Index

AAMC

. See Association of American Medical Colleges

ACA

. See Affordable Care Act

ACEs

. See Adverse childhood experiences

ACE Scale,

114, 120–121

summary of,

121–122

Addiction

in residents,

149–168

treatment for,

160–162, 164–165

Adverse childhood experiences (ACEs),

114

Affordable Care Act (ACA),

xvi

Alcohol abuse disorder,

203

in physicians,

xii

Allegheny College,

116

Alpha Omega Alpha Honor Medical Society,

20, 21–22

AMCAS

. See American Medical College Admission Service

American College of Endocrinology,

83

American College of Physicians,

21

American Medical College Admission Service (AMCAS),

107

American Medical Students Association,

141

American Medical Women’s Association,

92

Americans with Disabilities Act,

48–49

American Telemedicine Association,

87, 88

Anzia, Joan,

15–18

Arora, Dr.,

99

Arora, Hans,

209–211

Arora, Kavita,

209–211

Association of American Medical Colleges (AAMC),

130

perspective on clinician well-being,

145

review of social media and application to medical school,

119–120

Baby Boomers,

xvii, 24

Balint, Michael,

190

Beneficence,

17

Blogs

on decision to retire,

228–230

on health care about UCH,

28, 41–42

Brucer, Dr.,

150

Burnout

behavioral components of,

174–175

detection of early signs of,

165

of physicians,

xv, 42

reduction of,

xvii

stigma attached to symptoms of,

173–174

symptoms of,

43, 88–89, 156

technology for prevention of,

86

Burtone, Dr.,

40

“Busy work.”

See also Electronic medical record (EMR)

of physicians,

xiv

reduction of,

xiv–xv

Canter, Marty,

193–214

Carbon dioxide emissions

changes in,

186–188

Carbon Neutrality Initiative,

187

Careers

alternative, in medicine,

185–186

defining meaning in,

169–190

medical marriages,

193–214

medical specialty decisions,

213

physician fulfillment and,

188–189

Carney, Mr.,

29–30

Carnicle, Jocelyn,

118

Case vignettes

of addiction in residents

commentary,

162–167

scenario,

149–162

on biases and a well-being curriculum in medical school

commentary,

140–146

scenario,

125–139

on cognitive dissonance and defining meaning in medicine

commentary,

184–190

scenario,

169–184

on the culture of medicine,

xviii–xix

commentary,

15–25

scenario,

1–15

on health care

blogs,

28, 41–42

commentary,

42–50

scenario,

27–42

University City Health and,

27–52

of joy and meaning in medicine

commentary,

227–233

scenario,

215–227

of medical marriages

commentary,

207–214

scenario,

193–206

on morale in a clinical setting

commentary,

69–76

scenario,

53–69

of pre-med vulnerability and trauma,

101–124

commentary,

114–123

scenario,

101–113

on resilience

commentary,

69–76

scenario,

53–69

on trust, mentoring, and innovation

commentary,

91–99

scenario,

77–91

Chief Wellness Officer (CWO)

appointment of,

42

description of,

46

responsibilities of,

46–47

Childcare,

208–209

Chofan, Asim,

149–167

Cleveland Clinic,

xv

Clinical services,

187

Cognitive dissonance, defining meaning in medicine and,

169–190

Collaboration,

97

Commitment, as attribute for successful entry into medical school,

118–119

Communication

. See also Case vignettes

as attribute for successful entry into medical school,

115

in the health care industry,

33

“phone tag,”

97

with physicians,

70

skills for,

219

via technology,

89

Community service

. See also Volunteering; as attribute for successful entry into medical school, 116

Compassion, as attribute for successful entry into medical school,

116

Competence,

17–18

Confidentiality,

41

Co-Worker Observation Reporting Systems,

185

Critical thinking, as attribute for successful entry into medical school,

115–116

Culture

of the clinic,

68–69

of medicine,

xviii–xix, 1–26, 195–196

of residency,

162–164

travel and,

107

understanding differences in,

142–143

of well-being,

45

CWO

. See Chief Wellness Officer

Cynicism,

43

DALYs

. See Disability adjusted life years

The David Geffen School of Medicine,

116–117

Death, from suicide,

xii, 109

Dementia,

79

Denial,

19

Detachment,

43

Diabetes,

58–59, 98, 106

Disability adjusted life years (DALYs),

186

Doctor–patient relationship,

89, 202

Documentation,

95–96. See also Electronic medical record; Time

changes in,

179–180

Drug abuse,

149–167

Drummond, Mike,

208

E-consults,

59, 61, 98. See also Technology

technology and,

89

Education

educational interventions for implicit bias,

144

“just in time” resources in,

xviii

teaching,

220–221

technology and,

xviii, 17–179

Electronic medical record (EMR)

