Wellness: What's Your Why?

(electro-pop music) - This is "Lab Medicine Rounds", a curated podcast for physicians, laboratory professionals and students. I'm your host, Justin Kreuter, the Bow Tie Bandit of Blood Transfusion medicine pathologist at Mayo Clinic. Today, we're rounding with Dr. Venk Bellamkonda, assistant professor of emergency medicine and the wellness officer for the Department of Emergency Medicine at Mayo Clinic here in Rochester, Minnesota.

To use his own words upon being invited as a guest of this podcast, I'm stoked to have him rounding with us today as we talk about the importance of wellness. Thanks for joining us today Dr. Bellamkonda. - Please just call me Venk, and thank you so much for having me. I really appreciate it. - So Venk, I like to kind of start out with the why and I think when talking about the why I'm really curious about why are wellness efforts

a need to have rather than kind of a want to have? - Yeah, I think it always has to start there, right? Isn't it Simon Sinek's "Start With Why". And this one, the why is different for a lot of people and certainly, wellness and burnout are not direct opposites, but I usually start in my mind with, well, what is the cost if we don't do this and we have burnout?

Well, I believe Forbes had been quoted as saying that there could be potentially up to $190 billion annually in total healthcare cost, including productivity, healthcare expenses, et cetera, but that doesn't account for lost engagement. And some reports are suggesting that when people are not well they may engage about one third less than normally. So if we consider our FTE from a productivity standpoint for a business, that's a huge loss, even with the people who continue to work.

But beyond that, let's just think about the effects of a community that feels well whether it's wellness or wellbeing. And you have people who are happy and engaged, creative and thoughtful, willing to go the extra mile wherever their time allows, children growing up in really well-adjusted homes and the impact to that for the community, it's very far-reaching and touches everything from engagement, employee turnover, productivity, healthcare, healthcare utilization, illness prevalence.

So I think the effects of not addressing this are incredibly huge. And then, at an employer level I think it's become the standard to have to care about this. And so, if you want to have the best people for your jobs, you really should be thinking about this, otherwise, you'll be behind the times and the best candidates are gonna demand this and go somewhere else. - Wow, I love the way you frame that 'cause right away as you kind of flip it around is what if we don't do this?

And as you talk through a lot of those stats, it really kind of hits, I'm sure a lot of our audience too, about wow, this is significant. This is significant in multiple ways. And I really appreciate that you highlighted that there's a lot of individual differences as well. The diversity of how do we experience this construct varies. As you've been doing this deeper dive Venk, I'm curious, what has really kind of stood out for you?

What have you learned as you've taken on this role as a wellness officer for the Department of Emergency Medicine here at Mayo? I'm curious about that, 'cause I think this podcast is all about building these bridges between lab medicine and clinical practice. I think this is one of these podcast examples where when we think about wellness and the emergency of medicine, especially these past two years of the pandemic, I've been elaborating for a long question to say,

what's really struck you as is something that would be helpful for audience to understand? - Absolutely. Wellness is more than doing yoga, or eating fish each night, or having free food at conferences, or time off, or free coffee, it's way beyond that. And sometimes people think of it as money. In fact, on Twitter recently there was a somebody who was talking about compensation as a form of respect and wellness. And I think it's way beyond any one of these domains.

And in fact, a lot of those are really short-term happiness things. And usually, there's some regret afterwards when you eat the free pizza, at least for me there is lots of regret it, but you know what I've learned is that to improve wellness and wellbeing it's a very personal journey for an individual or for a department or for an institution. The same solutions don't work for everybody, because the problems are not the same.

And even within one person's experience, it will change based on the context that they're in. To give a great example, earlier in my career, I was really thinking about quitting medicine and I was a new dad and I was wildly successful in terms of everything you could see here at Mayo in terms of awards and opportunities, but internally, I just felt exhaust and like I wasn't achieving the standard I wanted to achieve at home. And so, that was my context.

Whereas, somebody else might be feeling, because of a financial stress that their wellbeing is fractured or tenuous. And then, somebody else might be thinking about it entirely from a COVID perspective. So this is very personal, and it's based on the context that that person or group is going through at that time.

And I think as a result, if we wanna talk about the best state or best practice, what I've learned is that you have to address wellness and wellbeing in all its facets that you can possibly address. So at political levels, community levels, enterprise levels, department levels, and individual levels.

And thinking about it from a physical health, financial wellbeing, social or community-building aspect, engagement, time, reimbursement, all of these things, if you address 1 or 2 of them in isolation you're not going to move the needle. It has to be as a concerted and thoughtful effort in as many domains as you possibly can muster. - Venk, as I hear you say that, all these facets, it sounds almost- - Too daunting. - Too yeah, thank you. Too big to get my hands around.

And so, I'm curious, I'm curious. Well, I imagine there's gotta be some sense of being iterative with your process. So, and to do that, I suppose you really have to reach out to your community and ask, "Where do we start?" And so, I'm thinking about our listeners here, our lab professionals, clinicians, students. I imagine what are those maybe first steps

that they can take and maybe initiate for their own local practice, what their initial support might look like? - I think people who are in a position to influence the community or the department as a whole, let's put that group to the side just for a moment, mainly because I think we can all relate to trying to address things at an individual level. And you don't need any committee approvals or a big budget to do so.

