Oak Street's inaugural chief wellness officer on innovation in provider well-being

Deb Edberg, MD, is the inaugural chief wellness officer of Oak Street Health, a Chicago-based network of value-based primary care centers for Medicare patients.

Becker's recently connected with Dr. Edberg to discuss provider wellness, her perspective on wellness as a practicing physician and what well-being initiatives Oak Street Health has implemented since her appointment.

Editor's note: Responses have been lightly edited for length and clarity.

Question: What has it been like shaping the role and responsibilities as the inaugural chief wellness officer?

Dr. Deb Edberg: For me, I've always had an interest in wellness. The past few years it's really come to the forefront to think about what it means to be well and a provider in our current environment. Even before the pandemic, there were certainly a lot of issues around burnout. Oak Street had already been thinking about wellness even as it was starting to implement its model. A lot of it is focused on patient care and the outcomes, but inherent in that model is well-being for the provider to make the job we do a little easier. 

Coming into this role, it was more about understanding what we were already doing and coordinating that in a way to think about it in a cohesive frame and then to take it even further and think about, "How do we innovate in the provider wellness space?" Oak Street is very innovative in how we care for patients and can also be very innovative in how we think about how we care for the providers who care for those patients.

Q: What are some of the biggest wellness challenges providers are facing currently?

DE: Patients are getting more and more complicated, and helping them navigate a healthcare system that's inherently challenging can be very stressful for providers. What we try to do is build a system around the work we do to make it easier for us, but there's a lot of different aspects of that.

Electronic medical records were not designed to make our lives easier. They were designed to make billing easier, and so we're sort of working backwards from that to try to figure out how we build an EMR that helps the patients get better and is less stressful for us. I come from a time where everything was written in documents and then slowly moved to the EMR, so I feel that very strongly in how we make the EMR process work better for us.

There's a lot of administrative burden, there's a lot of different insurance companies that require a lot of different documentation, and all of that takes you away from the stuff that you love, which is caring for patients and spending time with patients.

On top of that is the emotional burden of caring for really sick patients with a lot of challenges that impact their health even beyond the clinical space. There's emotional burden, moral injury, all of those things that we have to be attentive to.

All of that draws us away from the reason why we chose this field to begin with; there's a lot of meaning in the work that we do. Medicine is one of those professions that people like to say is a calling. In a lot of ways it is — we go into it because we want to help and care for people. We have big hearts, and that's the stuff that really drives us to work as hard as we work. 

Q: How would you describe what provider wellness looks like?

DE: It looks like a lot of different things to people and I think that's one of the biggest challenges, especially with an organization like Oak Street. A lot of wellness around healthcare has centered around healthcare institutions like hospitals or systems that are very geographically cohesive. Oak Street is primary care, spread out across the country in multiple smaller clinics, so there's a lot of subcultures within our bigger culture.

One of the biggest issues you'll hear people talk about is work-life balance. The truth is, that means something different depending on who you talk to. It depends what stage of life you're in, what's going on at home, what's going on in your career, how confident you are in the work that you do. Your needs are different, so for me helping people to realize we can meet them where they are and we can be flexible and adapt and offer them opportunities that can feed their wellness and also recognize what their individual challenges are. I think at the end of the day, what well-being looks like for me is a provider that wakes up every day feeling energized to go into the clinic, meet the patients, bring their best selves to each of their patient encounters and leaves the day feeling like they've done something worthwhile and meaningful.

Q: How does your perspective as physician yourself lend itself to this role as chief wellness officer?

DE: I think it's hard to be a chief wellness officer and not really experience what the providers are going through. I'm 50 percent clinical at one of our clinics that historically has had some of the patients with the most challenging issues. When providers talk to me, they know that I really understand what they're dealing with. It's really important that you don't sugarcoat the challenges — you have to validate what is hard about the stuff that we do. We don't always get it right and that's okay; we're in the process of trying to make things better. I'm right there with them. … I think it's really helpful to be right there in it to really understand the impact of the work that we're doing and to understand what we find meaningful and how people connect back to it.

Q: What are some of the wellness initiatives that you have started in this role?

DE: I've been spending a lot of time on listening tours and reviewing surveys. … We're looking at the microcultures within each clinic and how we enhance the leadership training that we're already doing to help support a culture of learning and community in each of the clinics. 

I also want to dig into peer support in a couple of different ways — peer coaching to help people think about their careers, peer support in how to manage the emotional challenges that happen in the work that we do, all the normal things that happen that we tend to isolate around. There's been a lot of data that shows that if you have a peer network of support, it can be really beneficial to help people realize that they're not alone. 

Q: May is Mental Health Awareness Month. Has Oak Street done anything specifically surrounding that?

DE: Our DEI department just had a speaker come to talk about emotional trauma and working through trauma. It was a really great conversation that we had. We all live in a society and we all have our personal lives as well. Everybody goes through traumatic events — sometimes together, sometimes as individuals — so how do we support each other and ourselves and focus on self care? That was one of the big initiatives that we rolled out for this month.

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