. See also “Busy work”; Documentation; Physicians

adaptation to,

199

daily messages in,

83

data included in,

176–178

demands of,

xiv

improvement in use of,

73

pajama time at home and,

177–178, 204

time spent on,

35, 92, 225

Elton, Caroline,

143

Emotional depletion,

43

EMR

. See Electronic medical record

Environment

carbon dioxide emissions in,

186–187

changes in,

186–188

climate change and health care industry,

175

physical structures and equipment,

187

Evansly, Dr.,

112–113

Facebook,

108

Family, of physicians,

5–6, 36

Federation of Medical Boards,

48–49

Fidelity,

18

Galvin, Brett,

194–214

Galvin, Cathy,

194–214

Garcia, Dr.,

78

Garcia, Luis,

101–124

Generation X,

24

Google,

231

Gordon, Brian,

28

Hall, David,

116

Haney, Susan,

47

HappyMD,

208

Harrod, Dr.,

125–139

Harvard University,

xv

Hawley, Nigel,

226

Health care industry,

xv–xviii

business model for,

220

changes in,

186–188

“change toxicity” of,

65

climate change and,

175

communication,

33

costs of,

xv, 97–98

efficiency of,

34

finances of,

74, 167

leadership in,

19–20

LGBT individuals and,

131

medically driven leadership in,

xvii

mission statement of,

57, 66

proposed changes in,

34

proposed organizational strategies in,

45

Quadruple Aim,

43–44

social justice in,

21

strategic planning in,

72

success of,

66

Triple Aim,

43–44

workflow improvements in,

69, 70

Health Professionals Advancing LGBTQ Equality (Gay and Lesbian Medical Association),

141

Heroin, addiction to,

153

Hippocratic Oath,

xix, 16–17

proposed changes to,

17–18

Holistic review,

117

Hope,

17

Hospital care,

187

Howard, Mr.,

101–124

Huddle Implementation,

63–64, 68

IDP

. See Independent development plan

IEDs

. See Improvised explosive devices

IHI

. See Institute for Healthcare Improvement

Implicit bias

consequences of,

142

description of,

140–146

educational interventions for,

144

IHI strategies to reduce,

142

solutions to the problem of,

142

teaching about,

143

Improvised explosive devices (IEDs),

134

Independent development plan (IDP),

83–84

long-term goals of,

84–85

Innovation, case vignette on,

77–99

Institute for Healthcare Improvement (IHI),

43

strategies to reduce implicit bias,

142

Intellectualization,

19

Isla, Lindy,

55, 58, 67, 77–99

Jackson, Ellen,

215–233

Jameston, Bill,

28

Johns Hopkins,

xv

The Joint Commission,

28, 142

“Joy of Medicine” program,

231–232

Justice,

18

social,

21

Kaiser Family Foundation,

23

Kaiser Permanente,

xv

Kirch, Darrell,

xvi–xviii, 123

Krebs cycle,

113

Lawsuits

long-term impact on physicians,

23

against physicians,

7–8, 22–23

Leadership

as attribute for successful entry into medical school,

117

description of,

72

programs for,

71–72

Leadership in Energy and Environmental Design (LEED)-certified buildings,

187

Lean Six Sigma Accreditation,

63

LEED

. See Leadership in Energy and Environmental Design-certified buildings

Legislation

Affordable Care Act,

xvi

Americans with Disabilities Act,

48–49

Paris Accord,

187

LGBT individuals

health care and,

131

in medical school,

132–139

Life span, of physicians,

x–xi

Lifestyle

changes in,

152, 205

of physician,

24

Losara, Dr.,

129

Malpractice Reports,

22

Management

description,

72

physician involvement in decisions,

73

Marijuana,

153

Marriage

medical,

193–214

successful,

217

Mayo Clinic,

xv, 43

MCAT,

107

Medical Board of California,

230

licensing requirements,

47–49

Medical license

. See U.S. Medical Licensing Exam

Medical marriage,

xx

case vignette of,

193–214

finances during,

211–212

negative side of,

210

principles of,

209–211

Medical school

admission teams,

115

attributes for successful entry into,

115–116

changes in admission process,

144–145

core competencies for preparedness for,

117

joy and meaning in,

225–226

multiple mini-interview format,

144–145

preprofessional competencies as attribute for successful entry into medical school,

