Building Relationships with Physicians and Mid-Level Providers: Practical Wisdom NACC National Meeting Columbus, Ohio March 13, 2006

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Building Relationships with Physicians and
Mid-Level ProvidersPractical WisdomNACC
National MeetingColumbus, OhioMarch 13, 2006

• Chaplain Mary E. Johnson, MAAssistant Professor
  of OncologyMayo Clinic College of Medicine

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Objectives

• To identify physician and mid-level provider
  (MLP) support w/in the scope of the chaplains
  role (theory)
• To identify intersections between the cultures of
  medicine and ministry (rationale)
• To identify collaborative strategies that support
  and encourage the chaplain-physician relationship
  (approach)

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Approach

• Why is this important?
• Cultural Comparison
• What is taught?
• Support strategies
• Education strategies

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WHY IS THIS IMPORTANT?Some Questions to Consider

• Is physician support part of your mission?
• What opportunities exist for physician support in
  your ministry setting?
• What has worked? What hasnt worked?

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It is easy to philosophize the philosopher is
said to be the one who bears with equanimity
the suffering of others.
W. J. Mayo, Minnesota Medicine. 1936.
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I had thought that life was brokenand that I,
armed with thepowerful tools of modern
science,would fix it. R.N.
Remen, Kitchen Table Wisdom. 1996.
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The well-being of physicians is important to
thewell-being of their patients.
Shanafelt, et al., Annals of Internal Medicine.
2002
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While much has been written about physician
depression, burnout, substance abuse and broken
relationships, very little is known about
physician well-being and its ability to enhance
care. Shanafelt,
et al., Oncology. 2005
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Loss is one of the most commonaspects of the
practice of medicine.The way in which we deal
with loss impacts the way we deal with the rest
of our lives. R.
N. Remen, 1996
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WHAT IS TAUGHT?
U.S. Canadian Medical Schools
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U.S. Canadian Medical Schools
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THE CULTURE OF MEDICINE

• Cure
• Fix
• Solve
• Resolve

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WHAT IS TAUGHT?

• Pharmacology - Pain Management
• Palliology - Symptom Management
• Psychiatry - Coping D/O (pathologization)
• (CurrMit Database, AAMC, 2005)

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CASE EXAMPLE

• Christmas Eve
• ICU
• Pulmonology Fellow
• Third withdrawal in 48 hours
• I didnt go into medicine to do this.

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SUPPORT/EDUCATION STRATEGIES

• Casual contact opportunities
• Mutual education opportunities
• Invite yourself to the table
• Participate in institutional leadership
• Read the literature

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The dying need the friendship of the heart--its
qualities, care, acceptance, vulnerability, but
they also need the skills of the mind--the most
sophisticated treatment that medicine has to
offer.On its own, neither is enough.
Dame Cicely Suanders
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BIBLIOGRAPHY
Mayo, William J., Education Guides the Young to
Good Citizenship, Minnesota Medicine. Vol. 19,
July, 1936. Remen, Rachel Naomi, Kitchen Table
Wisdom Stories that Heal. Riverhead Books, New
York, 1996. Shanafelt T, Bradley K, Wipf J, Back
A, Burnout and Self-Reported Patient Care in an
Internal Medicine Residency Program, Annals of
Internal Medicine. Vol. 136, 2002.
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BIBLIOGRAPHY
Shanafelt T, Novotny P, Johnson M, Xinghua Z,
Steensma D, Lacy M, Rubin J, Sloan J, The
Well-Being and Personal Wellness Promotion
Strategies of Medical Oncologists in the North
Central Cancer Treatment Group, Oncology. Vol
68, 2005. Curriculum Management Information Tool
(CurrMit) Database, American Association of
Medical Colleges. Mitchell K, Anderson H, All
Our Losses, All Our Griefs Resources for
Pastoral Care. Westminster Press, Philadelphia,
PA, 1983.
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ADDITIONAL RESOURCES

• jama.org (J. of the American Medical Association
  A Piece of My Mind)
• jco.org (J. of Clinical Oncology When the Tumor
  is not the Target)
• annals.org (Annals of Internal Medicine On
  Being a Doctor)