Central Line

Episode Number: 137

Episode Title: SafeHaven – A Clinician Well-Being Program

Recorded: July 2024

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VOICE OVER:

Welcome to ASA’s Central Line, the official podcast series of the American Society of Anesthesiologists, edited by Dr. Adam Striker.

DR. ADAM STRIKER:

Welcome to Central Line. I'm your host and editor, Dr. Adam Striker. Today we're going to do something a little bit different. I'm actually going to join you, the listeners, and together we're going to listen in on a conversation between two luminaries, Dr. Ronald Harter, ASA’s president, and Melina Davis, executive vice president and CEO of the Medical Society of Virginia. We're going to be learning about how ASA and the ASA Charitable Foundation are partnering with MSV and Vital Work Life to deliver ASA's new clinician well-being program, SafeHaven. I'm looking forward to learning about this new partnership and what members can expect from it. Also, just really happy to listen in, so let's hear what they have to say.

DR. RONALD HARTER:

So Melina, I've had the pleasure of being on the Central Line podcast before so many listeners may already know me -- I'm the president of the American Society of Anesthesiologists, but let's take a moment to tell them who you are and to introduce Safe Haven to our listeners. Can you talk through its history and what was the genesis of Safe Haven program, and then what's your role within that?

MS. MELINA DAVIS:

Thank you so much for having me and for your interest in Safe Haven and your support so much with your members and all anesthesiologists across the country. I think this is vitally important.

I am the CEO and EVP for the Medical Society of Virginia, and we founded Safe Haven. Um, it came to us after meeting with our members and talking with them and really understanding that their burnout had been growing and increasing. But they were really willing in meetings with us and conversations with our team to talk openly. And we could see so much about their lives and their emotions and their burnout state. But we didn't understand why they didn't feel comfortable talking to their peers or even seeking counseling to help deal with their burnout. And we decided to go on a listening tour across Virginia and really seek to understand what it was that was holding them back. And what we realized in that whole process is that it came down to some pretty basic elements that today seem so obvious, but at the time were not so clear. Really came down to they were fearful of losing their employment or their license with the Board of Medicine if anybody found out that they were even thinking that they could be burnt out or that they were struggling in any way. There was also real fear around the fact that if their mental health status had been talked about with the counselor, that it would be discoverable and used against them in a medical malpractice trial or a custody hearing or a divorce.

And we were sort of shocked to learn how often that happened, that while the rest of patients and citizens, we enjoy HIPPA protections, but that licensees had a requirement to self-report and report others in their profession as well, and that nobody quite understood what the law was and what the rules were on Reportability, and that ultimately they just didn't feel protected enough to seek help and address their personal burnout concerns.

So, like most medical societies, we happen to be terrific at advocating and working on legislative changes to help with medicine. And we went and looked at the code of Virginia and realized that they had real reason to be fearful, that they lacked a number of protections that we felt like they needed to have. And so we worked to then pass the first ever protection that provided confidentiality, immunity and privilege to, at the time doctors and PAs. We were the first ever state in the country to have these.

The legislation allows for the creation of the Safe Haven program, which also provides greater confidentiality for clinicians seeking help to address career fatigue and other mental health issues. It provides immunity, and that clinicians participating in the Safe Haven program will not be reported to the Virginia Board of Medicine unless they're not competent to practice or are a danger to themselves. And then it also provided privilege in that consultations, which take place under the scope of the Safe Haven program, are considered privileged communications and have to meet the highest standard of a court order to be used, and heretofore have been the lowest level. So that was very important.

And then we married those protections with services. We knew our team internally were not master's level counselors and coaches, so we went and found a national partner, Vital Work Life. They have been a tremendous partner for us and are on the cutting edge we think of this work. And they helped us build a suite of services that are unique and unlike others offered across the country. The services are available 24 over seven. They provide clinical peer coaching where you can talk with someone like you who can help you grow both personally and professionally. Counseling, which is available either face to face or virtual. It also offers an in the moment support that's available 24 seven so that if you get off work at 2 a.m. after a double shift, somebody is there when you need to talk to them or at 1:00 in the afternoon. A virtual concierge as well, which is an assistant to help you with every day and special occasion tasks, whether it's ordering flowers or buying a birthday gift or replacing a windshield. The concierge service is free to you as part of the subscription, and then the services that you ask for help with cost you out of pocket. And then we also have the Safe Haven app, which is a mobile access resource that provides wellbeing assessments, insights, videos, education and more so that you can keep learning and exploring when you have time and when you have the inclination.

