Transcript OHSU Presentation Template

Addiction – A Tale of Two Survivors
Michael Sprintz, DO
Mark Baskerville, MD
Anesthesiology and Perioperative Medicine
July 21, 2014
Circa 1998
JAMA – December 2013
Incidence
1 in 80
will develop a
Substance Use Disorder
Occupational Mortality Rate
per 100,000 worker years
Commercial Fisherman 21.2
Police Officers 18.6
Truck Drivers 13.3
Firefighters 2.5
Healthcare Workers 0.7
15.7
6 times Fire Fighters
22 times Healthcare Workers
1. Monitor Your Own Pulse
2. Leave Control in the OR
3. Respect Boundaries
4. Learn to Ask for Help
I care about your health
Low-tech Audience Response!
• Do you know of someone in anesthesia
found to be diverting controlled
medications?
• Do you know of someone who has died of
a drug overdose who is in a healthcare
related field?
Prevalence of Burnout in Residents and Physicians in Practice
• Burnout rates of 30 to 76% seen across 15 studies
of residents: multiple years, types of programs, US
and International teaching hospitals represented
(Thomas, 2004)
• Similar burnout rates among physicians in practice
(Chopra et al., 2004)
– 46-80% moderate to high EE
– 22-93% moderate to high DP
– 16-79% moderate to low PA
• Lower rates of burnout among academic
physicians (Tait, 2003)
– 37-47% burnout in academic physicians
vs. 60% burnout in physicians in private practice
Physicians in Training and Practice vs. General Population
•
•
•
•
Higher rates of burnout, stress
Similar to higher rates of depression
Similar rates of substance abuse
Higher rates of suicides—especially for
women
• 300 to 400 physician suicides
(Center et al., 2003; Shanafelt et al., 2012)
OHSU Resident and Faculty Wellness Program
All OHSU
and& Faculty
OHSU
Resident
Legacy residents
and fellows
All OHSU SOM
faculty (0.5 , >FTE)
Left to right: Sydney Ey, Ph.D., Dan Helfet-Hilliker,
M.D., Mary Moffit, Ph.D., Mark Kinzie, M.D.
How to Reach RFWP Clinicians
To schedule an appointment or get
consultation re: trainee/faculty concern:
Directly email or page any of the providers
listed at www.ohsu.edu/rfwp
Urgent consultation: RFWP pager 1-0975
Resident and Faculty Wellness Program
• Confidential, free coaching, counseling and
medication management
– Limits to Confidentiality: risk to patient safety or
danger to self or others
• Private, on-site location
• EMR: but not in EPIC and you can opt-out of EMR
• Meeting w RFWP is not reportable to medical
board
“Impairment is reportable, treatment is not”
• Schedule directly by emailing any of 3 providers
• Hours: Mon-Thurs 9-7, Fri 9-5
Positive Outcomes
(Ey, Moffit, Kinzie, Choi & Girard, 2013)
• 88% of OHSU residents, fellows (N = 448;
71%) knew about our program
• 87% OHSU residents, fellows “somewhat to
very willing” to seek counseling
• Utilization rate (new cases per yr) from 5%
to 17% in 8 yrs
• 93.9% of clients “very or mostly satisfied”
• PDs satisfied w/ referral process/consult
Barriers Still Exist
(Ey, Moffit, Kinzie, Choi & Girard, 2013)
“Reaching Out” Research Aims
• IRB approved study, funded by GME
• Suicide prevention among medical
residents, fellows, and SOM faculty by:
– Reducing risk factors of untreated depression
and substance use, hopelessness and
isolation
– Increasing protective factors of greater selfawareness, strong coping skills, increased
connection, and access to effective MH
treatment if needed
Stress and Depression Survey
• We invite all OHSU residents, fellows and
School of Medicine faculty to participate in
this important new physician wellness
initiative. Please take the OHSU Stress
and Depression Survey. Click on this link:
https://www.ohsuwellness.org/welcome
.cfm
Invitation to Take Stress and Depression Survey
User can take the Stress & Depression
Survey by creating a self-assigned User ID
and Password (encrypted)
The User ID is the only way user is known to
our clinicians
Only aggregate data reported
Our Clinician Response &
Dialogue
• User may provide an email address to be
notified when our team’s response is posted
or sign back on to the ISP site
• User’s email address is encrypted to protect
identity, not known to anyone, including our
clinical team
• Our clinician responds with feedback,
resources, offer to meet in person if
appropriate
Pilot with OHSU SOM Trainees/Faculty
April-June 2014
• Response rate: 23% (N=91)
• 78% of OHSU users reviewed clinician response
• 16% of OHSU users dialogued with clinician
• High distress: 15%
• Suicidal ideation in past 2 weeks: 6%
• Due to survey, sought treatment at RFWP:
12%
– “realized that I needed to take better care of
myself”
– “survey made it easier to come in”
Strategy to keep our team members safe
• Encourage balanced approach to life
• Readily available counseling within
department and OHSU
• More stringent monitoring of pharmacy
transactions and returned medications
• More realistic guidelines for testing for
drug use.