Physician Health and Wellness

Abstract

Physician health and wellness is a critical issue gaining national attention because of the high prevalence of physician burnout. Pediatricians and pediatric trainees experience burnout at levels equivalent to other medical specialties, highlighting a need for more effective efforts to promote health and well-being in the pediatric community. This report will provide an overview of physician burnout, an update on work in the field of preventive physician health and wellness, and a discussion of emerging initiatives that have potential to promote health at all levels of pediatric training.Pediatricians are uniquely positioned to lead this movement nationally, in part because of the emphasis placed on wellness in the Pediatric Milestone Project, a joint collaboration between the Accreditation Council for Graduate Medical Education and the American Board of Pediatrics. Updated core competencies calling for a balanced approach to health, including focus on nutrition, exercise, mindfulness, and effective stress management, signal a paradigm shift and send the message that it is time for pediatricians to cultivate a culture of wellness better aligned with their responsibilities as role models and congruent with advances in pediatric training.Rather than reviewing programs in place to address substance abuse and other serious conditions in distressed physicians, this article focuses on forward progress in the field, with an emphasis on the need for prevention and anticipation of predictable stressors related to burnout in medical training and practice. Examples of positive progress and several programs designed to promote physician health and wellness are reviewed. Areas where more research is needed are highlighted. Pediatrics 2014;134:830-835 INTRODUCTIONPhysician health and wellness is an issue garnering national interest because of the high prevalence of burnout in medical practitioners and trainees. Burnout takes a steep toll on physicians and has negative effects on patients and health care systems. 1 Research advances detailing the detrimental effects of chronic stress, including impaired immune function, inflammation, elevation of cardiovascular risk factors, and depression, 2-9 are directly relevant to pediatric practitioners and create a need for organized efforts to address physician health and well-being in the pediatric community. The purpose of this report is to provide an update on the issue of physician health and wellness with regard to how they relate to pediatricians. Rather than reviewing programs already in place to address substance abuse and other serious conditions in distressed physicians, this report focuses on forward progress in the field, with an emphasis on the need for prevention and anticipation of predictable stressors related to burnout in medical training and practice. Although specific recommendations are beyond the parameters of this report, examples of positive progress and national programs to promote physician health and wellness will be reviewed. BURNOUT: THE ANTITHESIS ...

Running on empty: a review of nutrition and physicians' well-being

“…At the professional level, there is a need to promote a medical culture that increases awareness of the links between nutrition and well-being among physicians and prioritises self-care and physician nutrition through professional frameworks and resources. For example, the Accreditation Council for Graduate Medical Education and the American Board of Pediatrics have included wellness, including nutrition, in their core competencies 44. Perhaps most importantly, changes at the organisational level, including policies promoting regular nutrition breaks for physicians, and implementing programmes and strategies to improve access to healthy food choices in all healthcare settings, extending food service hours to include overnight access for night-time shifts, and improving access to easy storage and locations to eat food and drink water near patient care areas, may have the best impact at reducing the lack of time and accessibility that prevents physicians from accessing healthy nutrition at work 1 40…”

Registrar wellness in Botswana: Measuring burnout and identifying ways to improve wellness

“…These requests are in line with the views of global experts, who are focusing on improving wellness of registrars-in-training, where both individually focused and organisational strategies have been found to decrease burnout among physicians. [4,16,19,20] The results from this study have led to the initiation of wellness activities for registrars at the University of Botswana, including wellness lecture series, access to free individual psychotherapy through the Department of Psychology and registrar social activities, including an annual appreciation luncheon. These activities have been well received by the registrars, but a continued focus on improving the wellness of registrars working in Botswana and across sub-Saharan Africa is urgently needed.…”

“…[4,10,18,19] The most frequently proposed wellness interventions by the Botswanan registrars included wellness lectures, improved mentorship and registrar social events. These requests are in line with the views of global experts, who are focusing on improving wellness of registrars-in-training, where both individually focused and organisational strategies have been found to decrease burnout among physicians.…”

Physician Wellness Across the Professional Spectrum

“…8 Burnout is measured most often with the Maslach Burnout Inventory, which specifically addresses 3 components: emotional exhaustion, depersonalization, and low sense of personal accomplishment (Box 1). The first 2 components of this scale are most frequently areas of poor scoring among physicians.…”

“…Areas that have been shown to improve physician wellness are work-life balance, social support, adequate rest, and regular physical activity. 8 Presently, the bulk of research and data that have…”