Words of Wellness

Volunteers have been foundational to the American Roentgen Ray Society (ARRS), allowing North America’s very first radiological society to ensure its strategic initiatives remain achieved. And to carry out the organizational needs and directives of this society, ARRS members and associate members alike are invited to serve on standing or ad hoc committees furthering our overall mission: improving health through a community committed to advancing the profession of medical imaging and its allied sciences. 

Presently, there are ARRS committees expertly focused on professional and practice improvement, scientific innovation, education, membership, and international outreach. The ARRS Professional and Practice Improvement Committee has been charged with overseeing our professional development programs, cultivating leadership opportunities, as well as initiating several practice quality improvements.  

Chief among these improvements has been establishing a brand-new ARRS Quality and Practice Improvement Subcommittee–a working group with an overarching charter of promoting both workplace wellness and personal wellbeing to ARRS members of each practice type, private or academic, at every stage of their career, from residency to fellowship to active practice and beyond.   

For “Words of Wellness” here in InPractice, members of the ARRS Quality and Practice Improvement Subcommittee discuss what “wellness” and “wellbeing” mean in their own clinical practices, research focuses, and everyday lives.

“I am a breast radiologist and professor of radiology in the division of diagnostic imaging at UT MD Anderson Cancer Center. Most physicians go into medicine and endure medical school and radiology residency for the betterment of patients. Along the course of training and further into our careers, data show a high prevalence of burnout in radiology. Additionally, physician burnout has been associated with negative outcomes for organizations, physicians, and patients.  

Since burnout is a workplace-related phenomenon, radiology practice leaders need to stop redesigning the radiologist. Instead, they should focus on redesigning processes. Physician leadership is inversely related to burnout. Therefore, practice leaders need to be held accountable for radiologist burnout in their workplaces. Radiologists work very hard to become credentialed and take care of patients, so they should not be marginalized into feeling like cogs in a wheel. The road to overcoming the complex issue of radiologist burnout to wellness requires leaders to listen to their radiologists, co-create solutions, and build trust across their teams.”

“My journey towards wellness has its roots in yoga. My yoga practice started in college, and during graduate school, I became a certified yoga instructor. During medical school, I taught yoga classes for my fellow medical students, weaving concepts of presence and self-awareness into my classes. 

As a trainee, I find that training and wellness are often difficult to reconcile; not just for myself, but also for my colleagues. The aspect of wellness that I struggle with the most is self-care. In medicine, we are trained with the expectation to place the hospital’s needs always before our own. Our training culture has classically praised the individual who finds more of themselves to give, without reprieve or compensation. The internalization of this culture manifests as a loss of self-worth. To balance this, I have found that the pillars of self-care can be derived from both the physical principles of yoga—flexibility and strength—in addition to the yogic principle of community. 

Flexibility, strength, and community are the mental and social foundations on which I build my self-care and self-acceptance.”

“Wellness at work starts with processes that improve your life, not impede it. Making your job something you look forward to, not dread. The first step is identifying what at work is leading to stress and unhappiness. 

These can be big things, such as we need more staff to cover calls, or small items, such as moving the cutoff time to read cases from 5:00 to 4:30 pm. The hard part is that these changes are extremely practice-specific. What has helped in my practice is likely to be irrelevant to someone else’s. Therefore, it is critical that leadership listen to radiologists and be willing to make changes. There is no one-size-fits-all, and no one outside your practice can tell you what to do. So, it all starts with identifying pain points, and then getting leadership to listen and be willing to change.”

I am an abdominal radiologist and professor of radiology and urology at the University of North Carolina at Chapel Hill. In my current role of executive vice chair, I have worked on several initiatives to improve work-life balance across all members of the team: faculty, residents, and staff.

In my view, small tweaks can lead to great improvement. Optimization of worklists to equalize efforts and/or allow for flexibility or remote interpretation has been key to finding that balance of teaching, clinical acuity, and clinical load for our team. These tweaks allow faculty to have autonomy and flexibility in their work and daily lives.

Efforts to help physicians practice at their level are equally important. Automation of protocols, software to propagate measurements from ultrasound examinations straight to reports, and motivated staff to help relay and close the loop on incidental findings are all examples of such efforts. It’s a constant work-in-progress that requires a unified team with open and honest communication between all team members.

I am an abdominal radiologist in the abdominal and ultrasound divisions at Mayo Clinic Rochester. Being a radiologist, I have found much of my source of unwellness and burnout tend to be psychological, rather than physical. There is a lot of mental burden, and it is no surprise that radiology is the most mentally demanding physician specialty with increasing workload contributing to burnout.

Music is something I have always enjoyed, and I’ve curated a “Wellness Playlist”—songs for those mentally tougher days in the reading room. Music has been found to improve mood and decrease anxiety and cortisol levels, even improving depression. Physiologically, music can decrease blood pressure, heart rate, and respiratory rate. In particular, listening to peaceful and low tempo music has been found to decrease heart rate.

There are times in the reading room where I find it useful to have relaxing music to help decrease anxiety and irritation, as well as calm down. However, there are days where I want and need to get pumped up to help tackle a rougher day, just like getting pumped up at the gym for a workout. In fact, motivational music has been shown to combat cognitive and physical performance decline caused by exercise fatigue in sports. Another factor shown to combat cognitive and physical decline is a 30-minute nap. This also showcases the importance and power of sleep, which we are all very aware of in mitigating burnout and unwellness. Since we are on the topic of sleep, listening to relaxing music has been found to be as effective as diazepam in reducing anxiety, and thus beneficial for aiding sleep. Music can lower our blood pressure, heart rate, and respiratory rate to help us fall asleep and achieve quality sleep, further boosting our wellness.