Purpose of review

The COVID-19 pandemic has forced many center-based cardiac rehabilitation (CBCR) programs to close or limit their usual offerings. In order for patients to continue to benefit from CR, programs need to rapidly adapt to the current environment. This review highlights ways CR has evolved, and reviews the history of CR and recent advancements in telemedicine including remote patient monitoring, and mobile health that can be applied to CR.

Recent findings

Despite that initial studies indicate that home-based CR (HBCR) is safe and effective, HBCR has faced several challenges that have prevented it from becoming more widely implemented. Many previous concerns can now be addressed through the use of new innovations in home-based healthcare delivery. Since its inception, CR has become increasingly recognized as an important tool to improve patient mortality and quality of life in a broad range of cardiac diseases. While there has been little need to modify the delivery of CR since the 1950s, COVID-19 now serves as the necessary impetus to make HBCR an equal alternative to CBCR.

BACKGROUND: Coaching has been demonstrated to be an effective physician wellness intervention. However, this evidence-based intervention has not yet been widely adopted in the physician community. Documentation and implementation research of interventions to address physician burnout in real world settings is much needed. OBJECTIVE: Assess the impact of a virtual physician coaching program in women physicians. DESIGN: Pre- and post-intervention surveys administered to participants enrolled in the program (N = 329). Effect size was calculated comparing pre- and post-intervention paired data (N = 201). PARTICIPANTS: 201 women physicians from 40 states in the United States of America and 3 international participants. INTERVENTIONS: Participants were given access to an 8 week virtual coaching program including eight individual, six small group, and 24 large group sessions. MAIN MEASURES: Stanford Professional Fulfillment Inventory (PFI) containing categories for assessing professional fulfillment, burnout, and the Clinician Self-Valuation (SV) Scale (a measure of self-compassion). KEY RESULTS: Burnout was found in 77.1% (N = 155) of participants at baseline, which reduced to 33.3% (N = 67) at completion with large effect size (Cohens d 1.11). The percentage of participants who endorsed significant professional fulfillment started at 27.4% (N = 55) and improved to 68.2% (N = 137) with a large effect size (Cohens d 0.95). Self-valuation improved from 17.9% (N = 36) of the participants endorsing a compassionate self-improvement perspective to 64% of the same participants eight weeks later. The self-valuation metric showed a very large effect size (Cohens d 1.28). CONCLUSIONS: Virtual physician coaching programs led by physician coaches can decrease burnout, improve professional fulfillment, and increase self-compassion. Non-institution-based opportunities for coaching available to any physician across the United States and internationally can facilitate access to effective physician well-being interventions.