ACU Professional Health and Wellness Initiative

Serving one's fellow man as a health care professional is a sacred honor. Many years of preparation, sacrifice and gratification postponement are required to earn this privilege. An information base is arduously assembled, and technical skills practiced and mastered. Whether from dental, medical, nursing, pharmacy or allied health professional school, this grooming and refinement continues after graduation. If all goes reasonably well, the neophyte, anxious to apply all that has been learned, enters the ranks of his or her profession with an enlivened spirit of altruism and a desire to serve mankind.

In the real world of practice, there often follows a rude awakening to the fact that technical knowledge and skill, though necessary, do not suffice to bridge the chasm between practice and broader life demands. An additional skill set is needed to optimally address the many challenges of home life, workplace and needs of the evolving self. The dynamic nature of changes modifying the health care environment and the impact of this change on individuals working in it has not been appreciated fully. Training and education in the health care professions do not prepare the graduate to understand and effectively navigate these rapidly changing environments. Increasing rates of professional discontent and burnout among clinicians attests to this dissonance between life management strategies and real life practice.

There is a growing recognition of the need to augment technical knowledge among health care professionals in order for them to perform optimally in practice. Many health professions' training curricula have been expanded to increase awareness of the emotional toll of work in demanding and stressful health care environments, sensitizing students to the realities of drug and alcohol abuse, emotional health problems and a variety of other conditions not addressed even a decade ago.

The causal connection between medical errors and excessive physician stress has been made reluctantly, and strides are being taken to make systems changes as well as encourage medical practitioners to make healthier decisions about their own lives. The Accreditation Council for Graduate Medical Education (ACGME) has modified its standards as they relate to individual call schedules and the number of consecutive hours residents are allowed to be on duty.

The Joint Commission for Accreditation of Healthcare Organizations (JCAHO) in recent years has extended the credentialing requirements of hospitals and healthcare organizations to include health promotion as well as services for the impaired physician. Centers specializing in health promotion and impairment prevention for physicians and other healthcare professionals have been developed throughout the country. Though encouraging, these strides are slow in taking hold and effecting change, as quality care issues and demands for cost efficiency are in constant conflict.

Taken together, these trends reflect a growing awareness and concern for increasing levels of professional dissatisfaction and burnout within the ranks of health care providers.

For health care professionals serving the underserved, there is the additional burden of treating sicker patients with more advanced disease when entering the system of care, and often doing so with limited resources. Community resource allocation assigns disproportionately fewer health care dollars to the uninsured, poor and underserved. This translates into even higher levels of stress for the health care practitioner serving this population, and constitutes nothing less than a health care crisis affecting all Americans, as documented by the recent IOM report, Insuring America.

In recognition of these realities, ACU (Association of Clinicians for the Underserved) has been proactive in addressing the issues of professional health and wellness among its membership who serve the underserved. As part of its professional support activities, ACU is developing a campaign, "Strength for Serving" to address these concerns, the goals being to:

1. Better understand the variables contributing to professional satisfaction and effectiveness, as well as those accounting for dissatisfaction, stress and burnout;
2. Develop model interventions to modify these variables in order to improve work satisfaction, personal and professional effectiveness;
3. Refine and replicate effective interventions, and contribute...