Lab Medicine Rounds

In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., sits down with Venkatesh Bellamkonda, M.D., assistant professor of Emergency Medicine and the Wellness Officer for the Department of Emergency Medicine at Mayo Clinic, to discuss the importance of wellness and well-being.

Show Notes

00:00 Intro

00:58 Why are wellness efforts a need-to-have, rather than a want-to-have?

04:18 What are we learning about wellness that is important for our audience to understand?

07:44 What are those first steps that our listeners can take and initiate for their own local practice, what would their initial support look like?

14:23 Are there classic struggles with improving wellness that you can help our listeners navigate if there are some pearls to share in that regard?

22:01 What do you think is in store for us in the future?

23:52 Outro

What is Lab Medicine Rounds?

A Mayo Clinic podcast for laboratory professionals, physicians, and students, hosted by Justin Kreuter, M.D., assistant professor of laboratory medicine and pathology at Mayo Clinic, featuring educational topics and insightful takeaways to apply in your practice.

(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.

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