Burnout and Wellness Strategies Used by Academic Physiatry Programs: An Analysis and Perspective From the AAP Chairs Council.

ABSTRACT: Physiatrists are at elevated risk of burnout, a work-related exhaustion syndrome resulting from chronic stress associated with emotionally draining work demands. The high reported rate of burnout in physical medicine and rehabilitation led the Association of Academic Physiatrists Chair Council to convene a workgroup to address burnout among academic physical medicine and rehabilitation physicians. The council recognizes that leaders of departments are accountable for all organizational stakeholders, including faculty, trainees, and staff. Department leaders are expected to understand and effectively manage the drivers of burnout among stakeholders. The workgroup identified several opportunities, including identifying and disseminating effective burnout mitigation across US academic medical center physical medicine and rehabilitation programs. As a result, in 2019, a work group conducted a survey of US academic physical medicine and rehabilitation program leaders to ascertain the use of strategies for reducing physician burnout. With the aim of identifying, educating, and advancing the development of effective interventions to address burnout among academic physical medicine and rehabilitation departments, the Association of Academic Physiatrists Chair Council advocates for increased education and utilization of effective strategies aimed at promoting physician well-being across organizational levels (national, organizational, work unit, and individual).

Association of Academic Physiatrists Women's Task Force Follow-up Report.

ABSTRACT: The Association of Academic Physiatrists convened a Women's Task Force in 2016, under the leadership of then Association of Academic Physiatrists President Gerard Francisco, MD, to evaluate data and metrics pertaining to the representation and inclusion of female physiatrists in the society. An initial published report focused on a retrospective analysis of data in categories such as leadership, conference presentations, and recognition awards. The findings, which highlighted areas in which the Association of Academic Physiatrists had been successful in supporting gender equity as well as areas in which female physiatrists were underrepresented, provided a base from which to strategically focus on closing gaps in representation. The task force developed an action plan that was approved by the Board of Trustees and included strategies aimed at closing gaps and collecting data to determine corresponding effectiveness. Because most of the categories fell under the supervision of various Association of Academic Physiatrists committees, an appointee from each committee ("diversity steward") liaised with the Women's Task Force. The diversity stewards reviewed the plan with their respective committees and collected data within their committee's purview. This task force follow-up report documents recent progress, consistent with the Association of Academic Physiatrists Board of Trustees commitment to transparency and gender equity.

The Vital Role of Professionalism in Physical Medicine and Rehabilitation.

Professionalism in medicine is universally embraced, and it is the foundation for core competencies in medical education, clinical practice, and research. Physical medicine and rehabilitation physicians must master a complex body of knowledge and use this to responsibly care for patients. Rehabilitation professionals work in various settings; however, each one must establish and maintain ethical standards consistent with the specialty and national standards. For example, the Accreditation Council for Graduate Medical Education lists professionalism as one of its six core competencies, which trainees must master. There is a growing interest in professionalism and some of the ethical issues that it encompasses. This report provides a general overview of professionalism. Future reports are needed, and there is an opportunity to consider many facets of professionalism in greater detail.

Association of Academic Physiatrists Women's Task Force Report.

The Association of Academic Physiatrists (AAP) convened a women's task force in 2016, and the members agreed on a list of metrics that would permit retrospective data review pertaining to the representation and inclusion of women physicians in the society. Examples of categories examined included leadership positions (i.e., board membership, board presidents, committee membership, committee chairs, and resident fellow physician chairs), conference presentations (i.e., annual meeting session proposals, annual meeting faculty, annual meeting plenary speakers), and recognition awards (i.e., recognition award nominations and recipients). The findings highlight areas in which the Association of Academic Physiatrists has been successful in supporting gender equity and other areas in which women physiatrists have been underrepresented. The task force worked with the Board of Trustees to construct an action plan, asking the respective committees to address areas of underrepresentation. A volunteer from each committee was deemed a "diversity steward" and going forward will work directly with the task force as a liaison to document an action plan and collect data. The board plans to transparently report progress to members and other stakeholders, and the task force aims to publish a follow-up report within the next 5 years.

Neuromuscular rehabilitation and electrodiagnosis. 1. Mononeuropathy.

UNLABELLED: This self-directed learning module highlights mononeuropathies. It is part of the chapter on neuromuscular rehabilitation and electrodiagnosis in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on diagnostic criteria and classifications of mononeuropathies, including carpal tunnel, brachial neuritis, and lumbosacral plexopathy. The timeline status post nerve injury is discussed in relation to findings on electrodiagnostic studies. The differential diagnosis and electrodiagnostic design and interpretation is detailed in the chapter. Treatment options are reviewed. OVERALL ARTICLE OBJECTIVE: To summarize the diagnosis, classification, and treatment of mononeuropathies, from an electrodiagnostic perspective.

Neuromuscular rehabilitation and electrodiagnosis. 2. Peripheral neuropathy.

UNLABELLED: This self-directed learning module highlights peripheral neuropathies. It is part of the chapter on neuromuscular rehabilitation and electrodiagnosis in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on diagnostic criteria and classifications of peripheral neuropathy, including diabetic, alcoholic, carcinomatous, human immunodeficiency virus-associated, and critical illness polyneuropathies. Treatment options are reviewed. The causes for difficult to obtain nerve conduction studies are highlighted. OVERALL ARTICLE OBJECTIVE: To summarize the diagnosis, classification, and treatment of peripheral neuropathies.

Neuromuscular rehabilitation and electrodiagnosis. 3. Diseases of muscles and neuromuscular junction.

UNLABELLED: This self-directed learning module highlights formation of a differential diagnosis as well as electrodiagnostic evaluation for those patients who present with the common complaint of weakness. It is part of the chapter on neuromuscular rehabilitation and electrodiagnosis in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the common symptoms and typical clinical findings that allow the clinician to narrow the differential diagnosis. This is followed by the diagnostic evaluation, with emphasis on the technical aspects and interpretation of electrodiagnostic studies. OVERALL ARTICLE OBJECTIVE: To summarize the clinical presentation and electrodiagnostic findings in persons with disorders of muscle or disorders of the neuromuscular junction.

Neuromuscular rehabilitation and electrodiagnosis. 4. Pediatric issues.

UNLABELLED: This self-directed learning module highlights the physician's role in the diagnosis and treatment of neuromuscular disorders in pediatric populations. It is part of the chapter on neuromuscular rehabilitation and electrodiagnosis in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses both clinical and electrodiagnostic features of common neuromuscular disorders in pediatric populations. The diagnostic value of somatosensory evoked potential is reviewed in a case of traumatic spinal cord injury without radiographic abnormality. Therapeutic interventions of progressive muscular dystrophy are discussed, as well as the differential diagnosis of floppy infant syndrome, the most common pediatric electrodiagnostic referral. OVERALL ARTICLE OBJECTIVES: (a) To become familiar with electrodiagnosis and rehabilitation for common neuromuscular disorders in the pediatric population, (b) to undrstand electrodiagnostic findings of Guillain-Barre syndrome corresponding to pathophysiology, (c) to become familiar with somatosensory evoked potentials, and (d) to be able to make differential diagnosis of floppy infant syndrome based on clinical findings as well as electrodiagnosis.