When we caught up with Dr. Siow, we asked her to describe a project she is currently working on. Here is what she shared with us.

I am passionate about improving wellness for physicians in a way that positively impacts our daily work lives. Work conditions that allow physicians to thrive, lead to better patient interactions and outcomes. I aim to use an approach that is evidence-based, driven by physician needs, and creates system and culture change. My efforts toward advancing wellness include advocacy, education, measurement and interventions. 

Prior to the pandemic, 30% of Canadian physicians reported high levels of burnout and 8% reported recent suicidal ideation. I am concerned about worsening burnout from chronic pandemic strain and additional demands on our work. Burnout is associated with addictions and substance use, death by suicide, increased medical error, and decreased quality of patient care. We need to act to improve physician wellness. We need to address system factors that drive 80% of burnout. We need to advocate for wellness beyond burnout and create positive change in our workplaces. 

I am exploring partnerships to implement a framework for improved physician wellness that targets system and culture change. I provide education to physicians about evidence-based strategies for wellness. I empower physicians to achieve sustainable change toward their own wellness. I innovate online spaces for physicians to connect and share experiences. I hope physicians recognize that we are not alone in the demands of our profession and utilize connection as a strategy to maintain resilience. These physician groups also offer an opportunity to explore solutions to system issues together. 

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Dr. Serena Siow, Calgary

What are your professional roles?

  1. MD, CCFP - family physician
  2. Hospitalist Physician and Hospitalist Site Representative, Rockyview General Hospital
  3. Clinical Assistant Professor, Department of Family Medicine, Cumming School of Medicine, University of Calgary
  4. Representative Forum delegate, Section of Family Medicine, Alberta Medical Association
  5. Physician Lead, Physician Wellness for Calgary Hospitalists

Please describe briefly your wellness initiative with the Calgary Hospitalist group.

Hospitalists are family physicians who provide care to over 60% of medical inpatients in Calgary hospitals. Improving wellness for this group of physicians would lead to better patient care and outcomes for their 1,400 patients seen on a daily basis. To understand the pre-pandemic state, we completed a needs assessment to measure wellness and determine priority areas. We found burnout is prevalent: 20% of Calgary hospitalists reported high levels of burnout (weekly or more frequent) and 32% of Calgary hospitalists self-reported burnout. We provide education on strategies to mitigate burnout and improve wellness. We launched a peer support team offering a system-level approach to supporting colleagues in distress. We present recommendations to influence wellness at an organizational level, including best practices for scheduling during a pandemic. We advocate for optimized practice efficiency, such as improving our overnight shift experience, and strengthening our working relationship with the emergency department. We ask that physician wellness be considered whenever any decision is made. We advance the visibility of wellness as an organizational priority. 

A system-level approach recognizes physicians as its most important resource and promotes a culture of improvement. Teams that value physician wellness achieve objectives during ordinary times and overcome challenges during times of crisis. Our framework to improve wellness is based on three main strategies: 

1. supporting physician resilience and emotional health 

2. improving practice efficiency through system change 

3. building a culture of wellness 

We plan routine evaluation to measure impact and promote continuous improvement. We are exploring partnerships to implement the next steps toward our vision for improved physician wellness. 

Tell us what your colleagues can expect from you in this role. 

Dedication, reliability, integrity, courage, compassion

Please describe briefly your partnership with Dr. Carmen Gittens.

Dr. Carmen Gittens is a colleague and friend. We established and lead the Physician Wellness for Calgary Hospitalists initiative together. Carmen is an incredible partner and advocate for wellness. She is enthusiastic, innovative and visionary in her commitment. I am inspired by her compassion and dedication to those around her. Our wellness efforts are better because of her involvement and contributions.

We understand you were recently profiled by Well Doc Alberta. Can you tell us about that?

I am humbled that our wellness initiative was profiled by Well Doc Alberta. We were set to be featured in their provincial showcase keynote session, which was cancelled due to the pandemic. I am glad Well Doc Alberta exists in our province and provides a forum for collaboration with others interested in advancing wellness. We are fortunate to benefit from Dr. Jane Lemaire’s experience and expertise. 

For you, what three words describe the current state of physician wellness in Alberta?

  1. challenging
  2. momentum 
  3. precarious

What three words describe your goals related to physician wellness in Alberta? 

  1. evidence based
  2. advocacy
  3. action

As a physician yourself, what is something you do intentionally to take care of your mental health?

I prioritize my own well-being and believe this makes me a better physician for my patients. I create space to pause and reflect on my thoughts and emotions through journaling and meditation. I set boundaries between work and home. I maintain support networks at work and outside of work. I am so fortunate to have wonderful, compassionate, supportive hospitalist colleagues!

What is your cue that an area of your own wellness needs your attention? 

I thrive and function at my best when I exercise consistently, eat healthy, sleep well and spend time with family and friends. When my motivation for any of these wanes, it is a cue that one area may need more attention. I am learning to notice when this happens and being kind to myself when it does.

What area of your wellness do you find the most challenging to look after? 

With shift work and after-hours as a routine part of my work schedule, sometimes it can be challenging to find enough time and energy for activities outside of work.

How is this challenge different now than it was earlier in your career? 

I am more aware now of what I need to function at my best. I am better at scheduling time off and extra rest days. This means prioritizing and saying no if already having a busy work week, which was challenging to do earlier in my career.

If you had a magic wand for physician wellness what would you do?

I want commitment to addressing the system factors that would allow physicians to thrive at work. Investment in dedicated capacity and infrastructure to influence change at every level are more impactful than informal champions of wellness. Physicians are incredibly resilient and committed to going above and beyond for our patients. I want action to support our efforts at a system level, realizing the positive return on investment to patients and the health care system. 

What one thing do you want your colleagues to know? 

You are important and your well-being matters. Prioritizing your self-care improves the care you provide to patients and makes you a better human being. Ask for help when you need it; we care about you. 

With respect to physician wellness, what is your greatest of all time (#GOAT) and why? 

I am grateful to all who dedicate efforts towards physician wellness. The AMA’s Physician and Family Support Program is my wellness #GOAT, for providing 24/7, 365 days a year, confidential support to physicians and medical trainees. PFSP is a vital program and must continue to operate from within the AMA. 

And now for fun, tell us your preference in each of the following pairs.

Dog or cat - dog 

Rural or urban - rural for vacation, urban for living

Sweet or salty - salty 

Introvert or extrovert - introvert 

Yoga or Zumba - yoga 

Text or call - call

Summer or winter - summer 

Journal or meditate - both! 

Sing or dance - dance

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