So the protections and the services together effectively are Safe Haven. And then since 2020 when we passed this, we've been able to extend it beyond physicians and PAs to pharmacists, to nurses, to students and then this last year to dentists. And now I'm happy to say we have full protections in six other states across the country. And six other states either have partial protections at this point and are going for more, or are working to bring protections to their state. And our hope is that we'll be at a tipping point here soon so that we could say it's everywhere and it's the new norm for taking care of our health care workforce.

I would love to ask you a question. Clinician wellbeing is at the heart of everything we're doing. Perhaps you could talk about why it's so important, and remind all our listeners today of the real costs of burnout, who it hurts, and how prominent it is in your profession and in your workplace.

DR. HARTER:

Great. Yeah, thank you for that, Melina. This is something that has been evident across healthcare, across all physician specialties, but is growing in its presence in anesthesiology, certainly in particular, which is what we're most focused on. And before the pandemic, actually, ASA supported a study by some members of our Committee on Physician Well-Being to survey our members and asking various questions about burnout in general and related issues. And the survey went out right as the pandemic was getting started. So it gave a pretty good, I think, baseline sort of back when the world was normal, you know, as normal as it as it's ever been. And found that it was fairly prevalent within our specialty. And then there was a follow up study by many of the same authors, again surveying ASA members, and it has increased in prevalence since then. And this is true across other surveys that look at multiple specialties. Anesthesiology is not at the top of the list, but we're also not at the bottom as far as prevalence. And we're towards the top and we're kind of unfortunately climbing the ranks, uh, amongst other physician specialties as far as our prevalence of burnout. So without question, it's a significant issue within our specialty.

We're aware that there's a broad range of consequences that can happen, certainly the most dire being death by suicide. We're aware that that is unfortunately an issue that that impacts far too many of our members. But beyond that, it's driving anesthesiologists out of practice or to reduce their practice or limit their practice at a time when one of the big contributors, um, to burnout is that there's a shortage of anesthesiologists. And so the more that we have anesthesiologists who are leaving just because of the burnout component of it, it only increases the burden then on the people who are continuing to try and do their best within their practice. So this is something that we felt was important on a whole lot of fronts to provide this for our members.

And even though there's various programs out there, I felt like as a leader within ASA, that we ought to explore if there were things that ASA could do uniquely beyond what they could otherwise get, either from their um, institutions employee assistance program or just seeking this out on their own. And, um, we had explored building something like this up within ASA and recognized that it was going to be really a challenge for us to be able to pull all the resources together, to have the expertise and be able to provide this type of program. And then we became aware of the Safe Haven program and Vital Work Life because of a connection with a leader within another national medical specialty society that had launched a pilot program with Safe Haven. And the more we learned about, the more we felt like this was exactly the kind of the suite of services that we were really looking to provide for our members. So I think everybody involved then was very motivated to move forward and do what we needed to do to provide this to our anesthesiologists.

MS. DAVIS:

I love that, and, you know, I just want to applaud you for focusing so much of your presidency on these kinds of efforts, particularly on wellness, during your term. I think it takes real vision, and I think you have it, and I'm grateful for your partnership as we try to combat this across the country.

Why is a specialty like ASA being involved in Safe Haven so important? And how do you see the role of ASA when it comes to supporting anesthesiologists and their well-being?

DR. HARTER:

Yeah, well, that's a great question. I think there's various benefits to anesthesiologists to having an entity like ASA be involved. One is that it can and has provided some financial support. Both ASA itself, as well as our charitable foundation, have provided significant financial support to allow this pilot program to be available at a significantly reduced cost. And so even though the price for the suite of services is already, I think, very competitive relative to what if you try to get these services on your own from various entities. It's a very nice price point, but we recognize that in particular, maybe residents, med students, even early career anesthesiologists, uh, might have a challenge with when they're, you know, facing their own educational debt and other expenses to be able to afford this, this type of service. So with our financial support, I think it brings it at a price point where it's more attainable for people at any career point.

