Meeting the Imperative to Improve Physician Well-being: Assessment of an Innovative Program
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
Improving physician health and performance is critical to successfully meet the challenges facing health systems that increasingly emphasize productivity. Assessing long-term efficacy and sustainability of programs aimed at enhancing physician and organizational well-being is imperative.
To determine whether data-guided interventions and a systematic improvement process to enhance physician work-life balance and organizational efficacy can improve physician and organizational well-being.
DESIGN AND PARTICIPANTS
From 2000 to 2005, 22–32 physicians regularly completed 3 questionnaires coded for privacy. Results were anonymously reported to physicians and the organization. Data-guided interventions to enhance physician and organizational well-being were built on physician control over the work environment, order in the clinical setting, and clinical meaning.
Questionnaires included an ACP/ASIM survey on physician satisfaction, the Maslach Burnout Inventory (MBI), and the Quality Work Competence (QWC) survey.
Emotional and work-related exhaustion decreased significantly over the study period (MBI, p = 0.002; QWC, p = 0.035). QWC measures of organizational health significantly improved initially and remained acceptable and stable during the rest of the study.
A data-guided program on physician well-being, using validated instruments and process improvement methods, enhanced physician and organizational well-being. Given the increases in physician burnout, organizations are encouraged to urgently create individual and systems approaches to lessen burnout risk.
- Murray A, Montgomery JE, Chang H, Rogers WH, Inui T, Safran DG. Doctor discontent. A comparison of physician satisfaction in different delivery system settings, 1986 and 1997. J Gen Intern Med. 2001;16:452–9 CrossRef
- Williams ES, Konrad TR, Scheckler WE, et al. Understanding physicians’ intentions to withdraw from practice: the role of job satisfaction, job stress, mental and physical health. Health Care Manage Rev. 2001;26:7–19.
- Crane M. Why burned-out doctors get sued more often. Med Econ. 1998;75:210–2, 215–8.
- Myers MF. Doctors’ Marriages. A Look at the Problems and their Solutions. Second Edition. New York: Plenum Medical Book Company; 1994.
- Rollman BL, Mead LA, Wang NY, Klag MJ. Medical specialty and the incidence of divorce. N Engl J Med. 1997;336:800–3. CrossRef
- Gross CP, Mead LA, Ford DE, Klag MJ. Physician, heal thyself? Regular source of care and use of preventive health services among physicians. Arch Intern Med. 2000;160:3209–14. CrossRef
- Center C, Davis M, Detre T, et al. Confronting depression and suicide in physicians: a consensus statement. JAMA. 2003;289:3161–6. CrossRef
- Baruch-Feldman C, Brondolo E, Ben-Dayan D, Schwartz J. Sources of social support and burnout, job satisfaction, and productivity. J Occup Health Psychol. 2002;7:84–93. CrossRef
- Canadian Medical Association. CMA policy. Physician health and well-being. CMAJ. 1998;158:1191–200.
- Spickard A Jr, Gabbe SG, Christensen JF. Mid-career burnout in generalist and specialist physicians. JAMA. 2002;288:1447–50. CrossRef
- O’Connor PG, Spickard A Jr. Physician impairment by substance abuse. Med Clin North Am. 1997;81:1037–52. CrossRef
- Brewster JM. Prevalence of alcohol and other drug problems among physicians. JAMA. 1986;255:1913–20. CrossRef
- Pincus CR. Have doctors lost their work ethic? Med Econ. 1995;72:24–30.
- Haas JS, Cook EF, Puopolo AL, Burstin HR, Cleary PD, Brennan TA. Is the professional satisfaction of general internists associated with patient satisfaction? J Gen Intern Med. 2000;15:122–8. CrossRef
- Arnetz BB. Psychosocial challenges facing physicians of today. Soc Sci Med 2001;52:203–13. CrossRef
- Bowman B. Sick docs get cold comfort from colleagues. National Review of Medicine. Available at: http://www.nationalreviewofmedicine.com/issue/2005/11_15/2_patients_practice05_19.html. Accessed July 26, 2007.
- Suchman A. The influence of health care organizations on well-being. West J Med. 2001;174:43–7. CrossRef
- Christensen J, Feldman M. (Guest Editors). Recapturing the spirit of medicine (special issue on physician well-being) West J Med. 2001;174:1–80.
- Joint Commission on Accreditation of Healthcare Organizations. Medical staff revisions reflect current practices in the field. Jt Comm Perspect. 2000,20:9,13.
- Scott K. Physician retention plans help reduce costs and optimize revenues. Healthc Financ Manage. 98;52:75–7.
- Arnetz BB. Techno-stress: a prospective psychophysiological study of the impact of a controlled stress-reduction program in advanced telecommunication systems design work. J Occup Environ Med. 1996;38:53–65. CrossRef
- Anderzén I, Arnetz BB. The impact of a prospective survey-based workplace intervention program on employee health, biologic stress markers, and organizational productivity. J Occup Environ Med. 2005;47:671–82. CrossRef
- Berwick D, Kilo C. Idealized design of clinical office practice: an interview with Donald Berwick and Charles Kilo of the Institute for Healthcare Improvement. Manag Care Q. 1999;7:62–9.
- Frankel VE. Man’s Search for Meaning: An Introduction to Logotherapy. Third Edition. New York: Simon & Schuster; 1984.
- Maslach C, Jackson SE. Maslach Burnout Inventory Manual. Research Edition. Palo Alto: Consulting Psychologists Press; 1981.
