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Wayne M. Sotile, Ph.D , 2016
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
Wayne M. Sotile, Ph.D.Founder
CENTER FOR PHYSICIAN RESILIENCE
Davidson, North Carolina
Choosing ResilienceThe Key to
Thriving Through Change
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Crucial Questions
•How happy are you?
•Who are you to the ones you
love and work with?
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High Demand
Low Control
Low Support
What’s It Like to Work in Healthcare Today?
Toxic Stress
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Wayne M. Sotile, Ph.D , 2016
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The Most Pervasive, Unchecked
Risks to Safety, Quality, Profitability, and
Satisfaction?
Burnout
&
Psychosocial Distress
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7395 Medline Publications “Burnout”
0
100
200
300
400
500
600
1977 1982 1987 1992 1997 2002 2007 2012 2017
# Pub
Updated September 29, 2014
MESH: STRESS, PSYCHOLOGICAL 1983-89, STRESS, PSYCHOLOGIC 1969-72
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0 10 20 30 40 50 60 70
Prev Med/Occupat Med/Enviro Med
Dermatology
Pediatrics - General
Pathology
Radiation Oncology
Other
Pediatric Subspecialty
Neurosurgery
Psychiatry
Urology
General Surgery Subspecialty
Ophthalmology
Internal Medicine Subspecialty
General Surgery
Average Burnout All Physicians
Participating
Physical medicine and Rehab
Radiology
Obstetrics and Gynecology
Anesthesiology
Orthopedic Surgery
Otolaryngology
Family Medicine
Neurology
Internal Medicine - General
Emergency Medicine
% Reporting Burnout
Shanafelt , Boone, Tan,
Drybe, Sotile et al.
Arch Intern Med. 2012;
172(18):1377-85
Burnout by
Specialty
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Wayne M. Sotile, Ph.D , 2016
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• Use Realistic Roadmaps
• Assess Yourself
Coping, Leadership
Change Psychology
• Build Resilience Toolkits
Keys to Resilience
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Work Family
SelfIntimate
Relationship
Anxious
Angry Guilty
Realistic Roadmap or Cajun Logic?
The Mythical Balanced Life
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Use Realistic Roadmaps
Best Predictor of Clinical and Operational
Outcomes Across Hospital Settings?
•% of Team Showing Burnout
Bryan Sexton, Ph.D.
Duke Center for Patient Safety
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Wayne M. Sotile, Ph.D , 2016
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•As Nurse Burnout Rates
Patient Survival Rates
Aiken LH et al. JAMA. 2002;288:1987-1993.
N = 10,184 Staff Nurses
234,342 Patients
Resilience Matters
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Does Burnout Matter?
•Medical Errors– Williams ES et al. Health Care Manage Rev. 2007;32:203-212
– Firth-Cozens J & Greenhalgh J. Soc Sci Med. 1997;44:1017-1022.
– Shanafelt TD et al. Ann Intern Med. 2002;136:358-67.
•Medical Malpractice Suits– Jones JW et al. J Appl Psychol. 1988;73:727-35.
• Patient Compliance – DiMatteo MR et al. Health Psychol. 1993;12:93-102.
•Patient Satisfaction– Linn LS et al. Med Care. 1985;23: 1171-78
– Haas JS et al. J Gen Intern Med. 2000;15:122-128
“Burnout adversely affects quality of care”
Wallace JE et al. Lancet. 2009;374:1714-21
Medical Family
DiscordSargent MC, Sotile WM, Sotile
MO, et al. J of Bone and Joint
Surgery. 2009. 91;2395-405.
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Make the Case
• Crucial Cross-Correlations:
– Work Outcomes / Provider Health
– Quality of Collaboration
– Career Satisfaction
– Your Family’s Satisfaction with You
– Your Happiness
Sotile W.M. & Sotile M.O. The Resilient Physician. AMA Press, 2002
Sotile W.M. & Sotile M.O. Letting Go of What’s Holding You Back. Harry Abrams, 2007
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Wayne M. Sotile, Ph.D , 2016
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Beware of Cajun Logic
Treating Paradoxes Like Problems
Problem(has a clear solution)
Paradox(a situation, person, or thing
that combines contradictory features or qualities)
Ralph Jacobson
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•Hardiness
•Character
•Teamwork
•Emotional Intelligence
Resilience Keys: Use Realistic Roadmaps
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Choosing Resilience
Emotional Intelligence
Self Management
• Self-Awareness
• Self-Regulation
• Motivation
Relationship Skills
• Empathy
• Social Skill
• Capacity for Influence
Positive Psychology
Wellbeing Meta Factors
Positive Emotions
Engagement
Relationships
Meaning
Accomplishment
Resilience
Simonds G & Sotile WM. Promoting Resilience in Neurosurgery Residents, 2015.
