A Conversation with Dr. Leila Durr

by | Nov 29, 2021 | Florida Mental Heath, Uncategorized | 0 comments

If the pandemic has a silver lining, it has made companies pause and look at their employees and how they are supporting their mental health. More and more companies nationwide are creating positions specifically to address employee wellness. But at AdventHealth, the conversations began well before the pandemic and continues through Dr. Leila Durr, the Director of Provider Well-Being for AdventHealth’s West Florida Division.

Dr. Durr promotes wellness, self-care, and resilience to more than 500 physicians and Advanced Practice Providers. As a licensed psychologist, Dr. Durr offers individual counseling, consultations, and workshops/trainings, approaching therapy from a strength-based lens with the belief in the power of the individual to make changes in their lives once they have taken the time to reflect and gain self-awareness. She is committed to creating a safe place for every provider to be heard and understood, to reconnect to the meaning in their work, to connect more effectively with colleagues, and to find ways to improve the quality of their personal and professional lives. We talk to Dr. Durr about burnout among front-line workers, how burnout has impacted them, and her commitment to addressing these challenges.

Tell us about burnout among healthcare workers. Are you seeing a lot more of it?
Research and data show about 79% of physicians said their burnout started long before the pandemic. It’s been an epidemic for physicians for a long time. More than 50 percent of physicians experience some sort of burnout. The pandemic further cranked up the fire under the pot of boiling water and brough more attention to it. I am also careful when I talk about “burnout” as it is often experienced by healthcare workers as a “resilience deficit” problem which is absolutely not the case for these professionals. But when a system is broken as healthcare currently is, there’s only so much that resilient individuals can do and handle before it takes a toll on them.  The toll of this level of chronic stress includes symptoms of anxiety, depression, insomnia, work/life imbalance, increased substance abuse, and moral distressand the additional stressors of the pandemic certainly didn’t help. Physicians are really good at compartmentalizing. But while they are focused on their work, their personal stuff builds up. Their batteries are just getting depleted. It is important when your battery is depleted for you to recharge. You charge your cell phone every day. We have to recharge our bodies every day. But physicians work even when their batteries are empty.

What did the pandemic do?
The pandemic made it so much worse; especially as they had to deal with it in both aspects of their lives at work and at home. There was no respite from the additional stressors of the pandemic which included rapidly changing medical knowledge and need for constant pivoting of policies, mixed messages in media coverage, polarized personal beliefs, constant concern about their own health, and frustrations with surges of the unvaccinated.

Why is it important to address burnout?
Part of our commitment to caring for anyone is to focus on the body, mind and spirit; and burnout affects physicians on both a personal and professional level. It affects their productivity, quality of care, and patient satisfaction but it also affects their own mental health, quality of life, and interpersonal relationships. Burnout isn’t only about being overworked. Yes, excessive workload and workflow inefficiencies are a significant component but other key factors that drive burnout include lack of control and flexibility over one’s work; limited community, trust and respect; and a mismatch between personal and organizational values.

How have you supported them?
Physicians are so used to taking care of everybody else and not prioritizing caring for themselves. They are always giving of themselves to their patients, colleagues, and families. I help remind them that they need to take care of themselves and to make themselves a priority. I try to approach it from the Wellness Wheel model and encourage them to make sure they are maintaining a balance in their lives within these dimensions: physical, emotional, intellectual, social, spiritual, and occupational. I encourage them to take time to rest, to exercise, to connect with others and to practice the self-care they recommend to their patients. I often visit physicians’ lounges and will just sit at a lunch table with a group of physicians and listen to them and do what I can to address their frustrations. Sometimes it’s just nice to have someone to talk to and if they want to continue our conversations, I offer them one-on-one short-term therapy sessions that is completely free and confidential. I’ve also held virtual mindfulness sessions where I help them learn and practice different strategies. I recently held family-friendly wellness events at Top Golf or a Fall Festival to help them take a break to recharge and connect with their colleagues and/or engage with their families. Sometimes physicians say they are too busy to play. But play is therapeutic and critical to your well-being and laughter is good for the soul and our mental health. I’m constantly looking for creative ways to reach them and engage with them so that they are aware of the resources available (including my support and services) and help normalize the use of it when they need it.

If a physician tells you in a therapy session that they’re burned out, what do you do?
I try to help them explore what feels most out of balance in their lives, including examining the congruence between their choices and values. It’s different for every physician.  At times, it’s giving them a space to vent and then problem solve what they feel would be the best way to help them get things back into balance. We look at what they’re wanting and what they’re needing. Often times, physicians haven’t stopped long enough to ask themselves “what do I want or need right now.” At other times, I encourage them to look for the “low hanging fruit” of what they have the most control over addressing first; such as their self-care through sleep, exercise and social and professional connections or setting some healthy boundaries for themselves. I focus on helping them be intentional about actively doing something that supports their wellness and balance. I put opportunities in front of them and make it easy for them to reach. Sometimes, I have had physicians reach out who have experienced a significant loss or trauma so I will do a number of sessions to help support them and give them a space to process their experience while we work at connecting them to longer-term therapy in the community if needed.

How can other companies help their employees?
Many companies already offer EAP (Employee Assistance Programs) which provide their employees mental health and other wellness-related services. But the pandemic has challenged all companies to think outside the box to see what else might be needed to support their team members. I am constantly seeing more and more corporate wellness positions on LinkedIn. By creating these positions, they are showing that this is a priority. But it’s important to do more than just providing such services. Making sure the work environment is one that provides psychological safety and fosters a culture of wellness is also essential. Within my organization, I am trying to be that voice of mental health and that voice of psychological expertise. Often, physicians experience burnout when the business of medicine and the practice of medicine are in conflict, so I try to shine my flashlight on areas that need to be examined and addressed. Making sure that leadership is talking to their employees about what is working and what isn’t and then if feasible, working together to problem solve ideas and solutions to facilitate a “win-win” outcome.  I don’t want our team members to just survive. I want them to thrive.