Remarkable Leadership: Meet Dr. Tom Campbell, Chief Clinician Wellness Officer

• By:  Emily Laubham
•   Share This

In 2019, Tom Campbell, MD, took on the newly created role of chief clinician wellness officer at Allegheny Health Network (AHN). Although awareness of clinician burnout was growing, few health systems had such a position, or the kind of formal, carefully surveyed wellness program that Dr. Campbell and his colleagues began to put in place.

A year later, efforts to prevent clinician burnout and promote wellness had to factor in an extraordinary new variable: the pandemic.

In this 2021 interview, Dr. Campbell, who also chaired the AHN Emergency Medicine Institute at the time, reflects on the impact of COVID-19, offers insights on clinician burnout, and talks about the pillars of a successful long-term wellness initiative.

In December 2022, we reviewed this article in conjunction with publishing a new article about AHN’s clinician and workplace wellness efforts, including insights from Dr. Campbell, now vice president and medical director of Clinical Wellness; Michele Steigerwald Tucci, senior vice president, Executive Strategic Programs & Institute Development; and Dan Shapiro, PhD, founder and principal of a burnout and wellness consultancy. As the new article points out, AHN’s most recent annual wellness survey and efforts have expanded beyond clinicians to include all employees of AHN. Noting the need to devote more time to his wellness role, Dr. Campbell added that, “the country has suffered a great reduction of health care workers, and it is critical to re-establish a nurturing environment that will attract more great people into the health professions to assure great care for our communities.”

Leading clinician wellness and emergency medicine…during a pandemic

Emily Laubham: Only one year after your position as chief clinician wellness officer was created, the pandemic arrived. How has that impacted the program’s strategy?

Dr. Tom Campbell: The first thing clinicians and other health care workers have wanted during this pandemic is clear information from the experts. We always practiced good communication, but that’s been even more of a focus during the pandemic.

People also need to feel protected. So there has been a focus across the network on making sure we have the right personal protective equipment (PPE) and letting people know how to get it.

A third thing national experts say clinicians want during the pandemic is to feel appreciated. The community has shown a great effort on that front, and internally, we are doing everything we can to show how appreciative we are, including financial recognition through a health care heroes fund.

We also recognize that even if our workers aren’t working more hours, which most were and still are, the work itself is more tiring due to wearing PPE and stress. A few ways we’ve responded is to help them get meals, give them the security of knowing that if they are worried about endangering someone at home, they have a place to stay, and make sure that there is easy access to breakrooms in every hospital — a nice soothing place to get a drink, eat some nutritious food, and have some sense of calm.

We also designed a clinician wellness website and added a section on pandemic-related wellness, including a 24/7 hotline that all staff, especially clinicians, could call if they needed additional support or help with stress management.

Emily Laubham: What impact has COVID-19 had on emergency medicine?

Dr. Tom Campbell: Emergency medicine is always on the frontlines. In this case, with an infectious issue, we got to see it first, diagnose it, and take measures to prepare for an influx of patients, because we are the front door to the hospital.

Early on, we did have staff who became ill or had loved ones become ill and had to be off work. We also had to transition facilities to make more private rooms and negative pressure rooms. Sometimes there were delays because of those factors. At this point, we are able to protect ourselves so we can provide great care, and we also can assure people that we are able to keep them and their families safe. If you need care, don’t be afraid to go to the hospital — you are probably safer in our emergency departments than in the grocery store.

Emily Laubham: Will the pandemic cause any long-term changes in emergency medicine?

Dr. Tom Campbell: We’ll be more prepared for infectious outbreaks of all kinds. Now, we have more negative pressure rooms and plans are in place to expand if needed. In certain respects, I think this experience will carry us more confidently into the future.

The bridge from emergency medicine to clinician wellness

Emily Laubham: Is there a connection between your specialty, emergency medicine, and your more recent work as chief clinician wellness officer?

Dr. Tom Campbell: I’ve always had an interest in clinician wellness because of my specialty. Emergency medicine consistently has had the highest burnout scores since we started to measure it. It’s a high-stress field, requiring you to handle the most unpredictable and sometimes chaotic situations.

Emily Laubham: How involved were you in launching the new role?

Dr. Tom Campbell: I had been doing my own education on the topic, realizing there was a growing interest in clinician burnout and how to prevent it. I became involved in national efforts through the American Medical Association (AMA) and other organizations. I also wanted to pay attention to wellness, which is obviously related but different from burnout. We want to promote wellness and prevent burnout.

As the institutes at AHN were forming, I talked to an HR rep about how a wellness program for physicians could be extremely beneficial. She helped me pitch a plan to leadership on how to survey and measure burnout in order to create a baseline, and from there we could create programs designed to improve those numbers. My initial pitch was for physicians, but we soon added residents, allied health practitioners, and nurses.

I was charged with trying to find the best way to get measurements. We looked at national programs to consult and found a good one in our backyard. Dan Shapiro, PhD, a psychologist at the Penn State School of Medicine, has a company that measures burnout and wellness in physicians, residents, advanced practice providers, and nurses. With the results from the first annual survey they helped us create, we saw what needed the most attention within each group, and that was our starting point.

Understanding clinician burnout

Emily Laubham: What kind of misconceptions do you face about burnout?

