Physician – Clinician Well-Being Knowledge Hub

Physician Burnout & Moral Injury: The Hidden Health Care Crisis

NAM — Wed, 31 Mar 2021 18:52:51 +0000

This infographic explores physician burnout and moral injury both before and during COVID-19, top causes for burnout, the mental health stigma that still exists in the medical community, the impact for patients and the health care system, and what can be done to address this growing crisis.

A Call to Action: Improving Clinician Well-Being and Patient Care and Safety

NAM — Fri, 13 Mar 2020 13:18:44 +0000

The Health Policy Institute of Ohio collaborated with The Ohio State University College of Nursing Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare to create A Call to Action: Improving Clinician Well-Being and Patient Care and Safety. The Call to Action outlines the bi-directional relationship between clinician well-being and patient care, calls attention to the health problems clinicians face related to burnout, and highlights the need for a comprehensive approach to prevention, treatment, and recovery efforts. As part of this approach, state policymakers and healthcare leaders have an important role in implementing evidence-informed policies and practices such as advancing positive organizational culture, promoting wellness programs, reducing stigma toward seeking mental health treatment, increasing access to mental health services, and monitoring the data on student and clinician wellness.

Age and Sex Differences in Burnout, Career Satisfaction, and Well-Being in US Neurologists

NAM — Thu, 19 Sep 2019 20:43:21 +0000

The following study contains a quantitative/qualitative analysis of survey responses from US neurologists. The purpose of the surveys was to examine age and sex differences in burnout, career satisfaction, and well-being. Questions in the survey covered personal and professional characteristics along with standardized instruments to measure burnout and career satisfaction. Results found higher rates of burnout and lower rates of career satisfaction in women than in men. The relationship of burnout with age combined with demographics of respondents was significant to this result. The differences in burnout, career satisfaction, and well-being by age and between men and women neurologists suggest that efforts to mitigate burnout would be most effective if they are personalized to reflect the physician’s age, career level, sex, and home life.

We Don’t Need Self-Care; We Need Boundaries

NAM — Thu, 19 Sep 2019 20:25:01 +0000

This op-ed from a female physician talks about the “faux self care” advice that women in medicine receive when they are burnt out. Women in medicine are often told to just get lunch, get a manicure, or do yoga but it ends up as an item on their to-do list that guilt trips them and doesn’t seem to solve any problems. This is because it is not actually self care. Self care is defined as the internal hard work of making decisions for yourself. However, for women in medicine, making these decisions is difficult, especially in a hyper-productivity oriented medical culture. She discusses the broken system that places the burden of improving resilience onto the individual and exonerates the system. She encourages setting boundaries as a form of self-care to counteract a system that will make doctors feel ashamed for reaching their limit.

Prevalence and Factors Associated with Burnout among Frontline Primary Health Care Providers in Low- and Middle-Income Countries: A Systematic Review

NAM — Thu, 19 Sep 2019 20:20:36 +0000

This systematic review analyzes the prevalence and factors associated with provider burnout in low and middle income countries. Articles from three electronic databases (EMBASE, MEDLINE, and CAB) were searched to find information on outpatient provider burnout in LMICs. They were reviewed to identify prevalence of factors associated with provider burnout. Results found heterogeneity in the definition and prevalence of burnout. Prevalence of burnout was found across multiple medical specialties (physicians, nurses, community health workers, etc.) Most studies used the Maslach Burnout Inventory to assess burnout. Further studies are still required to better measure the cause and consequences of burnout in order to guide the development of effective interventions.

Promoting Wellness and Stress Management in Residents through Emotional Intelligence Training

NAM — Thu, 19 Sep 2019 19:57:36 +0000

Previous literature on Emotional Intelligence (EI) demonstrates that physicians with higher levels of EI are less susceptible to burnout. The purpose of the study examines that theory by assessing the impact of educational intervention in increasing overall EI level in residents; specifically their stress management and wellness scores. Residents students volunteered to complete an online self assessment survey measuring EI before and after an educational intervention session. Results found that there was a significant increase in EI scores after the educational intervention in both stress management and overall wellness. Therefore teaching EI skills is highly efficient in promoting wellness amongst resident physicians.

Physician Burnout—A Serious Symptom, But of What?

NAM — Thu, 19 Sep 2019 19:42:14 +0000

This editorial published in Jama Network discusses the term burnout and how its meaning has gone far beyond what is understood about it as a diagnosis or syndrome. The call to action for burnout is not grounded in understanding its prevalence using validated measures. There is so much heterogeneity in methods of measuring burnout that drawing conclusions of its impact is nearly impossible. This points to either unreliability in measurement or populations that vary widely in risk. Additionally, the temporal relationship of burnout symptoms to professional dysfunction is unknown and needs further research to understand. Many propose having a research agenda the would emphasis and expand measurements of burnout through the MBI scale.

Medical Training Programs Need to Care About Physician Burnout. Should the Rest of Us?

NAM — Thu, 19 Sep 2019 19:11:20 +0000

In this opinion article, Timothy Hoff discusses his thoughts on who’s to blame in the rising rates of physician burnout. He points out how this growing problem has been largely ignored by medical schools and residency/fellowship programs for years. Rather, the blame is focused on external factors of health care despite the fact that medical students and residents already have high rates of burnout before entering practice. The students are viewed more as employees than talented assets that need significant investment to develop fully. Additionally, the culture around these programs overemphasize academic credentials while ignoring other skills such as resilience and emotional intelligence. When the role models in medical training themselves are also burnt out, this cycle continues to pass onto newer generations. Many other industries differ in the way that their “most prized talent” is treated from this aspect.

Association of Clinical Specialty With Symptoms of Burnout and Career Choice Regret Among US Resident Physicians

NAM — Wed, 18 Sep 2019 21:02:10 +0000

This study sought to identify the association between rates of burnout and career choice regret amongst resident physicians and whether this varies by clinical specialty. A prospective cohort study was conducted in which US resident physicians completed baseline questionnaires during their fourth year of medical school and then during their second year of residency. Exposures that were measured through the questionnaires included clinical specialty, demographics, educational debt, US Medical Licensing Examination Step 1 scores, and reported levels of anxiety, empathy, and social support. Results found that symptoms of burnout and career choice regret were prevalent amongst physicians, and were relatively higher within the fields of urology, neurology, emergency medicine, ophthalmology, and general surgery.

Creating a “Manageable Cockpit” for Clinicians: A Shared Responsibility

NAM — Wed, 18 Sep 2019 14:40:51 +0000

This article published in JAMA Internal Medicine discusses the need for a mechanism to manage stresses and liabilities during the current momentum for more data and greater clinician accountability. It is assumed that obtaining enough data on performance measurement of clinicians will result in better care. However, the majority of errors in health care are due to system errors. Additionally, most interventions are directed towards clinician interaction with patients rather than the root causes of quality and safety issues. The authors recommend creating a manageable “cockpit” that captures the cognitive workload that clinicians experience, establishes well-being as a health system metric, encourages and applies research for interventions, establishes best practices, and holds institutions accountable. The main question surrounding the issue is to figure out whether there are better approaches to improving patient safety and access to care while still enhancing well-being of health professionals.