117

process of admission,

102–124

surviving,

120

teaching about implicit bias in,

143

unbiased advice to students,

117

well-being curriculum and biases in,

125–146

Medical students

debt relief program for,

81

influence of mentors on,

130–131

mental health of,

xii

suicide and,

132

support system and,

113

Medicine

alternative careers in,

185–186

culture of,

xviii–xix, 1–26, 195–196

defining meaning in,

169–190

joy and meaning of,

215–234

medical marriages,

193–214

medical societies,

230–233

“old style,”

55

physician transition to retirement from,

218–219

podcasts,

217–218, 224

pre-med vulnerability and trauma,

101–124

unintended consequences of culture of,

18–19

virtual,

169–190

Medscape,

22

Mental health

of medical students,

xii

of physicians,

xii, 37

stigma about,

42, 49–50

“Triple Aim,”

30

Mentees, tips for,

94

Mentoring

barriers to,

63

career development plans and,

70

case vignette on,

77–99

implicit biases and,

95

process of,

92

program for,

61–62, 69

success of,

92

Mentors

influence on medical students,

130–131

residents and,

126–127

tips for,

93

Military,

132–133

Millennials,

24

description of,

167

as future physicians,

119

Mission statement,

57, 66

MMI

. See Multiple mini-interview format

Models

. See also “Project Echo”

business,

220

financial model,

177

physicians as role models,

76

WellMD “professional fulfillment model,”

45

Morale

case vignette on,

53–76

improvement of,

70

Morphine,

154

Multiple mini-interview (MMI) format,

144–145

National Academy of Medicine,

19

National Institutes of Health,

xvii–xviii

National Medical Association,

83

Newton, Louise,

215–233

Nonmaleficence,

18

“Note bloat,”

xiv

Odono, Ms.,

30

Ohio State University College of Medicine,

143–144

Optimism,

17

Oxycontin, addiction to,

149–167

Pain, chronic,

149–167

“Paint Your School Pink,”

141–142

“Pajama time,” xiv

Parenting,

208–209

Paris Accord,

187

Parsons, Abbie,

222–223

Passion, as attribute for successful entry into medical school,

118–119

Patient Advocacy Reporting System,

185

Patients

autonomy of,

21

boundaries with,

97

care of,

58

doctor–patient relationship,

89, 202

family and,

5–6

letters to physicians from,

3–15

physicians as,

165–167

time with,

96–97

virtual care technology and,

68

welfare of,

1

Peers,

23

physicians as role models,

76

Personal achievement,

43

Physicians

. See also Electronic medical record; Well-being

abuse of prescribed drugs,

xii

alcohol abuse disorder in,

xii

burnout,

xv, 42

“busy work” done by,

xiv

career development plans of,

70

case vignette on the culture of medicine and,

1–26

“change laggards,”

65

“compulsive triad” of personality,

xviii–xix

dedication of,

2–3

development of clinical expertise,

98

doctor–patient relationship,

89, 202

empathy from,

219

flexibility of hours,

97

fulfillment in career,

188–189

“hybrid,”

96

involvement in management decisions,

73

“laggards,”

70–71

lawsuits against,

7–8, 22–23

licensing,

74–75, 223–224

life span of,

xi–xiii

lifestyle of,

24

mental health of,

xii, 37

as money managers,

221–222

as patients,

165–167, 193–214

pressure on,

32

pro bono work,

230

relationships,

208

role identification of,

74

as role models,

76

schizophrenia in,

xii

self-care of,

163

“street credibility” of,

56

stress and,

6–7, 180–181

transition to retirement from clinical practice,

218–219

volunteering during retirement,

219, 230–231

“walk the talk” of,

57

Podcasts,

217–218, 224, 232

Posttraumatic stress disorder (PTSD),

134–136

Pre-medicine, case vignette of,

101–124

Prescription drugs,

187

physician abuse of,

xii

Press Ganey,

185

Primary care physician

lack of,

23–24

Professionalism

consequences of,

xviii–xix

monograph on,

20–21

pressures of,

9, 11–12

“Project Echo,”

