As the medical profession works through the challenges of the COVID-19 era, some health organizations and facilities are recognizing the power of peer support by establishing formal programs to provide it.

These programs can help clinicians cope with the challenges of their job through the sharing of experiences and advice. Setting up a formal program will require effort and buy-in from colleagues and administrators—but it could make a world of difference in any healthcare establishment.

 

Why doctors need peer support

Peer support represents an organizational shift from a culture of blame to one of empathy, according to an article published in 2020 by the AMA.

Peer support programs for physicians. American Medical Association. June 25, 2020.

 

According to the results of a qualitative study published in BMJ Open, physicians seek peer support for various reasons, including a need for advice, fear of not being able to cope, and the desire for solutions to their problems.

Horne IMT, Veggeland F, Bååthe F, et al. Why do doctors seek peer support? A qualitative interview study. BMJ Open. 2021;11(10):e048732.

 

Some of the doctors had sought support at a stage where it was possible to stop development towards ill health and burnout.

“Others had been clearly in need of support due to serious health or work issues that they were experiencing,” the authors continued. “However, why doctors turn to a peer-support service for help cannot be linked exclusively to the [three reasons cited above] nor to the doctors’ expectations of the help they would receive. This must be understood in light of experienced barriers to and facilitators of seeking peer support.”

 

Types of peer support

Peer support comes in two forms: informal and formal.

Informal peer support could involve a colleague asking a peer how they are doing after a stressful event. This approach can be insufficient or counterproductive, according to the AMA article. Clinicians may feel helpless and unsure of what to say to colleagues, who could minimize their feelings with comments like “Why are you unhappy?” or “You shouldn’t feel that way.”

Although formal peer support also involves non-mental health clinicians, it is fundamentally different, according to a 2022 AMA article.

Berg S. With a physician workforce in distress, set up peer support to help. American Medical Association. April 14, 2022.

Physicians aren’t necessarily trained to field colleagues’ pain and worries; they are trained to address patient complaints. To be part of a formal support group, physicians need to be trained to provide help in a time of crisis.

 

 

Value of peer support

In an MDLinx webinar discussing physician burnout, stress, and mental health, Maryna Mammoliti, MD, FRCPC, a Canadian psychiatrist and certified executive coach, spoke of the benefits of formalized peer support based on her experiences.

Many physicians are in very toxic workplaces where talking about mental health is going to be used against you.

“Peer support is one of the best anti-burnout ways of dealing with that or even [with] processing difficult patient cases,“ Dr. Mammoliti continued. “When we're triggered by our patient cases—whether it's because you have been threatened or because it's a sad case, you know that peer support in disclosing your emotional distress, that's all about emotional safety in your work environment.“

 

Establishing a program: 5 steps

The AMA outlined five steps to forming a peer-support program.

1. Make leadership aware that peer support is necessary. Research cited by the AMA showed that after medical errors, physicians prefer to receive support from peers rather than mental health professionals.

2. Choose who the peer-support team will serve. It’s best when a support team offers support to all healthcare workers who want it, but some programs can only provide help to other physicians due to limited resources. Consider starting small and building the program to provide more access.

3. Create a peer-support team with strong communication skills. Select a program director, program administrator, and suitable peer supporters. This team should be embedded within the organization.

4. Adequately train members of the support team. Peer support entails empathetic listening, question-asking, and sharing experiences. It should be performed in a private setting—either remotely or in person. Peer supporter training sessions provide opportunities to educate and for peer supporters to develop camaraderie. Peer support can be role-played during these sessions.

5. Activate peer-support interventions and offer other resources. Common questions provide structure to peer support and touch on topics including what is bothering the person, how they are coping, who is in their support network, and whether they need time off from work. Additional resources can include legal advice, therapy, and disclosure/apology coaching.

 

Spread the word!

Once formal peer support is established in a workplace, colleagues should be made aware that it’s available to them.

Research in the BMJ article showed that simply setting up a formal peer support program may be insufficient. The group should be publicized at grand rounds, faculty and staff meetings, and other gatherings so that members of the healthcare team are aware of it andhow it works.

Give the program a boost by recognizing peer supporters within the clinical community, perhaps by setting up an event to celebrate them. In addition to boosting morale and recognizing their efforts, it may also promote further awareness of the peer support program.

If a healthcare institution lacks formal peer support, and such a program isn’t feasible, consider trying the Physician Support Line, a free, confidential 800 number. Although staffed by psychiatrists (and not necessarily peers) the service provides support for doctors’ professional and personal problems.