Dr. Tom Campbell: You’ll hear people say that burnout is just people complaining, or the younger generation not wanting to work hard. But the research says this is a real problem. That’s also why I love that I’ve been given the funding and support to do annual surveys — that keeps the focus on the data.

When you look at large sample scores through the Maslach Burnout Inventory and other measures, you can see that burnout has been getting worse. Our country has a suicide rate among physicians that is twice the number of general society. It’s obvious that something has been changing in the last 10 years at least, and that has generated interest in determining the cause.

Some people think that the increase in burnout is caused by the burden of documentation due to using electronic health records or digitized versions of a patient’s chart. That’s a portion of the issue for clinicians who are 45 and older, who didn’t grow up with computers, but that’s not the case for younger physicians. However, for all ages, regulatory requirements and bureaucratic duties are a cause for burnout.

Emily Laubham: The AMA and others refer to clinician burnout as an epidemic. Looking at it that way, is there a structure used to understand and combat it, similar to how you would understand and treat other conditions?

Dr. Tom Campbell: The factors contributing to burnout can be separated into three categories: efficiency of the work environment, overall value of employee wellness, and personal resilience. When you look at the amount that each of those categories contributes to burnout, the work environment is most significant.

Emily Laubham: Is that surprising? I can see how some people might focus more on personal resilience.

Dr. Tom Campbell: For the most part, when we look at physicians and nurses, they are a more resilient group than most, and personal resilience is a factor. It’s just that the work environment is much more significant. Within your practice, if your workflow isn’t efficient and that’s causing longer hours, that’s a problem. If you don’t work as a team, that’s a problem. If your environment isn’t nurturing, that’s a problem. On the positive side, appreciation can be hugely important as part of the work environment. Not only should you be paid well, you should be rewarded appropriately and recognized. Plus, you should have a sense that your values mesh with your leadership’s values.

A data-driven wellness approach

Emily Laubham: What’s different about AHN’s approach to burnout and wellness compared to other organizations?

Dr. Tom Campbell: Many places still don’t have wellness programs, so having support from leadership to do what we’re doing is tremendous.

People’s ideas about wellness often focus on socialization. Not that I want to downplay social time — but wellness is much more than that. From an organizational standpoint, that brings us back to the importance of the surveys. It’s hard to know where to start with wellness, and what will be effective, without data.

When I talk to people in other programs, even those doing surveys aren’t necessarily surveying multiple levels of providers. Our multi-level provider approach gives us that extra layer of insight into what will help each group. As we continue to accumulate more data each year, we’ll be better equipped to bake wellness into everyone’s daily routine.

Emily Laubham: Can you give an example or two of how the annual survey drives action?

Dr. Tom Campbell: Instead of just creating yoga classes or something because we think that’s what people need, we’re taking the time to ask what they need. When we dug into our research with the nurses group, for example, one thing we found was that they often weren’t taking a break to eat or hydrate. Breaks were built into their schedule, people assumed that everyone was taking their meals or breaking to drink water, but they weren’t. What we found was that taking breaks impacted the work of their coworkers, so if they took a break at all, they were rushing so they didn’t leave coworkers with extra duties. You don’t realize these things unless you’re on the front lines or you ask the right questions.

Similarly, we have regulations on what you can bring to your work area to drink, because you don’t want open drinks around for infectious reasons. But we had taken those regulations to the nth degree, so we adjusted them to allow for something like a water bottle to be in a safe location in the clinical areas.

We also noticed that younger nurses who were working nights and weekends had higher stress scores. One thing we tried that has been successful was looking at scheduling and pairing up newer nurses with senior, more experienced partners during those shifts — just providing that extra layer of support and resources.

Emily Laubham: There is an article in this magazine on Jefferson Hospital’s employee caregiver support group. Do you have other examples where wellness support is addressing a specific group’s challenges that might be outside work?

Dr. Tom Campbell: Women clinicians have higher burnout rates than men. I think that an obvious reason is that women are traditionally burdened with more duties, and expectations, outside of work. Across the network, we’ve had a focused effort to address women’s needs better, and from one year to the next, we were able to reduce burnout scores. But we have a long way to go.

So that’s a big area for any hospital or human resources department, looking at stressors for women — things like child care, maternity leave, having a comfortable place to express breast milk. Some things may be easier to do right away, others may require longer-term strategies, but they’re all worth addressing.

Emily Laubham: Thinking about the long term, what is your focus as a leader to keep the clinician wellness program evolving?

Dr. Tom Campbell: I want to keep clinician wellness on every leader’s radar as a part of their goals every year. Leaders need to keep an eye on how often their clinicians, the people they’re responsible for, are doing those basic things like taking their breaks and meals, taking vacations, and getting proper rest. It’s also important to provide, and for everyone to know that we provide, ways for clinicians to reach out for support and psychological help. And that can be work-related or help with the difficult experiences that we know people go through — sick loved ones, deaths, relationship struggles, their own health, and so on. The other thing is, again, asking the right questions and gathering the right data, so that what we do to prevent burnout and promote wellness is truly effective. Ultimately, my vision is that we’ll be measuring and tracking wellness for everyone who works for AHN, not just providers.