Faculty Health in Academic Medicine Physicians, Scientists, and the Pressures of Success

In the 21st century, academic medical centers across the United States continue to make scientific breakthroughs, to make improvements in patient care, and to p- vide the most advanced information and guidance in matters affecting public health. The signs of growth are everywhere—in new research buildings, new pa- nerships with industry, new forms of molecular medicine, and new sensitivity to the role of the human spirit in healing. This growth is due in large part to the dedication and productivity of our faculty, who are providing more patient care, more research, more teaching, and more community service than ever before. Today, there are roughly 135,000 physicians, scientists, and other faculty wo- ing at approximately 125 academic medical centers around the country. Increasingly, they are asked to do more with less. Since the 1990s, academic medical centers in the United States have lost the financial margin they once enjoyed, thereby putting new pressures on research, education, and clinical care. Medical school faculty, previously given funded time for teaching and research, are increasingly drafted to bring in clinical revenues to cover their salaries. Dedicated to the missions of research, teaching, and care, our faculty have responded well to these challenges and perform at a very high level. However, we are beginning to see the results of ongoing stress.

Foreword. James Willerson, MD, President, University of Texas-Houston Health Science Center Preface. Ken Shine, M.D., Executive Vice-Chancellor for Health Affairs and Interim Chancellor for the University of Texas System Introduction The Context of Concern for Faculty Health. Thelma Jean Goodrich, PhD, Thomas R. Cole, PhD and Ellen R. Gritz, PhD Examination of Faculty Health Epidemiology. Daria Boccher-Lattimore, DrPH Causes and Treatment of Impairment and Burnout in Physicians: The Epidemic Within. Eugene Boisaubin, MD Measuring and Maintaining Faculty Health: Lessons from the University of Ottawa. Mamta Gautam, Personal and Social Dimensions The Architecture of Alignment: Leadership and the Psychological Health of Faculty. Susan McDaniel, PhD, Stephen P. Bogdewic, PhD, Richard Holloway, PhD and Jeri Hepworth, PhD The Career Management Life Cycle: A Model for Supporting and Sustaining Faculty Vitality and Wellness. Thomas Viggiano, MD and Henry W. Strobel, PhD Faculty Resilience and Career Development: Strategies for Strengthening Academic Medicine. Janet Bickel, MA Diverse Academic Faculty: A Precious Resource for Innovative Institutions. Elise Cook, MD and Harry Gibbs, MD Perspectives from the Humanities and Interpretive Social Science Organizational Culture and its Consequences. Kevin Grigsby, DSW The Ethics of Self-Care. Craig Irvine, PhD Faculty Health and the Crisis of Meaning: Humanistic Diagnosis and Treatment. Thomas R. Cole, PhD and Nathan Carlin, MDiv Retaining and Reclaiming the Call of Medicine. Henry W. Strobel, PhD Supports and Interventions A Model for Designing and Developing a Faculty Health Program: The M. D. Anderson Experience. EllenR. Gritz, PhD, Janis Apted, MLS, Walter Baile, MD, Kathleen Sazama, MD, JD and Georgia Thomas, MD Fostering Faculty Well-Being through Personal, Community, and Cultural Formation at an Academic Medical Center: Indiana University School of Medicine as a Case Study. Debra K. Litzelman, MA, MD, Penelope R. Williamson, ScD, Anthony L. Suchman, MA, MD, Stephen P. Bogdewic, PhD, Ann H. Cottingham, MAR, Richard M. Frankel, PhD, David M. Mossbarger, MBA, and Thomas S. Inui, SCM, MD Conflict Resolution in an Academic Medical Center: The Ombuds Office. Anu Rao, PhD, Walter Baile, MD and Patricia Parker, PhD Preserving Principal: Programming for Faculty Health and Well-Being. Thelma Jean Goodrich, PhD Conclusion Faculty Health: A New Field of Inquiry and Programming. Thelma Jean Goodrich, PhD, Thomas R. Cole, PhD and Ellen R. Gritz, PhD Afterword. John Mendelsohn, M.D., President, University of Texas M. D. Anderson Cancer Center Appendix. Foundations of Faculty Health: A Consensus Statement of Editors and Authors.