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Wayne M. Sotile, Ph.D , 2016
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• Use Realistic Roadmaps
Resilience matters
No perfect…
Respect paradox
It’s a journey!
Character
Teamwork
EQ
Keys to Resilience
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• Use Realistic Roadmaps
• Assess Yourself
Coping
Leadership
Change Psychology
Keys to Resilience
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Does Problem Solving Motivate?
Identifies –
problem
Conducts –
analysis of cause
Brainstorms –
solutions
Develops –
action plans
http://appreciativeinquiry.case.edu/
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Wayne M. Sotile, Ph.D , 2016
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Content
Structure
ProcessHow can we use our
resources
to build resilience
and deepen
our relationships?
Choosing ResilienceThe absence of hassles (or paradoxes)
does not predict resilience
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What Drives Satisfaction?
Culture
Recognition/ Appreciation
Compassion
Communication
Conversation / Inclusion
Re-thinking
Re-framing
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Assess Yourself
Your relationships
won’t feel any better
than you do
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Wayne M. Sotile, Ph.D , 2016
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Does Your Leadership Really Matter?
Biggest correlation with staff work
satisfaction?
•The perception of
supervisor support
Studer Group. Work Life Balance Among
Women in Healthcare Survey. 2008
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• N = 2813 employed physicians and scientists
• Vital Leadership Behaviors?
• Inform
• Engage
• Inspire
• Develop
• Recognize
Shanafelt TD et al. Mayo Clin Proc. 2015:1-9.
Impact of Organizational Leadership on
Physician Burnout and Satisfaction
Provider Ratings of
Division/Department Chair
↨
11% of variance in burnout
47% of variance in
satisfaction with the
organization
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Choosing Resilience
Assess Yourself
Your relationships
won’t feel any better
than you do
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Wayne M. Sotile, Ph.D , 2016
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25
The Psychological Underbelly
of Changing for Good
The
“Yea, Not Really”
Mentality
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• Use Realistic Roadmaps
• Assess Yourself
Are you a smart motivator?
Focus on structure & process
Streeeeetch, don’t strain
Expect “Yeanotreally”
Practice wonderment
Keys to Resilience
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• Use Realistic Roadmaps
• Assess Yourself
• Build Resilience Toolkits
Keys to Resilience
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Wayne M. Sotile, Ph.D , 2016
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Wonderment
….seeing the familiar
in unfamiliar ways
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Working fewer hours
in a job you’re not engaged in
will resolve none of your work/life
balance issues.
Engagement is the key!
29
Re-Think “Balance”
Wayne & Mary Sotile. Letting Go of What’s Holding You Back.. 2007
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Resilience Meta Factor:
Shaping Resilience
Counter Daily Hassles with
Daily Uplifts
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Wayne M. Sotile, Ph.D , 2016
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Resilience Meta Factor
The 3:1 Ratio of Uplifts : Hassles
• Joy
• Gratitude
• Serenity
• Hope
• Interest
• Amusement
• Inspiration
• Awe
• Pride
• Love
Fredrickson, B. Positivity. (2009)
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Combine Problem Solving with
Appreciative Inquiry
Appreciates –
What gives life?
Imagines –
What might be?
Determines –
What should be?
Creates –
What will be?
Identifies –
problem
Conducts –
analysis of cause
Brainstorms –
solutions
Develops –
action plans
Problem Solving Appreciative Inquiry
http://appreciativeinquiry.case.edu/
+
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Keys to Resilience
Recalling what’s been right
about our past
helps to create
Shared Notions/Images About
Our Desired Future
Leadership
Tool
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Wayne M. Sotile, Ph.D , 2016
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Resilience is Not an Event-Self-check
-Made adjustments
-Self-check
-Make adjustments
-Self-check
-Make adjustm..
Shaping Resilience
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Just showing up
is not enough..
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A hero is someone
who creates safe spaces
for other people
—The Resilient Physician. Sotile & Sotile, 2002
Be a Hero
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Wayne M. Sotile, Ph.D , 2016
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When you end
a dysfunctional legacy,
you justify your lifetime.
Wayne & Mary Sotile. Letting Go of What’s Holding You Back.. 2007
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1. Protect Happiness
2. Use Coping Realistic Roadmaps
3. Recognize Your Risks
4. Manage Your Change Psychology
5. Counter Hassles With Uplifts
6. Believe in Something Bigger than Yourself
7. Deepen Your Relationships
8. Manage Your Coping Style
9. Rethink “The Balanced Life”
10. Be a Hero
Keys to Personal Resilience
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•Believe in Yourself
•Appreciate Each Other
•Be Generous
•Be Gracious
39
Lessons from My Grandparents
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Wayne M. Sotile, Ph.D , 2016
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Thank You!
Wayne Sotile, Ph.D.
CENTER FOR PHYSICIAN RESILIENCE
www.TheResilientPhysician.com
Email: [email protected]
336/794-0230