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Physician Spotlight

Health Care May 2019
This Month Dr. Amaryllis Sánchez Wohlever, M.D.

Q. Why did you originally become a doctor, and do you feel your purpose in the medical field has changed over the years?

A. As a little girl, I loved playing with toy medical kits and pretending to be a doctor. I loved every tool in the kit—the bandages, syringes and the iconic stethoscope. My parents, brother, cousins, neighbors and even our puppies were reluctant patients! Then in middle school, I learned about Mother Teresa, and her compassion and deep prayer life inspired me to become a physician. Yet, it was my mother’s belief in me that led me to apply to medical school and begin the arduous journey to becoming a physician. I graduated from Penn State University College of Medicine, served as chief resident and have been blessed with a rewarding 25-year career as a family physician

Over the last twelve years, my work has broadened from caring primarily for patients in the exam room to also supporting physicians and the medical team in various ways. During an epidemic of physician burnout, countless physicians are trying to do the impossible daily within a very broken system in constant flux. Having experienced aspects of burnout while in full-time practice, meeting with a coach clarified my purpose, reawakened dreams, and redirected my life and work. I began to write books and was invited to speak to medical groups about physician wellness, leadership, advocacy and burnout prevention. I later pursued further training to become a health and wellness coach, and then trained in leadership and physician burnout coaching, so I could support my colleagues more effectively.

As a coach for physicians, I enjoy facilitating “Aha” moments that help them reignite neglected dreams or talents like playing the flute or serving patients in unique ways like offering house calls. I love helping my colleagues discover greater meaning in medicine by focusing on leadership, advocacy and empowering them to reclaim their voice and place in medicine. My goal is to inspire physicians to see their work as vocation and reignite a sense of hope, meaning and joy in serving people from full hearts.

I remind physicians to be who they are (as physician leaders) and to prioritize their needs (as human beings). If we neglect our humanity while caring for others, losing sight of the most important things in life, like our health, relationships and spirituality, that is too high a price to pay. We must find a way to serve others selflessly without neglecting our needs as human beings, which makes us less effective in the long run. I am honored by every opportunity to walk alongside my colleagues as they discover and pursue ways to do this better.

Q. What do you think is the biggest challenge physicians face today that may not have been an issue in previous years?

A. The biggest challenge we face as physicians in 2019 is the devaluing of our profession and expertise coupled with a vast loss of autonomy in clinical decision-making and daily practice. So many obstacles stand in our way that it is tougher than ever to advocate effectively for our patients. It is also exhausting, as technology has helped in some areas while adding complexity to what used to be simple tasks.

Many forces are disempowering physicians, including the fact that there are now more than ten non-clinical administrators for every physician. With more than 70 percent of doctors no longer independent, the physician’s voice has become severely diluted in medical settings. Add to this the exponential rise in non-physician practitioners, many of whom are expected to function like physicians without the critical foundation of medical school or supervised, hands-on training, with some having trained online with minimal clinical exposure or hands-on clinical decision-making while physicians are forced to take on the liability risk for their patient care. This is unfair and unsafe for patients, non-physician practitioners and physicians, and corporate settings seem to now favor this risky model that may appear to save money but doesn’t while gambling with patients’ health and lives.

All these factors combine with persistent intrusions by insurance companies, government and corporate interests, leaving physicians with all the responsibility for medical outcomes despite waning authority and autonomy. I’m actually surprised the rates of physician burnout are not worse, and I know this is because physicians are highly resilient, dedicated and care deeply for their patients. These qualities help us keep fighting, keep showing up and keep advocating, but our work is increasingly burdensome, and it’s taking a toll on our wellbeing and effectiveness.

Q. Has faith always led your work? If not, how has it changed it?

A. Early in my career, I went through a difficult time in my personal life while also navigating a stressful job in the military. One evening, I went for a walk and returned home still feeling down. For the first time in years, I said a simple, heartfelt prayer in which I asked God to reveal Himself and intervene in my life. There were no fireworks. No angels visited. Nothing earth shattering happened. Yet, something changed that day, and it eventually turned my work as a physician into a ministry.

Within a few weeks of that prayer, I was invited to a retreat that began a process whereby faith became the center of my life and my practice of medicine. While on a medical mission to Guatemala months later, I felt led to pray for a woman whose life circumstances seemed overwhelming. Heartened by this surprising blessing, she prayed for me in thanksgiving, and we both knew we were standing in the presence of God together—like two sisters seeking One greater and more powerful than either of us. The moment was life changing (I suspect for both of us). Since then, my goal has been to care for the soul and minister to the spirit while treating the body, whether with patients in the exam room, my loved ones, my colleagues and those I am honored to address as a keynote speaker.

Q. Are there specific experiences that inspired you to want to coach physicians?

A. My desire to coach physicians emerged from my journey to find greater meaning and purpose in medicine. When I left the exam room for a season while pregnant with my third child, the time away from medicine helped me grow in self-awareness and invest in myself as a person. Going through coaching helped clarify my goals and launched me toward a new way to live and work. I began to prioritize differently, set and enforce boundaries more effectively, and take charge of my life once more, ensuring my values and goals guided every decision. I also invested in myself as a leader and participated in several leadership academies and programs for physicians.

