After years of rising rates of physician burnout and increasing alarm over the epidemic’s impact, guidelines on promoting the well-being of health professionals have, for the first time, been developed with consensus and endorsed or supported by the American Medical Association (AMA), the Association of American Medical Colleges (AAMC), and other leading health organizations.
The CHARM-Arnold P. Gold Foundation Charter on Physician Well-Being, just published in the Journal of the American Medical Association (JAMA), is a landmark document designed to guide groups and individuals, from global healthcare organizations to medical students, residents and physicians.
The Collaborative for Healing and Renewal in Medicine (CHARM) and The Arnold P. Gold Foundation partnered to create the new charter. CHARM is a group of medical educators, leaders in academic medicine, experts in burnout research and interventions, and trainees working together with the combined mission to promote well-being among trainees and practicing physicians. CHARM believes that the well-being of all health providers is fundamental to the functioning of health systems, the safety of individual providers, and the provision of the highest quality patient care. The group is action-oriented and focused on creating deliverables for widespread dissemination that can empower individuals dedicated to building more supportive workplace communities for tomorrow’s physicians. The Arnold P. Gold Foundation is a nonprofit organization that champions the human connection in healthcare.
“The CHARM-Gold Charter on Physician Well-Being is a milestone in the quest to ease the terrible epidemic of clinician burnout,” said Richard I. Levin, M.D., President and CEO of the Gold Foundation. “We urge leaders of health systems and individual clinicians alike to use this important tool to help drive the change that is absolutely essential to the future of healthcare.”
The Gold Foundation provided a Mapping the Landscape, Journeying Together Advocacy Grant to CHARM to support the creation of a charter on physician well-being. The project was led by a team of five experts:
- Jonathan Ripp, MD, MPH of the Icahn School of Medicine at Mount Sinai;
- Hasan Bazari, MD of Massachusetts General Hospital;
- Larissa Thomas, MD, MPH of the University of California, San Francisco School of Medicine and Zuckerberg San Francisco General Hospital;
- Colin West, MD, PhD of the Mayo Clinic; and
- Elizabeth Gaufberg, MD, MPH of Cambridge Health Alliance, Harvard Medical School and the Arnold P. Gold Foundation Research Institute.
The Charter on Physician Well-Being
CHARM began considering the development of a “Physician Charter” in the fall of 2016, modeled after the American Board of Internal Medicine’s Professionalism Charter. The grant from the Gold Foundation supported a meeting hosted by the Accreditation Council for Graduate Medical Education (ACGME) in August 2017. The goal was to develop a consensus document that would have broad appeal and significant impact on the ways individual providers, medical practices, institutions, and health systems address the well-being of physicians. Representatives from more than a dozen national physician professional organizations attended; consensus input was incorporated into the final version.
The CHARM-Arnold P. Gold Foundation Charter on Physician Well-Being outlines a set of four fundamental principles to guide individuals and organizations in effectively supporting physician well-being within their communities of practice:
- Effective patient care both promotes and requires physician well-being.
- Physician well-being is inter-related with the well-being of all members of the health care team.
- Physician well-being is a quality marker for effective and efficient health systems.
- Physician well-being is a shared responsibility between individual physicians and the organizations and systems in which they work.
The document also outlines two societal level commitments, three organizational commitments and three individual commitments that would improve physician well-being.
Project lead Dr. Ripp commented, “We believe the CHARM-Gold Charter on Physician Well-being is the first codification of principles and commitments related to physician well-being to be conceived and endorsed by a wide range of professional societies representing a broad range of specialties. Our hope is that it will resonate widely across the ‘House of Medicine’ and serve as a framework for positive change in addressing the epidemic of physician burnout.”
The charter has already been endorsed/supported by more than a dozen organizations, including:
- AAIM – Alliance for Academic Internal Medicine
- AAMC – Association of American Medical Colleges
- ABIM – American Board of Internal Medicine
- ACCME – Accreditation Council for Continuing Medical Education
- ACLGIM – Association of Chiefs and Leaders of General Internal Medicine
- ACP – American College of Physicians
- ACOI – American College of Osteopathic Internists
- AMA – American Medical Association
- APA – American Psychiatric Association
- CMSS – Council of Medical Specialties Societies
- CORD-EM – Council of Emergency Medicine Residency Directors
- IHI – Institute for Healthcare Improvement
- NHMA – National Hispanic Medical Association
- NMA – National Medical Association
- SGIM – Society of General Internal Medicine
- SHM – Society of Hospital Medicine
Alexander Ommaya, DSc is the Senior Director of Clinical and Translational Research and Policy at the AAMC, one of the endorsing organizations. “The charter is an important set of principles and commitments that will help organizations enhance clinician well-being while improving patient care,” said Dr. Ommaya.
Additional Resources from CHARM
CHARM is committed as a group to advancing the awareness of individual and system-level interventions designed to mitigate trainee as well as provider burnout and promote well-being. In so doing, CHARM has already developed a number of tools and resources:
- Annotated Bibliography of Evidence-Based Interventions for Medical Student, Trainee and Practicing Physician Wellbeing
- American College of Physicians Practice Advisor Module: Making the Case to Address Clinician Burnout (free registration required)
- Well-Being in Graduate Medical Education: A Call for Action, published in Academic Medicine
- A Roadmap for Research on Resident Well-Being, published in The American Journal of Medicine