Speaker: Mukta Panda

Resilience of Health Care Professionals: Recharging through Relationships, Reflection, and Ritual

Physician burnout, depression, and suicide are tearing at the fabric of our health care system, which Dr. Mukta Panda has witnessed firsthand, written about, and sought to address for years. Mukta Panda, MD, MACP, FRCP-London, is a physician, speaker, and facilitator whose work seeks to transform the heart of patient care and medical education.

Dr. Panda has lived and practiced medicine in places as varied as India, London, Saudi Arabia, and now East Tennessee, where she serves as the Assistant Dean for Well-Being and Medical Student Education and a Professor of Medicine at the University of Tennessee College of Medicine at Chattanooga. She is also former chair of the Department of Internal Medicine. Her multicultural background strongly informs her work in health care as a clinician and educator where she strives to bridge the gap between evidence-based and empathy-based medicine. "I've learned the importance of embracing my own Indian culture, the faith I carry, and my spiritual roots, which are so embedded in who I am," she says. "My ability to live in the world, accepting differences, has been influenced by being in other cultures."

Author of over 60 publications, Dr. Panda focuses on spirituality in medicine, addressing fatigue and stress, educational and curricular development, and promoting the well-being of health care professionals.

"Burnout affects not only physicians but all stakeholders, from the janitorial staff and the cafeteria workers to the nurses and students, as well as the families of those who work in health care," she has observed. In a culture that privileges evidence over empathy, technology over touch, and what's measurable over what's meaningful, many of us – no matter our profession – feel more fragmented and isolated than ever.

"Evidence has its maximum impact when applied in the context of these other E's that make up the whole of empathy-based medicine: emotions, expectations, ethics, engagement, empowerment, effort, education, experience, error, environment, and equity," she argues. "Sometimes sufficient evidence isn't available, but these other E's provide a viable way forward. You may not always know what to do to cure the patient, but your heartfelt care will go a very long way."
In her latest book, Resilient Threads: Weaving Joy and Meaning into Well-Being (Creative Courage Press, 2020), Dr. Panda gives voice to the exhaustion and offers courage for another way. As a physician and medical educator, she has fought to return human touch to healthcare. As a mother, she has committed – and sometimes failed – to balance the personal with the professional. And as an immigrant, she has clung to the wisdom of her family and faith in the face of discrimination and fear.

By weaving stories of connecting to her patients, students, and colleagues with her own stories of belonging, she models how we can each thrive by creating community and self-awareness. "Ritual, relationships, and reflection are key threads in how I learned to thrive," Dr. Panda writes in the introduction of her book. So, too, are they key for the thriving of our world. Our well-being depends on integrating these threads into a new social fabric, one that honors the whole of who we are with what we do.

The issue of physician burnout is a personal one for Dr. Panda, and she says that in order to find a way forward, we must first accept that there is no magic answer. "It is a convoluted issue. It's like peeling an onion. You will take steps forward and backward, and that is okay. But it starts with the self." The second step involves building community. "Being in community requires courage and the ability to communicate and care deeply about the shared covenant. The word covenant feels sacred, as if there's ownership. I prefer that over mission or goal. It addresses the loneliness, but if we are working together on the same thing, there is unity that builds community."

"As we are so aware in the face of COVID-19, physicians who are relatively well (and relatively 'protected') are better able to serve their patients, students, colleagues, profession, and society," Dr. Panda says. "Partnership is needed now more than ever to mitigate and plan and advocate for self-care during this pandemic – and the post-traumatic stress to follow – not only for healthcare professionals but for our entire community at all levels: nurses, nursing assistants, physician assistants, physical therapists, mental health providers, custodians and cafeteria workers, receptionists, administrators, executive team, our families and the community at large."

Dr. Panda developed a new Oath to Self-Care and Well-Being that she co-authored with Margaret C. Lo, MD and Kevin E. O'Brien, MD on behalf of the Collaborative for Healing and Renewal in Medicine (CHARM). "In framing this oath to supplement our Hippocratic Oath, we see wellness as a shared responsibility between the individual provider and the system, with the major responsibility lying with the system itself," she explains.

Self-care and well-being of health care professionals is particularly relevant during this time as we witness the bravery of those serving on the front lines and the unwavering support of the communities rallying behind them. "In this COVID era, nurses are the ones who have given of themselves selflessly and with a smile," Dr. Panda reflects. "They not only care for the patients and their loved ones, they care for us physicians too. Many many times I have been offered a cup of freshly made coffee, a snack or food."

As we lean into the mysteries of this uncertain time, a line from Dr. Panda's new book offers comfort: "It's important to surrender and say to yourself, 'I don't need to have all the answers as long as I can live into the questions and hold the tension for what it is, to be comfortable with not knowing.' For me, there is so much peace in that."

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