I’ve always been a natural mentor, and going through coaching inspired me to pursue further training as a coach. The training made me recognize I have been a mentor and a supportive presence for my colleagues my entire career. Working one-on-one with physicians has been one of the most rewarding aspects of my work in recent years. For every physician I am able to support and equip with tools that help them enjoy their work again, hundreds of patients potentially benefit, and this brings me joy.

Q. Can you talk a little bit about your latest book “Recapturing Joy in Medicine”?

A. A colleague calls my new book “chicken soup for the physician’s soul,” and I have not seen another book like it. “Recapturing Joy in Medicine“ evolved over the last twelve years as I’ve become a proactive advocate for patients, physicians and the entire medical team. I felt led to inspire physicians to stand up for our patients and profession, speak up despite forces seeking to disempower us and prioritize our needs to increase our effectiveness, so we can lead health care again. With compelling and amusing stories weaved throughout, the book is interactive and practical. It is informed by my 25 years in clinical practice and health care leadership, fully aware of the challenges we face, yet hopeful for the future of medicine and our central role in the transformation we need.

Advance readers wish they’d had this resource while in medical school, and I hope it will find its way to every medical school, residency program and health system in the nation. If physicians read “Recapturing Joy in Medicine” and put its principles into practice, this book will be a game changer. It will embolden physicians to lead the transformation needed in medicine while remembering to care for themselves while caring for others. If we lose our humanity, our relationships and our health in this work, that is too high a price to pay—and we shouldn’t have to pay it. I wrote an article titled “Healing patients shouldn’t be killing doctors.” Of course not!

We are human beings caring for people; we are not providers, we are not machines. And that’s good because patients don’t need more machines; they need someone to walk alongside them and remind them they are not alone. As I discuss in the book, the greatest gift we bring to our patients is who we are—our humanity, our empathy and how we care for them and give them hope. We must be human first, and health systems and employers have a responsibility to create an environment that treats us as such and supports us in meaningful ways. These are a few of the topics discussed in this new and unique resource that I know will make a tremendous difference!

Q. What have you done so far to speak up for your patients, and what are your next steps?

A. I’ve been a physician leader active at the state level since residency, when I was chief resident and president of the Florida Association of Family Medicine Residents. Particularly over the last seven years, I’ve been an outspoken advocate for patient safety and maintaining high standards of care. To this end, physicians must be equipped and empowered to lead by example.

Unfortunately, this is where the disconnect begins, since many settings disempower their physicians, who spend their days jumping through hoops to provide high standards of care in spite of the obstacles that make excellent patient care increasingly difficult (inefficient electronic health records, government and insurance company intrusions, inadequate staffing, etc.).

Aware of all this, I have gone all the way to the Capitol at the state and national level to advocate, testifying before health care committees, meeting with legislators and learning how to navigate the medical political arena to fight for high standards of care for our patients and better work conditions for physicians. This courageous advocacy has brought the unexpected blessing of working with an inspiring network of physicians from every specialty all over the nation. Nothing fuels my efforts more than working with equally dedicated, motivated, hard-working and excellent physicians who care as deeply about their patients as I do.

What’s next for me in this regard is to continue to learn, advocate and let myself be stretched and filled with courage and determination for the benefit of patients. My greatest motivation is to ensure my children and their children enjoy the same quality of care I’ve both enjoyed and been able to provide throughout my life. The medical landscape has changed drastically, especially with some training programs for non-physician practitioners now being online, for-profit and generally inadequate to train these practitioners, who are then expected to behave like physicians without an adequate foundation in education or training. I plan to continue to advocate for high standards of care, patient safety and adequate training for every valued member of the health care team.

Q. What role did you play in assisting the FMA’s launch of their statewide healthy living initiative last year?

A. The Florida Medical Association (FMA) serves 25,000 physicians in our state, and I am a graduate of their physician leadership academy. When the FMA launched their Healthy Living Initiative in 2018, I was interviewed as part of their educational program about nutrition, physical activity, proper sleep and other healthy practices, and a video of the interview is now on their website along with various educational resources. One of these resources is a continuing medical education (CME) webinar of my presentation titled Inspiring Change: Lifestyle Choices Made Easier, which was recorded during FMA’s 2018 annual conference. The FMA also lists me as a state expert in physician wellness and burnout prevention. I value my involvement with the FMA, which is a tremendous advocate for Floridians, as well as physicians in training and in practice. I encourage every physician to join his or her state medical association.

Q. Why do you feel self-care is an important issue to discuss for medical professionals?

A. During this challenging time in medicine, it is more important than ever for physicians to prioritize their well-being and lead their patients and teams by example. It is imperative to avoid the unhealthy habits that often develop very early in medical training and replace them with a culture of wellness. We can’t give what we do not have. During a time when chronic medical conditions and the rates of obesity and cancer have reached epidemic proportions, whole-person care and prevention are vital goals for all of us. As physicians, we have a responsibility to educate, encourage and do all we can to support our patients on their journey toward healing and wholeness. The best way to accomplish this is by leading the way, which includes seeking help as needed to become more whole human beings in mind, body, soul and spirit.

 

Author Bio: Amaryllis Sánchez Wohlever, M.D. is married to a pilot-turned-preacher and is the happy mom of three terrific children. A Board-certified family physician, keynote speaker, retreat leader, and coach for physicians, she has been a leader in health care for 25 years. She is a blogger, freelance writer, medical editor and the author of four books, including her latest, Recapturing Joy in Medicine. She can be reached at faithfulMD.com.

 

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