And so, I think that's a great place for us all to begin, but I absolutely don't want anyone to walk away thinking that I'm putting all the onus on wellbeing on the individual, definitely not, but I will tell you from my journey I started there and it was really impactful and empowering for me to see what I could do just for myself and for my family. And I think, like I said, it's beyond the superficial things the pizza and the yoga and whatever, right? And so, where is it?

It begins with positioning yourself in a community or a place that sees you, and as you wanna be seen, if it's your identity as trans or a parent or whatever, you have to be in a place where you feel comfortable being who you are and that people will see you for who you are. And then, ideally you combine that with an opportunity to work for an institution or environment that aligns their values and their mission with your personal values in the way you wanna live your life.

And for some of us we haven't really taken stock of what our values are. And so, that might be a pre-work step before you even get to this. But if you know what your values are, making sure that your work and your school ties or community ties all align with that, is incredibly important. And I'll explain why in just a second. So we've started with being in an environment where you are seen for who you wanna be, and then being empowered to do things that align with your values.

And then, in an institution or environment or workplace where you feel you can actually make a difference, that you affect the trajectory of your life. It's very difficult to find wellbeing or personal satisfaction, if you don't feel that if you put in more effort or you reach out or you change your effort, that there's not a compensatory deflection or movement in your trajectory, feeling that you make a difference in your life is very important.

So those are the three foundational building blocks, I would say. And hopefully, you all listening, I'm assuming there'd be a lot of Mayo people, but I'm hoping that you feel that Mayo sees you this way and that you are valued and that your values align with Mayo values, but let's say you're listening and that doesn't fit.

Well, I think these are so foundationally important, that is probably worth your time and energy to think, can you modify what you do to fix that gap, or do you need to go do something else, for someone else to fix that gap? Because these are just so foundational, to be seen as who you are to know your values and do what aligns with your values and feel that you can make a difference.

The next layer to that is to really be honest with yourself and taking stock of what's going right and what's not, don't embellish either way. And I think sometimes that's hard to be reflective just for yourself about the truth of yourself in your situation, and think about it from a social perspective. Do you feel connected in your community both at work and at home? Does your work, how is your work going? Are you matched with your skillsets in this work? How's your physical health?

Are you getting the exercise you need? Are you getting your preventative healthcare screenings? Do you need something more than that? What about your spirituality? Is this important for you? Are you addressing it and as connected with that as you want to be? Your emotional wellbeing and your love dimension. Is that progressing the way it needs to happen, or do you feel like it's not? Financially, are you hitting your finance goals and are you not?

Are you prepared for financial challenges or are you not? Do you have mentorship and support guidance to help you grow in all the dimensions you want? Personally, it's not just for my work, but I want to grow for example, in my interest in chess playing. And so, I have a coach that helps me with chess. And so, making sure you have that guidance and mentorship and challenge in the things that you care about. And then your time.

Do you have enough time to get the stuff done that you care about the most? And if not, what needs to go to free up that time? Or do you have too much extra time, in which case, what can you fill it with. And believe it or not, there are people who have that problem. All of these, if there's an imbalance can make you feel less than your most well self. And so, those are things that I think are very easy to do.

If you take stock of these things for yourself then, even if you decide not to make any changes right away as opportunities come to your door, or they're leaving, you have an idea of what that will do to your balance, your homeostasis, not to be too fancy about it, but if you're losing social connection, because you're in a football league and that's ending, well, maybe you need to augment something else somewhere.

And you take up a book club or something else to supplement that, but you won't know if you'd let these things just happen to you in the background, but being more intentional about assessing them and having plans, is really very helpful.

- So as I've been listening to you, I wonder if this next question I had of on my mind, if this is a valid question or not, 'cause given the diversity that's out there, I was gonna ask you 'cause in the your role as wellness officer, I imagine you've interacted with a number of folks. And I'm curious if there are classic struggles

with improving wellness, that you can kind of help our listeners navigate if there's some pearls to share in that regard? - Absolutely, that is a totally awesome question. And there are, definitely are classic struggles or themes. And I'm going to kind of build off that question.

It's not so much classic causes for lack of wellness, but since many, many people these days are feeling that they're under a crucible for whatever reason, COVID, finance, life, whatever, the effects of that, and how do we handle that kind of exhaustion is a common struggle for us all. And I would say that one of the most helpful things that I've seen is I stumbled across a going home checklist from the National Health Service from the United Kingdom several years ago.

And I thought what a brilliant idea to help make sure that we don't take that burden of stress from work and take it home and take it out on our kids or spouse or whatever else, our plants, pets. How do we do that effectively? And so, I re-engineered the checklist and we created one for Mayo that you can get if you want for your division or yourself through the forms system at Mayo. But basically, it is a moment of reflection before you transition from work to home.

And in that reflection, you take a moment to think about and acknowledge three things that went well during the day. No matter how many other things didn't go well find three things that did. And some days it might just be that you got outta bed and it can be that. But then other days, if you don't take a moment you might overlook the fact that your coworker anticipated that you had a long night and brought you coffee, and stuff like that. So three things that went well.

