Wellness Program for Neurosurgeons [Neurosurgery Wiki]

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====== Wellness Program for Neurosurgeons ======
[[Wellness]] programs should emphasize [[solidarity]]
((Mackel CE, Nelton EB, Reynolds RM, Fox WC, Spiotta AM, Stippler M. A Scoping Review of Burnout in Neurosurgery. Neurosurgery. 2021 Apr 15;88(5):942-954. doi: 10.1093/neuros/nyaa564. PMID: 33471896.))

Implementing a wellness program for neurosurgeons is an important step towards ensuring their physical and mental health, as well as improving their overall [[job satisfaction]] and performance. Here are some components that could be included in a wellness program for neurosurgeons:

Regular physical activity: Encouraging neurosurgeons to engage in regular physical activity can improve their physical health and overall well-being. This could include offering gym memberships or fitness classes, providing access to on-site workout facilities, or organizing group exercise sessions.

Mental health support: Neurosurgeons face high levels of stress and pressure, which can take a toll on their mental health. Providing access to mental health resources such as counseling, therapy, or support groups can help them cope with these challenges.

Mindfulness and meditation: Incorporating mindfulness and meditation practices can help neurosurgeons manage stress, improve focus and concentration, and increase overall well-being. This could include offering guided meditation sessions, mindfulness workshops, or access to meditation apps.

Nutrition and healthy eating: Providing access to healthy food options, nutrition education, and resources for healthy eating can help neurosurgeons maintain a healthy weight, boost their energy levels, and improve their overall health and well-being.

Work-life balance: Neurosurgeons often have demanding work schedules, which can make it difficult to achieve a healthy work-life balance. Encouraging them to take breaks, offering flexible scheduling options, and providing resources for managing work-related stress can help improve their overall quality of life.

Continuing education and professional development: Providing opportunities for continuing education and professional development can help neurosurgeons stay up-to-date with the latest medical research and techniques, which can improve their job satisfaction and overall performance.

Overall, a wellness program for neurosurgeons should be tailored to meet their unique needs and challenges. By prioritizing their physical and mental health, neurosurgeons can improve their overall quality of life, job satisfaction, and performance.
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Once the accepted norm during Harvey Cushing's time, the mantra of work to the exclusion of family and lifestyle is now recognized as deleterious to overall well-being. A number of neurosurgical residency training programs have implemented wellness programs to enhance the physical, mental, and emotional well-being of trainees and faculty. 

A [[manuscript]] of Wolfe et al. from the Department of Neurosurgery, Wake Forest University, Winston-Salem, [[North Carolina]], Department of Neurosurgery, University of [[Minnesota]], [[Minneapolis]],  Department of Neurosurgery, University of [[Florida]], [[Gainesville]], Department of Neurosurgery, Vanderbilt University, [[Nashville]], Tennessee, Department of Neurosurgery, [[Louisiana]] State University, [[New Orleans]], Department of Neurosurgery, Tufts Medical Center, [[Boston]], Massachusetts, Department of Neurosurgery, Medical University of [[South Carolina]], Charleston, highlights existing organized wellness education within neurosurgery residency programs in order to describe the motivations behind development, structure, and potential implementation strategies, cost of implementation, and identify successes and barriers in the integration process. This manuscript is designed to serve as a "how-to" guide for other programs who may identify a need in their own trainees and begins the discussion of how to develop wellness, leadership, grit, and resiliency within our future generation of neurosurgeons
((Wolfe SQ, West JL, Hunt MA, Murad GJA, Fox WC, Dow J, Morone PJ, Wellons JC
3rd, Podet A, Wilson J, Wu JK, Spiotta AM, Fargen KM. A Comparison of the
Existing Wellness Programs in Neurosurgery and Institution Champion's
Perspectives. Neurosurgery. 2018 Oct 16. doi: 10.1093/neuros/nyy418. [Epub ahead 
of print] PubMed PMID: 30329099.
)).
----

