Facing high rates of burnout and loneliness, some doctors are calling for the return of physician lounges.
Once a fixture of hospitals, dedicated spaces for health workers to rest and socialize went out of style in recent decades as a result of cost-cutting measures and the rise of patient-centred design.
According to hospital designers interviewed for a 2012 paper, “staff should spend less time talking amongst themselves and more time talking to patients.” Some even described staff collegiality as a threat to hospital performance.
Studies have since shown that social isolation negatively affects health workers’ well-being, with medicine ranking among the loneliest professions.
“When the most meaningful encounters you have with your colleagues on any given workday happen in the elevator, for example, then that’s a shame,” says Rose Zacharias, Ontario Medical Association (OMA) president.
Virtual care has compounded this sense of isolation — not only are physicians seeing less of their colleagues, but they’re seeing less of their patients, too.
Americans leading lounge renaissance
In a 2021 report on system-level solutions to physician burnout, an OMA task force called for greater attention to the impact of physical workspaces on well-being.
The task force referenced reductions in burnout at the University of California, San Francisco Medical Center following the creation of a doctors’ lounge with “small amenities” such as electronic chargers and a fridge stocked with food.
Other American hospitals have reported similar successes. At Enloe Medical Center in California, staff burnout dropped from 48% in 2017 to 37% in 2020 after the hospital installed a doctors’ lounge complete with a dedicated chef, couches, computer stations, televisions, and a revolving art exhibit.
“What the lounge serves is a means to the end of building community, relationships, and the sort of trust that spills over into your professional interactions,” Zacharias said. “If we’ve had a positive encounter in the lounge, then we are more likely to collaborate in the operating room or the emergency room, which serves patients.”
More than couches and coffee
It doesn’t take much to reap the benefits of connecting more with colleagues.
The Mayo Clinic found that providing physicians with just one paid hour biweekly to meet with a small group of peers reduced burnout and increased their sense of meaning and engagement in their work.
Getting people to use a revamped lounge is another matter, though.
Working as an emergency physician at Orillia Soldiers’ Memorial Hospital in Ontario, Zacharias watched the doctors’ lounge fall into disuse as medicine went digital.
Seven years ago, the hospital attempted to revive the space with new furniture and a coffee maker, but “it didn’t bring the doctors back,” Zacharias said.
“Our practice patterns and the way we came and went from the hospital was not conducive to gathering and overlapping with one another in that physical space,” she explained. “If there’s no computer, no reason to come and check a mailbox, or if it’s down a dark hallway, well, having a lounge in the building is just not going to be that helpful.”
Hospitals should pay attention to the places where health workers gather naturally, and invest in those spaces, Zacharias said.
She and her colleagues ended up having more meaningful conversations in a small team room in the emergency department. The room had a few computers where her team would often work side-by-side.
“Had that space been even more enhanced with a coffeemaker, a microwave, and comfortable furniture, that would have been the ideal place because doctors were already there,” Zacharias said.
According to Nancy Merrow, the hospital has made further improvements to its doctors’ lounge since 2019.
The newly decorated and furnished lounge is “equipped with three computer workstations on hi-low desks, a meeting table, luxury leather recliners with built-in USB chargers, a new TV and microwave,” Merrow told CMAJ. “It is a busy hive of activity for our learners and practitioners alike, where they can put their feet up, catch up on work or conversation, and tune into rounds and meetings by Zoom.”
The hospital also fully refurbished the lounge in the perioperative area, and created a central all-staff wellness space “where we can enjoy the massage chair, walk the treadmill, ride the spin bike, or catch some Zen moments and a great cityscape view with yoga mats and wellness focused resources.”
Beyond physical spaces, when gathering in person wasn’t possible in the early days of the COVID-19 pandemic, Kingston-based family physician Roslyn Schwartz started a lunchtime Zoom call with other doctors to serve as a virtual lounge. Two years later, the group still meets to discuss anything from personal concerns to clinical questions.
“There are conversations that I can have with this group that would be different if I was having them in another social context,” Schwartz said. “I don’t have to explain certain assumptions or simplify my explanations.”
What about other health workers?
Doctors aren’t the only ones who stand to benefit from the lounge revival.
Burnaby Hospital in British Columbia has been “undergoing a re-engagement process” since 2017 to repurpose its doctors’ lounge as a “communications hub” for a broader range of health professionals, according to Donna Sue, an emergency physician involved in the project.
Previously, physicians weren’t using the space and were feeling disconnected from their colleagues and hospital administration, Sue said.
The entire hospital is undergoing redevelopment, and the lounge will move to a different space eventually, she noted. In the meantime, hospital administrators supported renovations including a kitchenette and “touchdown workspace,” including new furniture, coffee machines, and snacks restocked by a lounge manager.
Notably, the lounge isn’t just for doctors — nurses, midwives, dentists, oral surgeons and trainees gather there too.
“Medical staff who have been working at the hospital for a number of years having never met… started to meet each other in the lounge and have conversations,” Sue said. “It improved our well-being and morale and really strengthened collegiality.”
High rates of stress and burnout during the pandemic likewise prompted a Houston hospital to convert meeting rooms into “Zen lounges” for nurses.
The lounges feature massage chairs, scented candles, soothing music, and yoga mats in response to feedback from nurses. The hospital also provides yoga classes in the space, distributes wellness goodies including stress balls and face masks, and is piloting “uninterrupted lunch breaks” after learning that nurses were experiencing 10 to 15 interruptions on their breaks.
“We don’t really ever have a quiet moment in nursing,” according to Madison Chollett, clinical nurse coordinator at HCA Houston Healthcare Clear Lake. “This gives back those moments you may not get for 13 or 15 hours.”
The hospital is collecting data on these initiatives but, so far, most reports on the benefits of restoring lounges for health workers have been anecdotal.
A 2022 scoping review identified several ways that shared social spaces positively impact the learning and wellness of junior doctors — not least by providing informal and safe places for connection and reflection. However, the authors found only a handful of primary research studies on the subject.
“Further research would be useful to examine how and why this works,” they concluded.
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