86–89, 98–99

Psychiatrists

as “physician’s physician,”

165

support for medical students,

127–128

PTSD

. See Posttraumatic stress disorder

Quadruple Aim,

43

Racism, in medical school,

137, 140

Raley, Justin,

126–146

Rape,

135

Rea, Margaret,

163

Read, Dr.,

226–227

Relationships, of physicians,

208

Research, as attribute for successful entry into medical school,

116

Residents

addiction in,

149–168

culture of,

162

as mentors,

126–127

preexisting psychological strengths and vulnerabilities in,

163

Resilience,

45. See also Retirement

approaches to,

75

as attribute for successful entry into medical school,

116

case vignettes on,

53–76, 101–123

change and,

71–72

-enhancing activities,

75

Retirement

median age of,

228

transitioning into,

218–219

volunteering during,

219, 230–231

Richmond, Paul,

1–26

Road to Resilience,

75

Roberts, Dr.,

62

Royal College of Physicians and Surgeons of Canada,

21

Sacramento Sierra Valley Medical Society,

122

Safety,

98

Schizophrenia, prevalence in physicians,

xii

Seija, Luis E.,

119

Self-care,

163

as attribute for successful entry into medical school,

116

Seview, Dr.,

84

Sex, in medical marriages,

198

Shaper, Jack,

53–76, 81

Sierra, Roseanne,

28–29

Sierra Sacramento Valley Medical Society (SSVMS),

228

“Silver tsunami,”

xvii

Six Sigma, training,

69

Sleep, deprivation,

136, 157–158

Social justice,

21

Social media, AAMC’s review of social media and application to medical school,

119–120

SSVMS

. See Sierra Sacramento Valley Medical Society

Stanford University,

43

Stanford Wellness Framework,

70, 92

STEM (science, technology, engineering, and mathematics),

103

“Steps Forward,”

63–64

Stone, Dr.,

29

Stress

. See also Medical marriage

in physicians,

6–7, 19–20, 32, 180–181

of physicians,

6–7, 19–20, 32

technology for prevention of,

86

Suicide,

xii, 109

in family of physician,

36

by a medical student,

132–139

planned,

203

rates of,

xii

thoughts about,

165, 201

Teaching,

220–221

Teamwork,

97

Technology

. See also E-consults

education and,

xviii

to increase efficiency and reduce burnout levels,

95–96

mobile,

97

“phone tag,”

97

for prevention of burnout and stress,

86

training and,

178–179

use of with patients,

96, 97

virtual care through,

68

well-being and,

59–60

Telemedicine,

96, 169–190

flexibility of,

181–182

to help physicians work

differently,

184–185

safety of,

98

Texas A&M College of Medicine,

119–120

Texas Tech University Health Sciences Center El Paso,

118

Time

. See also Documentation; Electronic medical record

after scheduled work hours,

204

flexibility of physician hours,

97

with patients,

96–97

Tobin, Dr.,

55–56

“Triple Aim,”

30

Trust, case vignette on,

77–99

Twitter,

103

UC

. See University of California

UCH

. See University City Health

University City Health (UCH),

27–52

University of California (UC),

xv, 187

University of California, Davis,

120, 145, 163

University of California, Los Angeles,

116–117

University of Queensland, Australia,

115

U.S. Medical Licensing Exam (USMLE),

120, 133

Vanderbilt Center for Patient and Professional Advocacy,

185

Veracity,

18

Vine, Jordan,

194, 199–214

Volunteering,

219, 230–231. See also Community service

Volunteer Physician Registry,

230

Wall Street Physician,

229

Well-being

AAMC’s perspective on clinician,

145

aims of,

44

culture of,

45

curriculum in medical school,

125–146

“curriculum” topics for,

145–146

interventions for,

189–190

lifelong learning about,

xv

as motivation for career choice,

112

overview,

xiii

physician,

31

programs for,

217–218

support for,

114

technology and,

59–60

WellMD “professional fulfillment model,”

45

Wetzel, Aileen,

231–233

Workaholics,

198

Work-life balance,

62, 67, 167, 169–190

in medical marriage,

198

working after hours,

97

Workload, variety of,

96

World Health Organization,

43