Placing the needs of the [[patient]] above one’s own needs has long been the call-of-duty badge worn by the physician. Indeed, emergent patient care needs trump immediate personal needs such as sleep, fatigue, hunger, and family commitments. However, personal health and well-being are paramount to leading long and productive careers. Balancing the demands of a busy medical career with personal [[wellness]] is a daunting but necessary skill to acquire, yet there is little education on these principles available to physicians in training. For the most part, organized [[exercise]], [[diet]], and/or personal [[fitness]] programs are entirely lacking in modern graduate medical education.
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Programs that address overall wellbeing early in [[residency]] are necessary to prevent physician [[burnout]] and promote physician [[mental health]] to improve patient outcomes and ensure long and productive careers. A wellness initiative was implemented at the Dept. of Neurosurgery, [[Charleston]], [[South Carolina]] [[USA]], three years ago. 

A 17-question [[survey]] was administered to resident physicians in the department of neurosurgery. In addition to the resident survey results, they obtained personal perspective pieces from attendings and residents across all levels of training.

A total of 8 resident physicians completed a 17-question survey. 100% of participants felt that [[health]] and [[wellness]] initiatives are "very important" for resident physicians, that the initiative has been "largely positive" for the department overall, and that is has positively impacted their personal life in addition to their professional life. The majority (75%) of respondents indicated that participation has not affected patient care responsibilities "at all."

Participating resident perceptions of the wellness program are highly favorable. The [[survey]] results, combined with the perspectives across [[training]] levels provide insight for other programs wishing to implement program of their own
((Buchholz AL, Henderson F Jr, Lowe S, Alshareef M, Wolgamott L, Patel S,
Spiotta AM. Perspectives from a Residency Training Program following the
Implementation of a Wellness Initiative. World Neurosurg. 2018 Aug 10. pii:
S1878-8750(18)31790-X. doi: 10.1016/j.wneu.2018.08.009. [Epub ahead of print]
PubMed PMID: 30103061.
)).
----
Balancing the demands of a busy medical career with personal wellness can be daunting, and there is little education on these principles available to physicians in training.


To implement a voluntary wellness initiative in the Department of Neurosurgery, Medical University of South Carolina, Charleston to promote healthy lifestyle choices. This report details the [[baseline data]] collected as part of this quality improvement initiative.

The wellness initiative was implemented in July 2015 and available to all faculty and resident physicians in the Department of Neurological Surgery in collaboration with the Medical University of South Carolina Wellness Center. All participants were provided a [[Fitbit]] Surge HR wrist monitor (Fitbit, Boston, Massachusetts) and underwent baseline physical and psychological testing.

Six faculty physicians and 9 residents participated. Overall physical fitness levels varied widely between subjects. Health screening demonstrated abnormalities in 80% of participants (elevated systolic blood pressure in 60%, elevated diastolic in 47%, elevated serum low-density lipoprotein in 53%). Body composition analysis demonstrated body weight higher than ideal in 69% (47% overweight; 13% obese). Recommended average body fat mass reduction was 25.4 pounds. Seventy-nine percent reported below-average quality of life compared with the average healthy adult. All subjects reported wanting more time for personal health.

Baseline health and psychological screenings in our department demonstrated alarmingly prevalent, previously undiagnosed abnormalities on cardiovascular and body weight screenings. Obstacles to leading a healthier lifestyle have been identified and solutions have been incorporated into the program. This quality improvement initiative may serve as a template for other programs seeking to improve physician physical and mental well-being
((Spiotta AM, Fargen KM, Denham SL, Fulton ME, Kellogg R, Young E, Patel S,
Turner RD. Incorporation of a Physical Education and Nutrition Program Into
Neurosurgery: A Proof of Concept Pilot Program. Neurosurgery. 2016
Oct;79(4):613-9. doi: 10.1227/NEU.0000000000001358. PubMed PMID: 27465847.
)).