CODE speaking with Dr. Raphaela O’Day at the 4th Interdisciplinary Conference on Orthopedic Value Based Care 2020 

Session Topics:

  • Avoiding Staff and Physician Burnout

Interviewee: 
Dr. Raphaela O’Day
Sr. Performance Coach & Innovation Catalyst
Johnson & Johnson

Dr. Brian Cunningham:
Live here from OVBC 2020. We’re here with Dr. O’Day. She currently works with Johnson & Johnson at the Human Performance Institute. Thank you so much for taking a little bit of time out. We just listened to her give a great talk on physician burnout and health and wellbeing. Let me ask first, your path and your career kind of has taken a winding course. Tell us just a little bit about how you got to that place that you’re at right now.

Dr. Raphaela O’Day:
Sure. So first off, thanks so much for having me. It’s been a pleasure being here. So yeah, I have kind of an interesting path for how I’ve landed where I am today. It all makes sense in my head, but I would share with you that I started my undergraduate career in human physiology, really interested in how the human body works. I had dreams and aspirations of going into veterinary medicine because I love animals and then transitioned into thinking about medicine, as well. And one of the things that were interesting about that path was that I really recognized I wanted to get to know my patients. I really wanted to understand a lot more about what makes them tick, what makes them behave the way that they do, those kinds of things. And as I was speaking with physicians, even at that time, or people who were sort of in the process of getting educated in the field, they were already starting to say, “The amount of time that you get with patients is much less than you would potentially want.”

And so it was really through that and some exposure in my undergraduate career to psychology that I thought, “Okay, well maybe psychology is a place for me to sort of start to explore.” And so I started to take some courses and I loved it and I actually was also sort of good at it, which was surprising. So I decided to go into a graduate career sort of focused on that. So my undergraduate degree ended up being human physiology. My Master’s was in school and community psychology, focused on marriage and family, so really thinking about systems and how families and relationships function. And then my Ph.D. ended up being in educational psychology with a concentration around neuroscience. And what I would share about that early experience is that I always was somebody who wanted to marry this idea of the human physiology or the human being sort of through the more traditional medical model with psychology. And I thought how amazing it would be to actually be able to start to combine those two sciences to have more holistic conversations, right, whether that’s through the lens of research or even through treatment.

And so again, I graduated with my undergraduate degree and was more in a physiology space. I did research in immunology, cancer. And then as I was digging deeper into psychology, I transitioned to the University of Michigan where I was involved in nicotine research, so really understanding in a collaborative laboratory environment, the kind of psychological and physiological kind of components, which was really exciting for me. And then spent some time in serious mental illness. So I was really transitioning more heavily into the psychological arena.

And then the last 10 years have really been focused on the role that I have within Johnson & Johnson. I’ve had a couple of different positions, and I would just share with you that I’ve been responsible for creating the evidence base for a lot of the support tools that we provide in the context of changing behavior and now, more recently, over the last couple of years, focused on this idea of how do we help people perform at their best and help them to thrive and be the best version of themselves no matter where they’re showing up, whether that’s professionally or personally.

Dr. Brian Cunningham:
That’s fascinating. What a journey. One of the questions I had, I tell colleagues and residents all the time, it’s fascinating how much training physicians get in anatomy, physiology, where to make incisions, what drugs to prescribe, and then you graduate and you realize that 90% of your day is psychology. You’re trying to interact with patients. You’re trying to interact with your colleagues. You’re trying to come home and talk to your husband or wife after you’re tired, and you essentially get no training. You get done with medicine with tons of experience and tons of plans on how to be a doctor and you get almost no training on psychology. Do you think that’s a component that leads physicians to be more burnout or more stressed out? What are your thoughts on that?

Dr. Raphaela O’Day:
It’s an interesting question. So we know that there are many, many determinants that lead to or seem to contribute to this phenomenon of burnout. And I think that certainly, we understand that the organizational environment is a big part of that. The way that we potentially are taking care of ourselves can be an important parameter, but then the third piece is also how are we interacting with other people and how are we creating the kinds of relationships and interactions that not only provide impact for the other person but provide us with meaningful feedback about how we might be doing.

I don’t know if it’s whether or not that’s a cause, but I would say that the conversations we’ve been having is to help people to understand that we are holistic human beings. So whether that applies to us or our patient populations, we have to really be mindful and aware of our own psychological state, of the way that we’re feeling, of the way that we’re thinking, and then also be able to have interactions with other people that draw that to the foreground so that we can effectively manage it if it needs to be managed or effectively utilize it so that we can be as impactful as we can be with other people. To me, again, this holistic idea of not separating purely the physiological human being from sort of this other thing, I think, there’s this opportunity to sort of help people to understand that we’re really holistic human beings and our psychology impacts our physiology and the reverse too, right? So we’re connected.

Dr. Brian Cunningham:
So one of the great points you made during your talk was one of the first steps is just awareness and the ability to be maybe not courageous but bold enough to say, “Okay, I need to kind of make some changes. It’s okay to take a day off. It’s okay to have a recovery day. I don’t have to be ashamed of …” As you mentioned, it’s so classic. You close your calendar and you pretend like you’re out of the office on a vacation or a meeting, but really you’re just taking a break and it’s somehow not okay to say I’m taking a break. So I’m at that point I say, “Okay, you know what? I really need to kind of start to work on this. I’m aware of it.” What is that kind of next step? So you’re starting to wonder, “Maybe I should do something. What is there to do? I’m not really sure.” As a physician or a clinical person, what is that kind of next step once you start to have some awareness?