But I think the other thing that's very beneficial is that unlike employee assistance programs, even though they take great pains from every EAP program that I'm familiar with, they take great pains to reassure the people who participate that there's a wall between that and any sort of HR type of knowledge that would impact their credentialing to the medical staff, I think there is some skepticism of physicians that they just don't really want to always go to their employer to seek out this type of help. And so ASA is totally separate from their employer and so they can receive these services. ASA doesn't even know who enrolled. Safe Haven doesn't know. Vital Work Life is the one that retains the roster as I understand it. And so this is also not something that if somebody feels like, well, I don't know whether this will hurt my ability to seek a leadership role within ASA if I sign up for this, you know. ASA doesn't know who signs up and certainly your employer doesn't know. So, um, I think the prevalence of this and the place where people are coming from is so varied that I think providing options for people on how to seek out these types of services, um, hopefully makes it easier that everybody who wants these services will see a relatively straightforward path to get them.

MS. DAVIS:

Yeah, I think those are excellent points. I just want to also give ASA kudos because I think endorsing a program like this and also providing some funding for it to encourage people, also helps break down stigma and sort of disrupt our the culture of don't ask for help, right, you don't need help. I think they're normalizing, getting help and being healthy. I love that. I think that's a real leadership position.

DR. HARTER:

I'll just add to that. I think also a lot of credit goes to to Safe Haven for the services that you all have put together. It's not just counseling, you know, period, end of sentence. And that's all that's provided. As you as you pointed out, there's coaching. There's various other just work life support matters that also, I think helps to reduce some of the stigma that you're not just purely I'm seeking out a counselor. It's I'm seeking out a team to support the various needs that I have as a busy physician who's trying to keep everything moving forward between a busy job and obligations at home, etc. Um, so counseling is certainly an important part of it, but it's really by no means is the full extent of what the right Safe Haven offers.

MS. DAVIS:

That's right. I agree with that. Do you worry about all the things that are holding people back from seeking help? And what do you see as the most prominent or problematic barriers for people seeking help, and how do we get past that?

DR. HARTER:

Yeah, well, as we've already, I think, pointed out, there is stigma certainly to seeking out these services. And that's not unique to anesthesiologists or to physicians. I think that's true really, across all sectors of society, is that we still don't generally view this in the same light as we do going to our family physician to get our blood pressure treated. You know, there's just not as much openness about, um, you know, seeking out and receiving mental health care in the way that we were far more open about other health needs that we would pursue. So there's that kind of as an underlying piece of this. This is getting better, but there still are a handful of states where to apply for a medical license and or to renew your medical license, that there are questions that ask whether you've ever needed mental health services. And so that certainly adds to the barriers and to the stigma, because if there's concern that, well, I think I need this service, but I'll try and muddle through as best I can without really doing something that I might need to report to my medical board and who knows what implications that might have. And then in addition to that, at the medical staff level people seeking a medical staff appointment or again, reappointment. Um, those are still, I would say, somewhat prevalent. I was chair of my department for several years, so I filled out a whole lot of credentialing forms for people that are applying either to us or to new places who have been with us previously in training or working with us. So I see a lot of those forms, and I do see that the questions are more moving towards what your current state of mental health as opposed to, you know, 20 years ago when you were a stressed out medical student, did you seek counseling and didn't need to check the box? And that something that might get further discussion and scrutiny when it really has no place in determining somebody's current fitness for serving on medical staff. So I think those are improving, but they are still there. And I think even when we hopefully, you know, in the not too distant future, get to a point where those are no longer issues. It's going to take a while before people are totally reassured that this will somehow be something that comes back and impacts either their licensure or their medical credential. So that's moving in the right direction. But it very clearly a real issue um at present.

MS. DAVIS:

Yeah. No doubt. No doubt.

DR. HARTER:

So let's talk Melina a little bit more about the help that ASA and Safe Haven and Vital Work Life are working together to offer. Can you share with our listeners, Um, how Safe Haven is helping clinicians in general and anesthesiologists specifically today with the services that you offer?

MS. DAVIS:

Safe Haven, I think I said, is the first of its kind in the nation. It's now even recognized by the AMA as model legislation, which is really important to this next piece, which is we're trying to get it to every state in the country. I think I mentioned that we have full protections in six states already, and then we have six others that either have partial or are working to get full protection. We really need all states to have this. And, um, we really want to make sure that no matter where you are, you can have the full suite of protection. Right now, it's being offered to all anesthesiologists. And by joining through ASA all anesthesiologists get confidentiality no matter what, and they have access to the full suite of services through our partner, Vital Work Life. As you mentioned. So all they have to do is reach out and join. And like you said, you are offering a discounted membership, which makes it very affordable. At this stage I think that means not even a dollar a day. And that covers not just the clinician, but their entire family.

And most people don't recognize that this is different and that it's available to your whole family, because we know that life doesn't stop and start at work. Right? There is this crossover And our mission really is to change the landscape of the way we treat providers. And part of that is recognizing their whole life and their whole self, um, and get everybody around them the mental health support that they need.