- Arnetz BB. Staff perception of the impact of health care transformation on quality of care. Int J Qual Health Care. 1999;11:345–51. CrossRef
- Wallin L, Ewald U, Wikblad K, Scott-Findlay S, Arnetz BB. Understanding work contextual factors: a short-cut to evidence-based practice? Worldviews Evid Based Nurs. 2006;3:153–64. CrossRef
- Arnetz B, Blomkvist V. Leadership, mental health, and organizational efficacy in health care organizations. Psychosocial predictors of healthy organizational development based on prospective data from four different organizations. Psychother Psychosom. 2007;76:242–8.
- Arnetz BB. Physicians’ view of their work environment and organisation. Psychother Psychosom. 1997;66:155–62. CrossRef
- Arnetz BB. Subjective indicators as a gauge for improving organizational well-being. An attempt to apply the cognitive activation theory to organizations. Psychoneuroendocrinology. 2005;30:1022–26. CrossRef
- Freeborn DK. Satisfaction, commitment, and psychological well-being among HMO physicians. Perm J. 1998;2:22–30.
- Edwards N, Kornacki MJ, Silversin J. Unhappy doctors: what are the causes and what can be done? BMJ. 2002;324:835–8. CrossRef
- Oregon Medical Association. Report of the 2004 Oregon Physician Workforce Survey Report of Results. Available at: http://www.oregon.gov/DHS/healthplan/data_pubs/reports/04opsurvey.pdf. Accessed July 27, 2007.
- Bargellini A, Barbieri A, Rovesti S, Vivoli R, Roncaglia R, Borella P. Relation between immune variables and burnout in a sample of physicians. Occup Environ Med. 2000;57:453–7. CrossRef
- McCall L, Maher T, Piterman L. Preventive health behavior among general practitioners in Victoria. Aust Fam Physician. 1999;28:854–7.
- Schwartz JS, Lewis CE, Clancy C, Kinosian MS, Radany MH, Koplan JP. Internists’ practices in health promotion and disease prevention. Ann Intern Med. 1991;114:46–53.
- Wachtel TJ, Wilcox VL, Moulton AW, Tammaro D, Stein MD. Physicians’ utilization of health care. J Gen Intern Med. 1995;10:261–5. CrossRef
- Kahn KL, Goldberg RJ, DeCosimo D, Dalen JE. Health maintenance activities of physicians and nonphysicians. Arch Intern Med. 1988;148:2433–6. CrossRef
- Rosen IM, Christie JD, Bellini LM, Asch DA. Health and health care among housestaff in four U.S. internal medicine residency programs. J Gen Intern Med. 2000;15:116–21. CrossRef
- Doan-Wiggins L, Zun L, Cooper MA, Meyers DL, Chen EH. Practice satisfaction, occupational stress, and attrition of emergency physicians. Wellness Task Force, Illinois College of Emergency Physicians. Acad Emerg Med. 1995;2:556–63. CrossRef
- Linzer M, Konrad TR, Douglas J, et al. Managed care, time pressure, and physician job satisfaction: results from the physician worklife study. J Gen Intern Med. 2000;15:441–50. CrossRef
- Frank E, McMurray JE, Linzer M, Elon L. Career satisfaction of US women physicians: results from the Women Physicians’ Health Study. Society of General Internal Medicine Career Satisfaction Study Group. Arch Intern Med 1999;159:1417–26. CrossRef
- Doherty WJ, Burge SK. Divorce among physicians. Comparisons with other occupational groups. JAMA. 1989;261:2374–7. CrossRef
- Arnetz BB, Ekman R. Stress in Health and Disease. Weinheim, Germany: Wiley-VCH; 2006:122–40.
- Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136:358–67.
- Forsberg E, Axelsson R, Arnetz B. Effects of performance-based reimbursement on the professional autonomy and power of physicians and the quality of care. Int J Health Plann Manage. 2001;16:297–310. CrossRef
- Buchbinder SB, Wilson M, Melick CF, Powe NR. Estimates of costs of primary care physician turnover. Am J Manag Care. 1999;5:1431–8.
- Landon BE, Reschovsky JD, Pham HH, Blumenthal D. Leaving medicine: the consequences of physician dissatisfaction. Med Care. 2006;44:234–42. CrossRef
- Crouse BJ. Recruitment and retention of family physicians. Minn Med. 1995;78:29–32.
- Firth-Cozens J, Greenhalgh J. Doctors’ perceptions of the links between stress and lowered clinical care. Soc Sci Med. 1997;44:1017–22. CrossRef
- Suchman A. The influence of health care organizations on well-being. West J Med. 2001;174:43–7. CrossRef
- Quill TE, Williamson PR. Healthy approaches to physician stress. Arch Intern Med. 1990;150:1857–61. CrossRef
- Meeting the Imperative to Improve Physician Well-being: Assessment of an Innovative Program
Journal of General Internal Medicine
Volume 22, Issue 11 , pp 1544-1552
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- physician satisfaction
- organizational behavior
- health care administration
- Industry Sectors
- Author Affiliations
- 1. Department of Medicine, Legacy Health System, 1015 NW 22nd Avenue, Portland, OR, USA, Portland, OR, USA
- 2. Division of Occupational and Environmental Health, Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA
- 3. Division of Social Medicine, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- 4. Legacy Clinical Research and Technology Institute, Legacy Health System, Portland, OR, USA