Bring Back a Real F%cking Doctors Lounge!
Douglas Farrago MD
Medical Doctor (retired). Expert in the area of Physician Retention. Keynote speaker. DPC advocate and author of three books on this topic.
When I began my first employed job there was a doctors’ lounge. It was big and comfortable and stocked with food. Doctors would mingle there all day and discuss cases and talk about personal issues. It was awesome. And then it was gone. Why? Nobody knew? There were whispers about economics. There were supposed complaints about NPPs not being able to go in as if this was some sort of discrimination. It didn’t matter why. It was just sad to me. And I wasn’t the only one. These are quotes from doctors from a Sermo (1) article:
????????? “We don’t have one. I have brought it up multiple times to administration, but I just get the “oh, that would be a good idea” and nothing ever happens…“ – Pathology
????????? “[Our] lounge is a joke… the CMO hangs around and we don’t talk.” – OBGYN
????????? “In 15 years and 3 jobs since residency, I have never seen a Doctors’ Lounge” – Neurology
????????? “I’ve been to some really nice ones. The last time was more than 15 years ago. An anachronism, likely even then.” – Surgery
????????? “No doctor’s lounge in the main hospital I work at unfortunately… small lounge in ED where I work at with a couch, one computer, but it’s a mess and never cleaned – basically a place where we store our stuff….” – Emergency Medicine
????????? “When I was a med student it was great. But I wasn’t allowed in unless accompanied by a resident or attending. I relished those days. It was good to be able to share a meal and discuss shared patients and their issues. It was definitely good for patient care. Since then, I have seen nothing like it. Where I am now there is just a break room for OR staff.” – Ophthalmology
????????? “The NHS hospitals used to invariably have a doctors’ ‘Mess’ – the equivalent to the lounge, I guess. Mess parties were legendary and still subject of folklore / tales for those that can remember. And yes, nurses invited! More important it was a place to meet, unwind, and de-stress with colleagues. It’s really sad that this structure has largely been dismantled in the UK. In part due to the everincreasing workload meaning that juniors and seniors
simply don’t get time to ‘stop’ when at work.” – Pulmonology
????????? “We have an incredible doctors’ lounge at the main hospital to which we admit… I am the only family physician who does hospital, but it’s a great time for me to connect with all the specialists. We talk shop, update each other on developments in our field, discuss current cases on the floor, but also plenty of personal talk, with sports and politics… A lot of work, relationship-building, and relaxing takes place there, and it adds to our quality of life and sense of community.” – Family Medicine
????????? “When I worked in a more rural area, about 7 years ago, the doctors’ lounge was a great place to informally consult with other physicians. Sooooo hard to get specialist referrals… in 5-10 minutes, great advice/direction as opposed to the patient waiting a year or more to get an appointment.” – Pediatrics
Are there other reasons it was taken away? Maybe (2):
“It all essentially boils down to the monumental loss of independence and autonomy of physicians, as they’ve switched to a controlled employee-type corporate system in an environment of increased bureaucracy and workload. It also represents a sea change in how hospital administrations view and treat their physicians. The lounge is considered too much of a luxury to lavish on doctors in an era of cost-cutting and number-crunching. It may also be considered risky to allow physicians any downtime, and perhaps intimidating for administrators to know that there’s an area where doctors can freely congregate and mingle. Where is there time anyway, with all the computer work that’s always needed?”
Maybe times have changed, but maybe we need to go back in time. This is from an article by The Atlantic in 2013 (3):
What makes the doctors’ lounge so important? It once provided a base of operations for physicians who came to the hospital to round on their patients or perform procedures. They would show up there at odd times throughout the day, pick up their white coat, grab a cup of coffee, or just rest for a few minutes. Most of all, they talked to one another. Many senior physicians recall the doctors’ lounge as the most important hub of medical collegiality in the hospital.