We're also working to address burnout at a systems level and promote the sense of psychological safety through a multifaceted approach. We’re working at the policy level, at the legislative level, making sure that we have this accessible, confidential resource available no matter when you are done working or when you need help, but that you can keep with the training and education to keep learning. And the coaching we're finding is being used as well to help with career development and leadership development. Very important.

I think it's really important to note too. So far, we're seeing about 50% of people who subscribe to Safe Haven actively use Safe Haven. And when you look at an EAP provided by an employer, less than 1% of physicians usually use those services, and less than 3% of nurses usually use those services. So to see 50% is really striking. Um, and early indications are that people who use Safe Haven are seeing a 20% reduction in their burnout. That's really important. That's a big movement. But my favorite stat so far is that 14.3% are seeing an increase in their well-being. So not only are they seeing the burnout go down, they're actually seeing their well-being go up. And these two things have a relationship, but they're not the same thing. And I really want people in medicine today and health care today to be really talking beyond resiliency and overcoming burnout and getting to wellbeing and healthy and thriving and moving upward up the burnout continuum versus downward in the burnout continuum, if that makes sense. But I think these are all ways in which we're seeing Safe Haven have an impact. And and how ASA is really invested in making a difference here.

DR. HARTER:

Yeah, that's a terrific point, Melina, that wellness is not simply absence of burnout. Absence of burnout is kind of step one of of many steps, as you point out, towards truly having wellness and really having that broader wellbeing than just simply I put out the fires of burnout, but I'm still not really at the top of my game, as it were. And just to underscore your point about costs of the program now, so ASA has a pilot program that we launched about a month ago for 500 subscriptions. There's last count where we've got about 70 that have signed up in that first month. I haven't seen numbers in a week, so it might be a little more than that now. And so the price point of that is with ASA support, it's less than half of the regular group subscription price. And so the price of this pilot program, a subscription with the support of ASA and the charitable foundation, is $149 for the duration of the 18 month pilot program. It started in June and it will conclude 18 months from that. So as we sit here now in its early July, there's about 17 months still remaining in the pilot program. And at $149, that's less than $10 a month, not only for the anesthesiologist who subscribes, but also for their family members as well, which for the services that are provided is really remarkable.

MS. DAVIS:

Remarkable and important.

DR. HARTER:

And I think also I, you know, my observation too or my theory, I guess is not even an observation. But, you know, that's great that there's been so great of a percentage of subscribers that are actually using the service. But as we were discussing this among ASA leadership, when we were talking about what are our metrics for success? How will we determine if this was a successful pilot and a successful launch? And I felt very strongly that we didn't want to have that bar for percentage participation be too high, like an 80 or 90%, because, one, that's just way beyond what, as you point out, is typically seen in other types of assistance programs. But also, I think it's probably not unreasonable that people might sign up for this pilot I've termed as you know, wellness insurance. So I may not need it today. I may not need it next week, but I might need it, you know, I might have a difficult case. It, you know, at 2 a.m. and I just need to talk to somebody. And that's another one of the important part of the suite of services is that 24 over seven 365 um, crisis response that, um, you may not necessarily have if you're the only physician that's in the hospital at 2 a.m. within your department, that's tremendously valuable to have. And I would contend, even if you go through the entire pilot program and you didn't use it at all, there still is value to that. And I think just like having disability insurance, you know, you you may not need it, but you, you kind of know it's there. Um, if you do need it. And so I think we will see similarly that there'll be pretty significant number of people who sign up that never use it. But it doesn't mean that it still didn't provide some value to them personally.

MS. DAVIS:

Well, you know, it's interesting that I just heard of an anecdote, a story where a radiology oncologist actually called in to the 24 seven hotline because they were feeling stress not from work, interestingly, because their daughter was having mental health issues, she was going through a divorce and she was going through a career change, and she was calling him all the time at work, and he was getting stressed out by her stress, and he didn't know what to do. And through the assessment, they worked it out. That first he was going to work with a peer coach to help with that sort of work life balance piece, but then then a counselor was also needed. And then he only had, I think two sessions with the counselor felt better, felt like he had built some skills, but then convinced his daughter to use the services and she really benefited. And so sometimes you just don't see things coming and you may have everything in order, but something shifts in the people around you and how you want to help them or how you can engage with them. You might need guidance and help so that insurance can kick in, like you say, where you have a backup, you can call somebody and figure it out, even if it wasn't as much about you.