Dr. Raphaela O’Day:
Yeah. So I like starting with awareness because I just feel like a lot of times our environment is so chaotic that we have forgotten to check in with ourselves.

Dr. Brian Cunningham:
Absolutely. Yep.

Dr. Raphaela O’Day:
And so that’s step one, to your point. What I would say about what to do, I would say one, be intentional about it.

Dr. Brian Cunningham:
Okay.

Dr. Raphaela O’Day:
Right?

Dr. Brian Cunningham:
Yeah.

Dr. Raphaela O’Day:
So first off, once you have an awareness that it’s not working and you need, let’s say, recovery, which is usually the challenge, right?

Dr. Brian Cunningham:
Right.

Dr. Raphaela O’Day:
Like, “I don’t have anything to do. I need to do something.”

Dr. Brian Cunningham:
Yeah, exactly.

Dr. Raphaela O’Day:
That’s not usually the problem. I think usually what happens is people are not necessarily using recovery to be able to sort of reset, for lack of better terms.

Dr. Brian Cunningham:
Yep.

Dr. Raphaela O’Day:
And so, for me, it’s a test and learn, quite honestly. Right? So what will work for you? So I’m not here to tell you that it’s these three things.

Dr. Brian Cunningham:
Right.

Dr. Raphaela O’Day:
I think some of it is done we have enough opportunity to sort of try something, check back in with ourselves, and see whether or not it could be something that would help us. So for me, going and taking a walk, if I’ve just had a really difficult conversation with someone where I can just get into … I live in Florida so I have the opportunity to go outside a lot more than maybe some other people.

Dr. Brian Cunningham:
Right. Sure.

Dr. Raphaela O’Day:
But just getting out into nature and being in an environment where I can kind of disconnect from that conversation and process works for me.

Dr. Brian Cunningham:
Yeah.

Dr. Raphaela O’Day:
And it gets me out of my chair. Again, breaking linearity so I get to move a little bit too. So that works for me. It might be taking a moment and showing some gratitude.

Dr. Brian Cunningham:
Right.

Dr. Raphaela O’Day:
It might also include going for a 15-minute run, getting some physical activity.

Dr. Brian Cunningham:
Right.

Dr. Raphaela O’Day:
So there are lots of strategies that have shown to be effective. What I would share is that although they’ve been effective, it’s not my job to put them onto your proverbial to-do list. It’s really about whether they provide the kind of impact you’d like to see. And that is very personal. Right?

Dr. Brian Cunningham:
Right. Yeah.

Dr. Raphaela O’Day:
So I think it’s not so much about what we should be saying to people, this is what you have to do.

Dr. Brian Cunningham:
Sure.

Dr. Raphaela O’Day:
It’s about helping them recognize what works best for them and then bringing intentionality.

Dr. Brian Cunningham:
Yeah. Okay. That’s great. Almost developing a bucket of tools and then trying to see which one fits in your life and gives you the result that you’re looking for. And if it doesn’t, please stop doing it.

Dr. Raphaela O’Day:
Right.

Dr. Brian Cunningham:
Yeah. I think there’s a growing sense, specifically in the orthopedic community, awareness around burnout as both a challenge as well as potentially an opportunity to kind of intervene and prolong careers and increase satisfaction. And we’re here at the Value Based Care Conference, and I think, there’s some discussion around value for different stakeholders and how to bring value. Is there a role for wellbeing or avoiding physician burnout and keeping people at a kind of top performance in the value of preventing both the patients as well as to other stakeholders?

Dr. Raphaela O’Day:
So I definitely believe so. I think that’s the move towards the quad blame. I think it’s this recognition that physician well being is an important contributor to what we were trying to achieve in the context of healthcare. And I think how people show up into that environment, recognizing how challenging it is, is an important part of this conversation.

Dr. Brian Cunningham:
Right.

Dr. Raphaela O’Day:
I do think that prevention is an important opportunity.

Dr. Brian Cunningham:
Yeah, absolutely.

Dr. Raphaela O’Day:
Certainly, if people are in a state of burnout, it requires a lot of support for that individual, as you know. I shared some of the statistics, right?

Dr. Brian Cunningham:
Yeah.

Dr. Raphaela O’Day:
There can be really critical consequences that we, of course, need to, at all costs, avoid.

Breanna Cunningham:
Right.

Dr. Brian Cunningham:
That said, I think this idea of creating environments where people can be the best version of themselves requires us to really take a look at what do human beings need in order to do that?

Dr. Brian Cunningham:
Right.

Dr. Raphaela O’Day:
And are we setting up environments and systems in such a way where that is more likely to occur? And so for us, when we think about this wellbeing is a really critical part of this conversation. It’s health and wellbeing, right?

Dr. Brian Cunningham:
Right.

Dr. Raphaela O’Day:
And it’s kind of the true definition of how the World Health Organization defined health, which is not just the absence of disease, but this broader well being mentally, emotionally, for us to be able to fully function as human beings. And so that’s what I think the opportunity is. And I think it’s an incredibly important part of the conversation that helps people really be the best version of themselves in an environment that, right now, needs all of us to be at our best.

Dr. Brian Cunningham:
Right.

Dr. Raphaela O’Day:
Because I think it’s a pretty challenging one.

Dr. Brian Cunningham:
Right. Fantastic. Well, thank you so much for spending some time. We’re so grateful. If you have a chance, check her out. Fantastic speaker. Fantastic opportunity. And we’ll see you guys back soon. Thanks.

Dr. Raphaela O’Day: 
Thank you so much.

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