YFC Interview with Dr WC Leung on Well-being

INTERVIEW WITH DR W.C. LEUNG ON WELL-BEING

By Dr Eric Hui-lun LAU (Chairman of Young Fellows Chapter), Dr Zion Wing-hei TO (Treasurer of Young Fellows Chapter)
The Hong Kong College of Otorhinolaryngologists

https://www.hkam.org.hk/en/initiative/promotion-doctors-well-being

1. What is Well-being and Why is it important to doctors?

U.K. Department of Health defines well-being as “feeling good and functioning well and comprises an individual’s experience of their life; and a comparison of life circumstances with social norms and values.”¹ Hong Kong Academy of Medicine (HKAM) is mandated and empowered to promote and advance healthcare for Hong Kong citizens and foster a spirit of co-operation among medical and dental practitioners. Quality patient care and doctors’ well-being go hand in hand, and the Academy is committed to assuming a leading role in cultivating and promoting the well-being of Fellows and specialist trainees of its constituent Colleges as a shared responsibility among individual doctors, respective employing institutions, and policy makers.

In October 2021, a Well-being Charter (身心健康約章 Link²) has been promulgated. Some of the purposes are to foster a caring and supportive culture within the healthcare professions, to advocate policy changes and propose initiatives to the Government on professional well-being issues, to organise mental health training, and to embed awareness of well-being in training and continuous professional development. Employers are encouraged to promulgate good practices to build supportive systems at the organisational level through the establishment of effective communication channels, deployment of appropriate resources, and quality improvement strategies.

A Task Force on Well-being, chaired by the Academy’s Honorary Secretary and composed of dedicated colleagues, has been set up to devise plans and effective promotion of different initiatives since the COVID-19 pandemic started Click here (https://well-being.hkam.org.hk/) to visit a designated webpage, which you can find useful information and tips on promotion of well-being, as well as the Academy’s incremental approach - ASAP (Awareness, Self-care, Ask for help, Promotion of well-being).

2. How has Well-being become a particular area of interest for you?

Dr WC LEUNG interest in the field of Well-being dated back in the days when he obtained his fellowship as a senior medical officer (SMO). He started a research project on a topic related to domestic harmony inspired by his mentor Professor Ho-Kei Ma. His research mainly focused on mental health of pregnant women especially those who suffer from domestic violence. He received continuous support and funding regarding this research by his department on which he further developed great interest towards the field of mental health and well-being. His early research found that around 10% of pregnant women suffer from domestic violence thus this topic should be addressed and managed as this will affect the whole pregnancy journey. Although his research mainly focused on pregnant women, he believed well-being is important to all walks of life and different age range. Being the Honorary secretary of the Academy, he believed that well-being is important to doctors as it will affect work efficiency and also patient care.

3. Do young fellows have more obstacles from maintaining their Well-being?

Young fellows were defined as obtaining fellowship within 10 years. During this period, young fellows face unique challenges that can impact their well-being. Regarding work, they underwent the transformation from being a trainee under supervision to a fellow who need to work independently and gradually obtaining experience to become trainer. At the same time, one may experience various change in terms of family dynamics such as getting married and having children bearing various responsibilities in life. In summary, there is a huge transition from navigating education and career choices, building relationships, and facing financial pressures can contribute to increased stress and uncertainty. Additionally, societal expectations, peer influences, and technological advancements can add to the complexity of maintaining well-being for younger individuals. It is important for young fellows to recognize these challenges and seek support and resources to effectively manage them.

Apart from taking care of young fellows, the Academy is now shifting gears and spending resources to take care Senior Fellows which defined as 25 years or above obtaining fellowship. Topics need to be addressed include retirement and financial plans and so forth.

4. Are there any ways to self-assess your Well-being?

There are various objective ways to self-evaluate one’s Well-being. The first tool we can use is The Copenhagen Burnout Inventory.³ It is an instrument specifically developed for the Project on Burnout, Motivation and Job Satisfaction (PUMA) project, a five years prospective intervention study on burnout in the human service sector conducted by the National Research Centre for Working Environment, Denmark in 1999. It can further be classified into three categories namely Personal burnout, Workplace burnout and Client burnout. A healthy doctor-patient relationship can also enhance one’s Well-being. When we encounter a ‘likeable’ patient show showed understanding, follow instructions with good compliance will undoubtedly enhances our working experience and in turn our Well-being. While facing a grumpy patient who always complain no matter what will have detrimental impact towards our perception and even management to our patients. In fact, this is a bi- directional factor interplay with each other. Other useful tools for assessment of Well-being include Generalized Anxiety Disorder-7 (GAD-7)⁴ Screening for generalized anxiety disorder and Patient Health Questionaire-9 (PHQ-9)⁵ assessing the severity of depressive disorders.

5. Could you give our ENT young fellows some advice on the approach to Well-being? Could you elaborate on "ASAP" ?

It is important to take actions ASAP⁶ to manage stress and to avoid burnout to ensure quality of patient care. We should adopt an incremental approach to manage stress by – Awareness, Self-care, Ask for help and Promotion of well-being. Regarding Awareness, it helps one to understand and recognize the causes, signs and symptoms of burnout, stress and other mental well-being issues. Self- care refers to perform self-assessment tools as above to recognize the potential crisis in Well-being. Ask for help is important to facilitate a peer support network and provide information on getting professional help. A voluntary programme for Academy Fellows and specialist trainees to offer or find support through informal communication that may be beneficial to mental well-being. Academy Fellows are free to enrol as Peer Supporters. Promotion of well being refers to cultivate a culture of care and support, making recommendations for well-being improvement at the organisation level and organising well-being programmes.

6. Does the Academy of Medicine offer anything to support their fellows?

Mindfulness is defined as intentional present-moment awareness without judgment. It can be cultivated through a variety of meditation practices. Training in mindfulness has been proposed as a means of alleviating burnout of the healthcare providers, increasing satisfaction, and improving patient care. The Academy has been conducting a free mental health training programme, titled “Mindfulness Induction Group”, to equip Fellows and specialist trainees with techniques of applying mindfulness in daily lives and workplace to reduce stress and improve well-being. Four sessions were successfully held. Stayed tune for the announcement of the upcoming sessions on the Academy website and this webpage, or through e-blasts.

Reference:

1. Department of Health, The United Kingdom of Great Britain and Northern Ireland. Wellbeing: Why it matters to health policy. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/277566/Narrative__January_2014_.pdf. Accessed August 25, 2021.
2. https://www.hkam.org.hk/sites/default/files/well-being/Well-being%20Charter%20of%20Hong%20Kong%20Academy%20of%20Medicine.pdf
3. https://well-being.hkam.org.hk/cbi/
4. https://www.med.cuhk.edu.hk/study/current-students/student-wellness/self-assessment/gad-7
5. https://www.med.cuhk.edu.hk/study/current-students/student-wellness/self-assessment/phq-9
6. https://well-being.hkam.org.hk/