Numerous healthcare systems now offer programs aimed at improving physician resilience and wellness, including those summarized below.
- At Baylor Scott & White Health in Texas, the SWADDLE (Staff Well-being Assistance During Difficult Life Events) program offers physicians individualized support by trained peers. The program “is also designed to support healthcare providers through unanticipated adverse events, including medical errors, traumatic patient outcomes, lawsuits, agency complaints, or mass casualties, many of which can also serve as a nidus for burnout,” the authors stated. Baylor Scott & White Health also offers prevention initiatives and wellness services.
- The Carolinas Healthcare System in North and South Carolina developed a program called LiveWELL (Work, Eat, Learn, and Live), consisting of on-site representatives and various web-based resources. Educational events focus on stress management through resilience techniques, and the Employee Assistance Program at Carolinas Healthcare System offers free, short-term counseling and monthly ewbinars pertaining to resilience and burnout.
- WellMD, the wellness program at Stanford Hospital in California, is led by physician experts and “promotes resilience improvements and burnout reductions through a variety of initiatives and programs, including online resources, stress reduction and mindfulness classes, and a crisis hotline,” as explained in the review. “Importantly, the committee is committed to studying the efficacy of these programs as they are implemented across the Stanford system.”
Expanding the Focus
Along with the predominant emphasis on personal resilience, which Dr Squiers and colleagues argue is too limited, there should also be a focus on reducing exposure to stressful stimuli. They believe one major contributor to the increase in burnout is the growing burden of administrative tasks that diverts physicians’ time and energy from practicing medicine. Clinicians often spend more time doing administrative work than on direct patient care — for example, medical interns spend 40% of their working hours on the computer vs 12% on patient care, and practicing physicians perform administrative work up to one-sixth of the time.10,11
Physician groups have begun to address this topic with proposals for broader solutions, such as the American College of Physicians’ position statement calling for a reduction in administrative tasks in health care, the American College of Radiologists suggestion that burnout be resolved by changing the work process rather than the physician, and the National Academy of Medicine calling for further research on the impact of organizational change on burnout.
“Although most efforts at preventing physician burnout are focused on improving individual physician resilience, healthcare organizations are failing to change the system that is increasingly asking doctors to perform tasks, largely administrative in nature, for which they have no passion,” Dr Squiers and colleagues concluded. “It is time to stop treating symptoms and redirect our focus to fighting the disease of burnout.”
- Rothenberger DA. Physician burnout and well-being: a systematic review and framework for action. Dis Colon Rectum. 2017;60(6):567-576.
- Schrijver I. Pathology in the medical profession? Taking the pulse of physician wellness and burnout. Arch Pathol Lab Med. 2016;140(9):976-82.
- Squiers JJ, Lobdell KW, Fann JI, DiMaio JM. Physician burnout: are we treating the symptoms instead of the disease? Ann Thorac Surg. 2017;104(4):1117-1122.
- Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377-1385.
- Shanafelt TD, Balch CM, Dyrbye L, et al. Suicidal ideation among American surgeons. Arch Surg. 2011;146(1):54-62.
- Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc. 2015;90(12):1600-1613.
- Balch CM, Shanafelt TD, Dyrbye L, et al. Surgeon distress as calibrated by hours worked and nights on call. J Am Coll Surg. 2010;211(5):609-619.
- Dyrbye LN, Varkey P, Boone SL, Satele DV, Sloan JA, Shanafelt TD. Physician satisfaction and burnout at different career stages. Mayo Clin Proc. 2013;88(12):1358-1367.
- Meredith LS, Sherbourne CD, Gaillot S, et al. Promoting psychological resilience in the U.S. military. Rand Health Q. 2011;1(2):2.
- Block L, Habicht R, Wu AW, et al. In the wake of the 2003 and 2011 duty hours regulations, how do internal medicine interns spend their time? J Gen Intern Med. 2013;28(8):1042-1047.
- Woolhandler S, Himmelstein DU. Administrative work consumes one-sixth of U.S. physicians’ working hours and lowers their career satisfaction. Int J Health Serv. 2014;44(4):635-642.