DR. HARTER:

Great point.

So, Melina, you've already shared with us some of the successes that you've been able to observe from how Safe Haven has helped broadly with reducing burnout and increasing wellness amongst people who participate in in the Safe Haven programs, as well as the anecdote of the radiation oncologist who got some real time, um, benefit for himself and then for a family member. Do you have any other examples of success stories where this has really made a difference for people?

MS. DAVIS:

Two that I think are really important for people to hear about, and one had to do with a financial consultation to help a student with their loan stressors. Well, it's actually a resident had called in and after talking with their colleagues about their student loan repayment option and wondering what was the best way to navigate them, they were feeling stressed, but frankly, they just didn't know which way to go, and they didn't know what avenue to go down that was best for them. The resident then called Vital Work Life after a fellow resident shared the information that she had gotten and how it had helped her make some important decisions and set her up for success. So she said she only needed three calls in. Her situation was resolved. The resident was able to schedule a telephonic session with a financial consultant. And at the end of their work together, she had a plan in place for the loan repayment that didn't break the bank. And so something really tangible came out of that. Um, of course, I believe there was this relief as well from the stress. But sometimes these things can be very pragmatic, and you can get this very tangible and important element in your life built. Um, and we had another resident call, actually, who planned her entire wedding by calling the concierge service, which I think is incredible. So she managed to make it through residency, married, and somebody else planned her wedding. So I thought that was fairly genius.

DR. HARTER:

That that is terrific. Yeah, those are great examples where stress can come from many and varied fronts, that it's great that the Safe Haven program can really help the people who subscribe to it to get assistance, really on on any of those different fronts. So that's terrific.

So, Melina, um, as we talked about, there's a lot of physician health monitoring programs out there. How is Safe Haven different than, uh, physician health monitoring program that might be available from an employer or from a state medical physician health program or some other entity that might be out there.

MS. DAVIS:

I'm so glad you asked. You know, Safe Haven, we designed it to make sure we were addressing all the issues affecting the causes of burnout and the stigma of getting help, but most importantly, to encourage early intervention so that health care professionals can continue to care for patients safely before they get into the deep delves of burnout, and there is a downward loss spiral that can happen with burnout. And our goal was to try to get people earlier and keep them healthy and well. And and we all go through stressors. Resiliency in many ways is this term of just keep going anyway. Our goal is to try to get people healthy, to move back up the that funnel, if you will.

It's really important to remember that that boards of medicine and other regulatory board are there to play a vital role in supporting the well-being of health care professionals, but also the safety of patients. And they really have to hold licensees, and in this case, doctors, nurses, dentists, etc., accountable. If they get to a place where their behavior or the behavioral health is so degraded that it's causing patient safety problems or behavioral problems, or substance use disorder problems. And most of the physician health programs really are designed to deal with that moment, that very deep moment where the board is aware and the board needs to be aware or you need help to get out of it. But in many cases it means a suspended license to go on to those programs. So in most cases, it's a mandated relationship and it's very close to licensure oversight.

With Safe Haven, we want you there only as a volunteer. We only do volunteer. We don't take any referrals that are mandated into the program because this is about you and what you need. Um, we do do an assessment. If we find that there is a substance use disorder or there is some very deep issue, then we have to find a way to have, um, a crossover into that. But so far in Safe Haven’s, uh, experience, we have not found that in our assessment. We really have found that we have people dealing with very strong burnout, and we've had people deal with moral injury. We've had people with stress and anxiety and depression, but none of which has needed that licensure oversight as defined by the law or for patient safety. And we're able to help people with these early interventions and coaching and counseling and education. So it really is different. And frankly, we need the monitoring programs. The profession really has to hold itself accountable and have a last effort to save a career. But Safe Haven was designed to keep you healthy and get you back in there and be earlier in the loss spiral.

DR. HARTER:

So do you have any tips that you know other than be sure to sign up for Safe Haven. But, uh, any tips for our listeners as far as things that they can do and kind of their daily life or their approach to things to help them to combat burnout.

MS. DAVIS:

Oh gosh. You know, I love you all so much. You all care about us every day. What I do notice is you don't always care for yourselves first. You're always worried about our oxygen masks going on, if you will, versus yours. And I just challenge you all to put yourself first at least one time a week. I want more than that, but at least once a week. Pick a weeknight that's dedicated to just something that you want to do or something that fills you back up, that gives you hope, that gives you life force, that gives you health.

