Returning to clinical work and doctors’ personal, social and organisational needs: a systematic review

Abstract

ObjectiveThis systematic review aims to synthesise existing evidence on doctors’ personal, social and organisational needs when returning to clinical work after an absence.DesignSystematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesAMED, BNI, CINAHL, EMBASE, EMCARE, HMIC, Medline, PsycINFO and PubMed were searched up to 4 June 2020. Non-database searches included references and citations of identified articles and pages 1–10 of Google and Google Scholar.Eligibility criteriaIncluded studies presented quantitative or qualitative data collected from doctors returning to work, with findings relating to personal, social or organisational needs.Data extraction and synthesisData were extracted using a piloted template. Risk of bias assessment used the Medical Education Research Study Quality Instrument or Critical Appraisal Skills Programme Qualitative Checklist. Data were not suitable for meta-analyses and underwent narrative synthesis due to varied study designs and mixed methods.ResultsTwenty-four included studies (14 quantitative, 10 qualitative) presented data from 92 692 doctors in the UK (n=13), US (n=4), Norway (n=3), Japan (n=2), Spain (n=1), Canada (n=1). All studies identified personal needs, categorised as work–life balance, emotional regulation, self-perception and identity, and engagement with return process. Seventeen studies highlighted social needs relating to professional culture, personal and professional relationships, and illness stigma. Organisational needs found in 22 studies were flexibility and job control, work design, Occupational Health services and organisational culture. Emerging resources and recommendations were highlighted. Variable quality and high risk of biases in data collection and analysis suggest cautious interpretation.ConclusionsThis review posits a foundational framework of returning doctors’ needs, requiring further developed through methodologically robust studies that assess the impact of length and reason for absence, before developing and evaluating tailored interventions. Organisations, training programmes and professional bodies should refine support for returning doctors based on evidence.

The efficacy of psychoeducation to improve personal skills and well-being among health-care professionals returning to clinical practice: a pilot pre-post study

“…The one-day workshop consisted of reflective exercises, group discussion and personal case studies. The intervention covered three main themes reflecting emerging research: self-care, identity and personal reflection and group care and relationships (Attoe et al , 2022). These themes were carefully selected to address the multifaceted challenges and concerns that health-care professionals experience during their return to clinical practice.…”

“…Current organisational strategies have, however, focused less on the integration of returners as a potential strategy for minimising the burden of the workforce crisis (NHS England, 2019). Nevertheless, health-care professionals returning to clinical practice face unique psychosocial and occupational challenges pertaining to personal skills and well-being, which, despite their well-documented importance for patient care outcomes, are seldom reflected in return-to-practice interventions (Attoe et al ., 2022; Saunders et al , 2020).…”

Physician Re-Entry: Scoping Review Protocol v1

“…A systematic review in BMJ Open looked at the personal, social and organizational needs for physicians when returning to clinical work (Attoe et al, 2022). Building upon this research, there may be other areas beyond clinical work that physicians return to upon re-entry into medicine.…”