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Utility of a Brief Screening Tool to Identify Physicians in Distress



Despite a high prevalence of distress, few physicians seek help. Earlier identification of physicians in distress has been hampered by the lack of a brief screening instrument to assess the common forms of distress.


To evaluate the ability of the seven-item Physician Well-Being Index (PWBI) to i) stratify physician well-being in several important dimensions (mental quality of life [QOL], fatigue, suicidal ideation); and ii) identify physicians whose degree of distress may negatively impact their practice (career satisfaction, intent to leave current position, medical errors).


Cross-sectional study.


National sample of 6,994 U.S. physicians.


PWBI, Mental QOL, fatigue, suicidal ideation, career satisfaction,and clinical practice measures.


Physicians with low mental QOL, high fatigue, or recent (< 12 months) suicidal ideation were more likely to endorse each of the seven PWBI items and a greater number of total items (all P < 0 .001). Assuming a prevalence of 19 %, the PWBI could reduce the post-test probability of a physician having low mental QOL to < 1 % or raise it to > 75 %. The likelihood ratio for low mental QOL among physicians with PWBI scores ≥ 4 was 3.85 in comparison to 0.33 for those with scores < 4. At a threshold score of >4, the PWBI’s specificity for identifying physicians with low mental QOL, high fatigue, or recent suicidal ideation were 85.8 %. PWBI score also stratified physicians’ career satisfaction, reported intent to leave current practice, and self-reported medical errors.


The seven-item PWBI appears to be a useful screening index to identify physicians with distress in a variety of dimensions and whose degree of distress may negatively impact their practice.

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Sources of Funding

Funding for this study was provided by the American Medical Association and the Mayo Clinic Department of Medicine Program on Physician Well-Being.

Role of Sponsor

The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.

Conflict of Interest

Dyrbye and Shanafelt developed the Medical Student Well-Being Index, and Mayo Clinic holds the copyright on this technology, which is referenced in the article. Mayo Clinic and Dr. Dyrbye and Dr. Shanafelt have a financial interest in the technology, which has been licensed to a commercial entity although no royalities have been received to date.

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Correspondence to Liselotte N. Dyrbye MD MHPE.

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Dyrbye, L.N., Satele, D., Sloan, J. et al. Utility of a Brief Screening Tool to Identify Physicians in Distress. J GEN INTERN MED 28, 421–427 (2013).

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  • physicians
  • quality of life
  • mental health
  • self-assessment tool
  • physician well-being index
  • PWBI