The next one, acknowledge one thing that went not well or was difficult for the day. Think about it, process it for a moment, be kind to yourself and let it go. And just acknowledge that you're not going to work on that and you're gonna let it go before you enter the house. Next, think about one person that you want to acknowledge and you directly recognize them even if it's in your thoughts.

For example, I'm very grateful that I got to be on this podcast today and I'm going to probably at the end of my workday, think about how awesome that was and directly acknowledge all of you for having me. Identify one teammate who could use a pick me up and reach out to them.

And this is important, because sometimes in our moment we will forget to look at the people beside us and we can have a huge impact upon their experience just by thinking, "Oh, you know that patient was kind of brutal to my colleague. Maybe I can just give him a call or shoot him an email and say, 'I'm thinking about you. I know that was really hard.

And if you need me, here's my phone number, gimme a call.'" And the effect that that will have not only on your wellbeing for recognizing and building a sense of community there is sciences say that will uplift your own spirits, but the effects to the other person are also quite dramatic. Okay, and then the next one is reflect on at least one action that you did during the day that aligned with your personal values.

And again, this is so that you relate each day to the fact that you are moving your personal value set forward. And if we don't deliberately look at it that way it can often be that we feel like the day was spent processing email or not getting something done, when in truth, if we think about it what we did really did fit with our values at least some part of your day did. And if you can't think of that, well, that's also a reflection going back to those foundational pieces that we talked about.

If so many days pass, and you can't reflect anything with your values, that's important to recognize. And the last piece is just deliberately acknowledge and tell yourself, you're about to transition into a rest and recharge period, and that's healthy and normal. So you're gonna leave work behind and you're gonna come home and be as present as you can be in the way that you can.

And I recognize some people are on-call or you might have leadership duties or whatever, but there's still a mental opportunity to just tell yourself that that's what's gonna happen so that you don't carry baggage across that boundary into the threshold of your house. So I think these are not necessarily shared causes of poor wellbeing or wellness, but rather the effect of being unwell or under a crucible, as I said before, can and be very similar and we can mitigate it with a similar strategy.

- As hearing you talk about that checklist I really like how it seems to in your day, be a way to close one chapter of your life and open another. Kind of celebrating that we are multitudes, so there's multiple facets out there within us, areas we participate in.

And the other thing that I really love about that is it sounds like you're also threading in not just for myself what three things that went well, what is one thing that was difficult, but I hear the connection and the thread to community what's one person that really I connected with or what's one teammate that I need to reach out to? It's really threading us together. - Exactly.

Woven in there are that building community, helping uplift people, thinking about our values, gratitude, some of these big picture themes that go beyond yoga and pizza and time off and money. And they are, earlier I talked about how much more important these things are.

Well, my experience is that people who have these foundational blocks in the right places, their ability to survive and thrive under stress is much greater than people who are in work environments that they don't feel seen, don't feel value, don't feel like they can make an impact. When that's the case, we're much more brittle. And the unfortunate reality is that life is always gonna throw challenges at us. I mean, these last two years have brought that to the surface, right?

And if we are not first, building with the right blocks then our houses and our buildings that we build ourselves up in are gonna fall. - So I'd like to kinda close the podcast by kind of looking to the future. And I think, going back to how you started this podcast about how it really is an essential and just how awareness is growing, not just awareness for like you were saying some very basic stuff, but some meaningful things in our life in these various facets. I'm kind of curious for,

what do you think is in store for us in the future as you're saying in the near future, it's just gonna be the standard of employment to have these kinds of programs? - Absolutely. I'm biased in this and I love technology. So I sit and think about tech quite a bit. And these last couple years obviously, have challenged most of us to think about how we interact with other humans differently.

And it comes at a time when even pre-COVID things were moving into a metaverse and you see that in the change of Facebook's name, for example, to Meta. And I think that puts a challenge on us in wellness and wellbeing, how do we maintain or push forward in our individual wellbeing when we may be physically more isolated? Can we leverage virtual reality, augmented reality to help build community when we may be across bigger distances?

And I think it's a cool challenge and I wouldn't be surprised if we see lots of innovation in that space over the next couple years. I think, I'm personally very excited to see what comes and I have a few tricks up my sleeve for the emergency department that I'd like to test out. - I bet you do.

And as listeners may not know, I really appreciate a lot of the education and teaching that happens in emergency medicine and I like to drop in and spy and learn from your wonderful grand rounds that guys do. And I'm looking forward to seeing that Venk. - [Venk] Me too. - So we've been rounding with Dr. Bellamkonda

on the importance of wellness. Thank you for being here with us Venk. - It's been my pleasure. Thank you for having me. - So to all of our listeners thank you for joining us today. We invite you to share your thoughts and suggestions via email. Please direct any suggestions to mcleducation@mayo.edu. If you have enjoyed "Lab Medicine Rounds" podcast please follow or subscribe.

Until our next rounds together, we encourage you to continue to connect lab medicine and the clinical practice through insightful conversations. (electro-pop music)