Physician lounges are dying: How hospitals now foster connection

Pre-pandemic, hospitals' physician lounges were already desolate spaces. The effects of the COVID-19 pandemic coupled with a growing to-do list have further encroached on physicians' ability to interact with colleagues, which can exacerbate burnout. Now, hospitals are investing in other efforts to reinvigorate connection among physicians. 

"Individuals who are isolated or are lonely, they are more likely to have less overall wellness; more likely to experience symptoms of burnout," Marjorie Bessel, MD, chief clinical officer at Phoenix-based Banner Health, told Becker's

Studies have shown social isolation can negatively affect healthcare workers' well-being. For instance, this 2022 study shows loneliness is a significant predictor of exhaustion and disengagement. 

The drop in workplace interaction 

In a 2013 article in The Atlantic, Richard Gunderman, MD, PhD, wrote about physician lounges increasingly becoming a space where "physicians are alone." While once a hub for water cooler discussions and building relationships with colleagues, Dr. Gunderman described how lounges became sparsely attended in order to catch up on paperwork or other administrative tasks. 

Both a high volume of patients throughout the pandemic and more rigid infection control practices have further advanced the ghost town atmosphere in physician lounges. 

"Since the pandemic hit, there has been so much activity and focus on keeping everybody safe, that many of the areas that were considered congregate areas — where people would be eating and drinking without their masks on —  have become and are looking very different," Dr. Bessel said. 

"Physicians, of course, being the scientists that they are, are still incredibly cognizant of the risks that they encounter when they're with other individuals in a close surrounding," Dr. Bessel said. 

Over the years, physician schedules have become more jam-packed, another factor behind a declining level of interaction.

"Patient volumes, the time required to see patients — even when volumes don't increase — the complexity of medical practices, has reduced the time physicians have available to decompress, to remember that they're part of a team — a team with lots of other people that are involved," said Colin West, MD, PhD, a quantitative health sciences researcher at Rochester, Minn.-based Mayo Clinic. 

Medical practice is also increasingly managed electronically.

"We end up being really tied to our computers. In a lot of respects, physicians — whether they're working in a hospital or clinic — [have] become office workers," Dr. West told Becker's.

For every one hour physicians spend in direct clinical face-to-face time with their patients, they spend an additional two hours on electronic health record and desk work during the day, according to a 2016 study published in the Annals of Internal Medicine. On top of that, physicians spend an average of nearly two hours per day on EHR tasks outside of work hours, according to a separate study published March 28 in JAMA Internal Medicine.

"Telehealth-type work has certainly contributed to this isolation because, oftentimes, the telehealth is occurring not in a medical building or in a medical community," Lisa Bellini, MD, senior vice dean for academic affairs at Penn Medicine in Philadelphia, told Becker's. "And so people not only didn't see their colleagues, but they didn't see their patients."

The pandemic dramatically accelerated the use of telehealth. According to a 2020 ​​analysis by the American Medical Association, the percentage of physicians who used video conferences with patients grew from 14.3 percent in 2018 to 70.3 percent in 2020. Though use of telehealth has declined since the start of the pandemic, it still is higher than before COVID-19 emerged.

How systems are fostering physician connections 

While isolation contributes to burnout, experts say increased connection mitigates it. 

"One of the most powerful antidotes to burnout is engagement, and it actually doesn't take a lot of engagement to mitigate burnout," said Penn Medicine's Dr. Bellini. 

Dr. West directs Mayo Clinic's physician well-being program within the department of medicine, which is based on a clinical trial conducted in 2014. The program involves group discussions of six to 10 physicians who meet for an hour to discuss a topic that is broadly relevant to the physician experience, such as work-life balance or job satisfaction. Physicians can sign up for a six-month long session and the goal, according to Dr. West, is to meet once a week for an hour. Mayo Clinic pays for the physicians to share a meal during the engagement sessions. 

Findings from the research on Mayo's approach "showed it actually reduced burnout, produced meaning at work," Dr. West said, adding that more than 50 percent of physicians sign up for at least one six-month block of this session, with most signing up for multiple iterations. 

Banner Health sponsors structured activities a few times a year to foster social connection among physicians as part of its Cultivating Happiness in Medicine program. The activities can be led by any physician or advanced practice provider in the organization. 

"It's a structured activity where we ask them to talk about a certain topic," Dr. Bessel said. The discussion is coupled with a social activity of the group's choice. They've included team lunches, paint by numbers and outdoor exercise-related activities. Many of the activities were conducted virtually at different points throughout the pandemic. 

"It's really well-received. Even during the pandemic, 50 percent of those physicians and APPs that are within our employment arena participated in at least one activity during the year," Dr. Bessel said. 

It's not often half of an organization's physicians participate in a voluntary activity, so "it must be hitting the mark," Dr. Bessel said. 

Efforts are also being made to prioritize connection on the education side. 

"We are working on changing our model to include more learning communities, dividing our students into smaller groups where they have group mentoring and more group learning and relaxation space," Emily Walvoord, MD, associate dean for student affairs at Indiana University School of Medicine in Indianapolis, told Becker's. 

At the very least, healthcare organizations should bring renewed attention to communicating the importance of workplace connections, Dr. West said. 

"One of the first big things that needs to happen is that practices, organizations and individual physicians have to be reminded — and have to remind themselves — that connection is important; that it's not just about our relationships with our patients, although those are at the center of what we do. We also need to share success stories" he said.

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