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Utility of a Brief Screening Tool to Identify Physicians in Distress

Journal of General Internal Medicine volume 28, pages 421–427 (2013)Cite this article

ABSTRACT

BACKGROUND

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.

OBJECTIVE

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).

DESIGN

Cross-sectional study.

PARTICIPANTS

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

MAIN MEASURES

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

KEY RESULTS

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.

CONCLUSIONS

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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Acknowledgements

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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Authors and Affiliations

  1. Department of Medicine, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Liselotte N. Dyrbye MD MHPE & Tait D. Shanafelt MD

  2. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA

    Daniel Satele BA & Jeff Sloan PhD

Authors
  1. Liselotte N. Dyrbye MD MHPE
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  2. Daniel Satele BA
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  3. Jeff Sloan PhD
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  4. Tait D. Shanafelt MD
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Corresponding author

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). https://doi.org/10.1007/s11606-012-2252-9

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  • DOI: https://doi.org/10.1007/s11606-012-2252-9

KEY WORDS

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