On the other end of the spectrum are the hospitals that still have them, but they aren’t being used. More from The Atlantic article:
In hospitals that still have doctors’ lounges, they are often nearly deserted. On the infrequent occasions when more than a handful of physicians are found there, typically they are not engaged in conversation with one another, but tending to medical paperwork or dictating patient discharge summaries. Increasingly, the doctors’ lounge represents a place where physicians are alone.
Being alone is never a good thing for doctors. This leads to more burnout.?
Investing in a modern doctors' lounge may be the smartest thing a hospital could do as a part of a physician retention program. Diane Sliwka, MD, hospitalist and professor of medicine at the University of California, San Francisco (UCSF) School of Medicine, said this in an AMA piece (4):
“When we surveyed our own physician work experience, we found a need people kept bringing up was that there wasn’t a space for physicians to come together and get away from the action of work. People are increasingly busy, and that factor, plus technology and geographic dispersion, over time leads to this feeling of disconnection. This likely contributes to the feeling of isolation that many physicians struggle with. We expect that doctors work together, but in many cases, we don’t actually work together—people are seeing their own patients and doing their own work and it’s less and less common that people are coming together. Deliberately creating time and space for connection at work is one of the multiple strategies needed to address the burnout problem, yet often overlooked for its simplicity.”
And here is the key: Dr. Sliwka believes the success of the new lounge isn’t so much in the amenities themselves as the physicians’ recognition of the effort being made on their behalf and the feeling of ownership over a space meant just for them.
Reasons to open a Doctors’ Lounge for physicians only:
1.?????? Collegiality
2.?????? Feeling of being valued
3.?????? Face-to-face interaction
4.?????? Cohesiveness
5.?????? Space to think
6.?????? A place to relax, unwind, catch up with co-workers
What goes in the Physicians’ Lounge – this should be part of a discussion by the doctors so that they have a voice in choosing what goes in there. What I put below are just some of the things that others have used. Feel free to ignore and add your own.?
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1.?????? Computers at workstations
2.?????? Comfortable rest areas
3.?????? High quality snacks and refreshments
4.?????? Printers
5.?????? Television
6.?????? Space so that doctors can actually sit in small groups and talk
7.?????? Fresh flowers and seasonal décor
8.?????? Reading material: medical journals, magazines, coffee table books
9.?????? Comfortable seating with a mixture of couches, chairs, ottomans, etc.?
10.??? Suitable lighting (not overhead fluorescent lights)
Who Should Be Allowed in the Physicians’ Lounge?
This can be a tough one, but it shouldn’t be. It is called the Doctors’ Lounge for a reason. In my opinion, it should be only physicians. That’s it. NPPs should have their own area because to mix the two would equate the two and they are NOT equal. At all. This is not to demean them or belittle their value. Doctors need their own space without looking over their shoulders. I would have the physicians discuss this first and possibly vote on this, but it could get testy, especially if you do not offer a space for the NPPs. This is where a good physician retention specialist comes in. They would help to get this done the right way. Maybe you create a room for NPPs to hang out as well? What you don’t want is something that was sent to me from a fellow physician:
?
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What message does this send?
It all may come down to the name. I am throwing this out there, but what if it was called a Physicians’ Safe Space. In this world of political correctness, it may be best to use this to your advantage. Explain the reason for creating the Physicians’ Safe Space was to combat burnout and help the mental health of your doctors. How can some argue that? Now I am not saying you actually name it that. You can if you want, but you can also keep the term Physicians’ Lounge but allude to everyone that it is really a Physician Safe Space. Get it?
??????????? ?
References
2.???? https://www.kevinmd.com/blog/2017/10/demisephysicians-lounge-symbolic-decline-profession.html
3.???? https://www.theatlantic.com/health/archive/2013/11/whathappened-to-the-doctors-lounge/281112/
(This is chapter TWENTY-THREE from my book?The Hospital Guide to Physician Retention: Why Creating a Physician-Friendly Environment is Critical for Your Organization's Success. See earlier chapters on my LinkedIn, For more info, go to physicianretention.com)