“If You Build It, They Will Come”: Attitudes of Medical Residents and Fellows About Seeking Services in a Resident Wellness Program

Abstract

Background High rates of burnout and distress in resident physicians suggest a significant number would benefit from counseling. Intervention A resident wellness program (RWP) was designed to lower known barriers limiting resident access to services. Methods In 2011, medical residents and fellows were surveyed and logistic regression analyses were conducted to identify demographic and training program differences in perceived barriers and willingness to access the RWP. Results Of the 88% of trainees who knew about the RWP, 87% indicated they would be very likely or somewhat likely to seek out services. Time remained the biggest barrier for residents to getting help. Being male (odds ratio [OR] = 0.54, 95% confidence interval [CI] 0.34–0.84) or an ethnic/racial minority (OR = 0.49, 95% CI 0.28–0.85) was associated with greater unwillingness to seek counseling. Reluctance to access the RWP was associated with concerns about helpfulness, confidentiality, being unable to take a break, and stigma. Women (OR = 1.60, 95% CI 1.06–2.42) and primary care residents (OR = 1.58, 95% CI 0.98–2.54) were more likely to be concerned about taking a break. Men were more likely to question the helpfulness of counseling (OR = 0.55, 95% CI 0.36–0.85). Conclusions The RWP removed barriers of cost and knowledge about counseling services. More educational outreach is needed to address sex and ethnic differences about RWP utilization and attitudes in medical culture about a physician's right to address personal health care needs.

Feasibility of a Comprehensive Wellness and Suicide Prevention Program: A Decade of Caring for Physicians in Training and Practice

“…Contrary to prior research on residents' accessing counseling on-site, 25 the majority of this AHC's trainees indicated a willingness to access our program on-site, reported fewer barriers, 16 and when they did seek treatment reported a high level of satisfaction. Training program leaders, key promoters of our services, also expressed satisfaction with the RFWP.…”

“…Barriers to treatment still exist. Specifically, demanding clinical schedules continue to be the most frequently mentioned barrier to accessing treatment by trainees, 16 even after our GME office mandated that programs allow trainees to attend personal or family health care appointments on a quarterly basis. 30 Trainees typically schedule RFWP meetings outside of these protected blocks of time due to the urgency of their need.…”

“…4,6 These barriers include concerns about confidentiality; treatment costs; limited flexible time; uncertainty about efficacy; stigma; and questions about reporting treatment on credentialing, medical licensing, and life and disability insurance applications. [16][17][18] As an alternative to professional treatment, highly distressed physicians may self-prescribe, turn to family for solace, or ''struggle in silence.'' 19,20 In this article we describe components of a wellness and suicide prevention program designed to reach out to medical trainees and faculty, and to encourage them to prioritize self-care and seek professional treatment if needed.…”

Implementing a Universal Well-Being Assessment to Mitigate Barriers to Resident Utilization of Mental Health Resources

“…2,3 Previously published interventions that addressed mental health and suicide prevention programs for medical residents had utilization rates between 12% and 25%, raising concerns that trainees may not be taking advantage of those resources. [4][5][6] Commonly cited barriers to physicians seeking help include time constraints, treatment cost, concerns about confidentiality, perceived stigma, and concerns about problems with obtaining a license or hospital privileges. [2][3][4][5][6] Making residents comfortable with seeking out mental health services is an integral part of preventing burnout and suicide and ensuring well-being.…”

“…[4][5][6] Commonly cited barriers to physicians seeking help include time constraints, treatment cost, concerns about confidentiality, perceived stigma, and concerns about problems with obtaining a license or hospital privileges. [2][3][4][5][6] Making residents comfortable with seeking out mental health services is an integral part of preventing burnout and suicide and ensuring well-being. There is a paucity of literature regarding effective strategies for mitigating barriers and increasing utilization of mental health services.…”