I would also say it can be challenging, but find ways to advocate for clinician wellbeing in a way that feels safe and comfortable for you. Because what I know about clinician and anesthesiologist is that you really want to make sure that people are healthy and safe, and it's okay to say that out loud. And that changes the dynamic where you become an advocate and you feel good and strong in that space, and it starts to make a difference in the culture. And I would just also encourage you to be an active champion of creating psychological safety cultures and bringing a culture of psychological safety to your workplace and ask for it. Ask people to to check in to Safe Haven, um, in your state and in your workplace. Um, you deserve to have this and advocating will feel very empowering to you. But remember, just to take care of yourself as well. So those are my my best tips.

DR. HARTER:

Yeah. Thank you. That's that's terrific advice. I think that, uh, physicians in general and anesthesiologists are certainly no exception, that, um, we work incredibly long and stressful hours, and in many cases have other administrative or academic duties in addition to clinical duties, and be there for all of the family type of support and activity and get eight hours of sleep every night and, you know, work out three times a week. And it's, you know, very quickly there's just not enough hours in the week to accommodate all those things. So I think that's terrific advice to add. At a bare minimum, carve out some chunk of time that's truly for yourself and for your own well-being.

MS. DAVIS:

Dr. Harter, I have one last question for you. When should people reach out and how do they get involved to find help for themselves or friend or or even bring Safe Haven to their state?

DR. HARTER:

Well, that's certainly an important question. And it's a it's a good one to wrap up our discussion on. So, um, I think they should reach out. They certainly should not wait until they are literally at the brink where they just can't fathom going on another day, continuing doing what they're doing, doing. In other case, whatever the situation they find themselves in. Um, I think there's enough challenges and stresses that anesthesiologists face that getting support from Safe Haven or some other, you know, similarly situated type of program. I think that's something that everyone really needs to consider pursuing for themselves. And as we talked about earlier, you know, the more that this is something that people do, the more that it normalizes it and reduces the stigma for the rest of our colleagues. That would be my you know, my first piece of advice is no time like the present to seek out those services.

And I think, you know, finding help for themselves, for a friend. I think that there's a lot of places to turn for that. Safe Haven is certainly one of those. But, you know, certainly colleagues, family members, it's pretty clear that from various studies on burnout that having supported home or at work or both, you know, those are really important components of reducing burnout. And so having someone to reach out to talk to about these things and likewise, you know, if you have colleagues that are having issues, if they reach out to you to direct them towards some, some resources that that can help them.

And then I think within their state really, I can't commend Medical Society of Virginia enough for all that they've done for creating safe haven and creating safe spaces with respect to licensure, um, within their state and now several others. And so if your state, um, doesn't have those types of protections, I would say they could reach out to the Medical Society of Virginia, and I'm sure that they could provide some guidance on how to how to bring those types of protections to their state. And to be clear, whether you're in one of those, I think Melina said six states, whether you're in one of those states or not, you still can certainly benefit greatly from all that Safe Haven has to offer. But in those states, then there's additional layers that help to protect your individual privacy from your employer and any other external sources. And I'll let you fill in the gaps on that, Melina.

MS. DAVIS:

That's perfect. Well, people want to reach out to Safe Haven, they can, um, first check out our website at www.safehavenhealth.org, or they can write to us by email at SafeHavenHealth@msv.org, and we'll be happy to answer any questions or talk with them. And on that site you can see where your state is today. And and we can help you get involved with your local medical society to bring protections or to become an advocate or whatever we can help you do. We will certainly do that. Our board is absolutely committed to this issue. They consider it just the highest priority of our organization, and we are just so grateful to be working with the ASA. You all are visionaries, and you clearly care about anesthesiologists and medicine and making it healthier. And you're really setting a new national standard with this program. And we just can't say enough about how grateful we are to partner with you. Really, truly.

DR. HARTER:

Well, there's a very kind words, Melina, but, uh, I really appreciate that you all have this type of program that we could offer to physician anesthesiologists. So I thank you so much for all of the great work that you and your your colleagues in the Medical Society of Virginia are doing on this front. Thank you. It's been a great conversation.

MS. DAVIS:

Thank you.

DR. STRIKER:

Well, that was an interesting and informative conversation. We certainly appreciate Dr. Harter and Melina Davis for dropping by and sharing their expertise and passion for this very important topic. If you'd like to learn more about the program and how it can help you or a friend, visit asahq.org/safehaven. And come back soon for more Central Line.

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