association of County and City Health Officials and the Centers for Disease Control and Prevention is an effective tool for increasing community preparedness,” said the Department of Health (DOH). This public health program assesses local health department capacity and capability to plan for, respond to, and recover from public health emergencies. Working together can help prioritize the concern that continues to build in regard to health equity. In an article, Health Affairs and Project Hope, who work with health equity, pointed out that a need to better understand health equity through measurement could help assess the effectiveness of the efforts to improve equity. “There is no national standard method for capturing data on key variables needed to assess health equity. Some organizations, such as the Office of Management and Budget, the Health Resources and Services Administration and National Committee for Quality Assurance, have developed guidelines for collection of race and ethnicity data, but they are not always consistent,” stated Health Affairs and Project Hope. “There is even less consensus on what categories to use to capture data on other variables, such as language, sexual orientation, gender and disability status. There are also no standard measures for assessing performance in improving health equity. The latter is essential to creating accountability and transparency for health equity.” As we learn more about health equity, we will be able to properly work with those that would benefit from improved health equity. In a recent article, Alison Yager, executive director of the Florida Health Justice Project, stated that philanthropic donations have streamed toward health equity issues, but the pandemic has underscored how underprepared the state is to deal with these problems. Tice circled back around in the article and stated, “We know that Florida has systematically disinvested in our public health infrastructure year after year for the past decade. It’s in a moment like this where those decisions have really come home to roost. We’ve seen how our systems have really lost (their) muscle.” With this in mind, it is important to move forward with a positive outlook in order to expand the resources available for those facing health inequity. In Tice’s interview she said, “Rather than trying to convince you this is an actual thing, we can work together to solve it.” Now assessments can be conducted and organizations such as the Voices Institute and the Florida Department of Health can work towards a better outcome for healthcare prosperity in our community.

Photo by Anna Shvets, courtesy of Pexels