Keeping stress in check for medical practice staff around the holidays

The end of the calendar year can be packed with festive events and plans to celebrate, which leads to managing multiple time-off requests, disrupted schedules and more within a medical group.

Those added complications can compound existing stress levels many Americans face in daily life. The American Psychological Association’s November 2017 Stress in America^TM study found that while Americans’ stress levels have not changed in the past year (a 4.8 average on a scale of 1 to 10), people are more likely to report feeling effects of stress, including lying awake at night, feeling nervous or anxious, fatigued or irritable/angry.

A Nov. 28 MGMA Stat poll asked respondents what their organization does to help staff de-stress during the holidays. Of the 1,101 total responses, practice leaders said their organizations:

• Offer an event or party (67%)
• Give extra time off (13%)
• Offer relaxation techniques (1%)

Another 10% responded “not applicable” — many said their organizations do nothing specifically for the holidays — while 9% responded “other,” some of whom noted they do team-building activities, snow skiing or offering a cash-out of paid time off benefits.

One notable concern for practice leaders who responded to the poll was struggling to keep holiday events or parties consistent and fair for a medical group with dozens of locations and multiple divisions and service lines.

Multiple members in a recent MGMA Member Community discussion noted their organizations regularly close the office for a holiday party while still paying staff for their time. Others noted some type of holiday bonus or monetary gift — some based on years of service, others based on employment status.

One MGMA member noted that beyond mindfulness and other social gatherings, the holidays are a good time for staff recognition. Elizabeth Yankello, RN, CPN, CMPE, legal nurse consultant and practice administrator, Sewickley Valley Pediatrics & Adolescent Medicine, Wexford, Pa., said that in addition to a bonus based on years of service, “each provider picks one staff member who they feel has gone above and beyond for the year, and that person receives a higher amount.”

Yankello also noted that her practice hosts a gathering for staff and providers and their spouses in mid- to late January. “Having this celebration after Christmas has always worked well for us since everyone is typically so busy during December,” Yankello said.

One MGMA Stat poll user said the practice does a Christmas in July event when staff are less busy with holiday shopping and other seasonal events.

Mindfulness throughout the year

Specific activities to reduce stress beyond the holiday season also have proven to be useful. Engaging in mindfulness exercises has been shown to improve several clinical biomarkers such as blood pressure, stress hormones and heart rate, according to Joel Kahn, MD, chief operating officer and chief medical officer, eMindful Inc., Orlando, Fla., who explained the science behind it during his presentation, “Resilience training with providers and professionals,” at the MGMA 2017 Annual Conference in Anaheim, Calif.

While Mindfulness-Based Stress Reduction (MBSR) initially was developed to use meditation in two-hour blocks over 10 weeks and paired with a seven-hour retreat, Kahn noted MBSR has been modified over the years to address busy, modern schedules. “When we start these programs, almost everybody says, ‘I can’t spend that much time doing it, I’ll never get the providers to spend an hour or two hours a week doing this program,’” Kahn said. To deal with time constraints, Kahn helped develop a program consisting of dozens of shorter sessions, two to 10 minutes each.

Kahn also noted that many unhealthy habits become learned and natural parts of a person’s behavior spurred by cues outside their awareness. Learning to notice those cues and the reactions to them is a key part to having the ability to alter those behaviors to achieve a healthier lifestyle.