Music is an outlet from the stress of work for VCU Health’s Francesco Celi. (Photo by Zaid Hamid)
Francesco S. Celi is the William G. Blackard Professor of Medicine, chair in the Division of Endocrinology Diabetes and Metabolism, and director of the Virginia Commonwealth University Health Diabetes Program at VCU’s Department of Internal Medicine. Those many titles translate into work on diabetes research in an active laboratory, writing grants, penning scientific articles, teaching, holding clinical consultations with residents and patients and a lot of administrative work.
“A major source of burnout among people who work in the health field is that you have to do a lot of documentation for each patient,” says Celi, who does not leave that task until the end of the day as many others do, but completes it immediately after a medical consultation. ” But when I do that, I’m not doing my medical work. Also, I have to compartmentalize my clinical care from my research.”
As a counterpoint to his high pressure and detail-focused career, Celi plays violin in the VCU Health Orchestra. Each Wednesday night, medical students, nurses, administrators, physicians and paramedics crash the cafeteria for a rehearsal, trading stethoscopes and scalpels for string, woodwind, brass and percussion instruments.
(From left) VCU Health Orchestra violinists Tara Stamm, Ph.D.; Katherine Mayer, NP; and Francesco Celi, M.D., perform at the Internal Medicine Celebration of Excellence in February 2019. (Photo by Kevin Morley courtesy VCU)
“It’s really a joy and it makes me feel great,” says Celi, who started playing the violin as an adult as he was helping his now-grown daughter learn the instrument. “What we do at work doesn’t have any role in the orchestra. I’m the last chair of the violin and I’m not that good, but the prize is just sitting with colleagues and friends and making music. We feel like a community. And it’s a good counterpart to medical work.”
Finding a passion outside the office is not just a mark of diverse interests, it’s crucial to your health. That’s especially true for medical professionals. The American Medical Association in 2019 reported that of 5,000 doctors who participated in a survey, 43.9% showed at least one symptom of burnout. And that was an improvement from past surveys, according to the report, which noted that the survey marked the first time since 2011 that the rate was below 50%.
Stress, frustration with multiple administrative systems, physical injuries, outside controls, and long hours of paperwork are factors that lead to burnout for medical professionals.
Lisa Ellis, an obstetrician/gynecologist and an associate professor of internal medicine at VCU, says the changing culture of medicine has an effect on medical providers, and that the ensuing stress and burnout also make medical professionals at risk for suicide. “We often have limited control over what we can order and can do, because of the growing power of insurance companies and governing regulations,” she says.
Ellis has been trained by the American Medical Association and the American College of Physicians as a Wellness Champion for physicians and providers. Addressing burnout is a topic she is passionate about. She has conducted workshops and retreats at national conferences.
Health systems across the country are taking on this problem in different ways. A recent conference at VCU for physicians provided an afternoon of speakers, panels, small group work and development of priorities for the organization to move towards a “Utopia of Wellness.” That conference was designed to foster a culture of wellness, providing resources that advocated for systems changes to improve the work/practice environment and promote professional satisfaction.
Ellis says addressing workplace changes is something hospital systems can do to prevent burnout. For example, medical residents were asked what VCU could do to make their lives easier, and several respondents said providing free coffee would help, so they would not have to run to cafes to tank up on their favorite beverages. VCU leadership met the request and is also providing snacks and fruit for the young doctors as well as a dedicated work space and exercise equipment.
Ellis emphasizes the importance of workplaces ensuring that their medical providers are able to focus on the professional activities and duties that they love. Asking each doctor or nurse what their passion is and ensuring they can do that goes a long way toward allaying burnout.
Cultivating outside activities — even cooking or crafting — also plays an important role in ebbing burnout, Ellis says. “You use an entirely different part of the brain.”
Ellis likes lobbing horseshoes. She played as a child in South Dakota with friends and family, and as a college student in Wisconsin, because it was something that people of any age and athletic ability could do together. Now, she and her husband play competitively at events in Nags Head, North Carolina.
(From left) Mary Falterman, Denise Weisberg and Vienne Murray (Photo by Jay Paul)
Enjoying the Ride
Denise Weisberg is a free-wheeling soul.
The vice president of quality and risk management at Henrico Doctors’ Hospital, Weisberg loves to take her bicycle out on the road with other enthusiasts with the Richmond Area Bicycling Association. She mostly trains for rides with women around the area, but often brings her bike along when she travels, too. “I ride because it’s good exercise and because of the scenery,” she says. “The roads are beautiful. It feels freeing.”
It’s also a way to alleviate stress. Weisberg notes that professionals in medical fields face long hours, low reimbursements and higher patient loads. Such challenges and frustrations can lead to burnout.
Vienne Murray, an obstetrician/gynecologist with West End Obstetrics & Gynecology and Henrico Doctors’ Hospital, often joins Weisberg, and also takes a break from the stress of her job by running and riding horses. Athletics has always been a part of her life and it helps her with her professional responsibilities.
“You have to be very, very controlled as a physician,” Murray says. When you’re speaking, you have to be very measured but when you’re running, you can go as fast as you can. It’s fun to get your body as well as your mind working.”
Philip Dawson (left) enjoys rowing in his free time. (Photo courtesy Philip Dawson)
Taking Flight and Working Out
The emergency room is known for high stakes issues and stress, says VCU emergency room attending physician Joe Ornato, who also led Richmond’s EMS System.
Ornato has his own plane that he flies for business, primarily going to professional conferences. He’s a certified pilot, who became interested in learning how to fly when he was in the military and rode in planes serving injured soldiers.
“Flying a jet for me is paradoxically relaxing,” he says. “On the one hand, especially in adverse weather and during complex instrument approaches into busy airports, it demands a high degree of proficiency and constant attention. On the other hand, it takes me into a completely different world than the everyday at work and gives me a great deal of satisfaction at being able to perform highly complex tasks in a different domain consistently and safely.”
Ornato also finds an outlet in music. As a teen, he played trumpet in party bands at hundreds of weddings and bar mitzvahs. Now, he produces the VCU Medical Orchestra’s recordings. “With the VCU Medical Orchestra I go by ‘Joe.’ It’s wonderful to see everyone at the same level. We’re all just musicians.”
Phillip Dawson, a pediatrician with West End Pediatrics, a practice in the partnership Pediatric Partners of Virginia, has been a triathlete and a regular participant in adventure racing for 30 years. Recently, though, he was recovering from an injury sustained while cycling when his bike “touched wheels” with another, causing him to “go over and break his femur.”
Dawson usually exercises about 10 hours a week, picking events to participate in as goals. As he heals, he says he will fill his time with good books and Netflix.
“I’ve always been active,” says Dawson, who describes pediatrics as stressful yet self-affirming as doctors create close relationships with families. “Exercise is how I relax. In a sense it’s very social. I’m with people I’m not with every day.”
