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Self-Care, Resilience, and Work-Life Balance

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Physician Mental Health and Well-Being

Abstract

Resilience and wellness are more than an absence of distress or disease. In the population at large, a relatively small subset of people achieves a full and happy life and is flourishing. The same applies to physician well-being and resilience. There is growing awareness that more must be done to promote physician resilience, increase satisfaction within the profession, and prevent burnout. Both individual and organizational efforts serve complementary and synergistic roles. There is no “one size fits all” tactic for encouraging self-care, wellness, and resilience, but the different pressures at each stage of the physician life span can inform individual and organizational approaches. Attending to personal self-care with good nutrition, adequate sleep, and regular exercise promotes well-being, as does the practice of cognitive-, behavioral-, and mindfulness-based strategies for stress reduction, empowerment, and happiness. Being able to focus on the aspects of work that are most meaningful appears to protect against burnout, as does having control over the practice environment. Authentic social connections at home and at work foster resilience. Good role models and mentors enhance career satisfaction. In order for physicians to overcome stigma and seek help when appropriate, changing cultural norms and increasing organizational support are critical. Physicians indoctrinated within a culture that boasts of superhuman stamina understandably have underdeveloped skill sets for self-care and for achieving a meaningful work-life balance. To achieve what they have, ongoing significant sacrifice becomes engrained as a way of life contributing to high rates of burnout and distress. This chapter provides a glimpse into the real-life struggles throughout the life cycle of a physician ranging from the premedical years to the preretirement years and offers pertinent evidence-based solutions and remedies.

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References

  • Amutio A, Martinez-Taboada C, Delgado LC, Hermosilla D, Mozaz MJ. Acceptability and effectiveness of a long-term educational intervention to reduce physicians’ stress-related conditions. [Research Support, Non-U.S. Gov’t]. J Contin Educ Heal Prof. 2015;35(4):255–60.

    Article  Google Scholar 

  • Baker K, Sen S. Healing medicine’s future: prioritizing physician trainee mental health. AMA J Ethics. 2016;18(6):604–13.

    Article  PubMed  Google Scholar 

  • Beckman HB, Wendland M, Mooney C, Krasner MS, Quill TE, Suchman AL, et al. The impact of a program in mindful communication on primary care physicians. [Evaluation Studies Research Support, Non-U.S. Gov’t]. Acad Med. 2012;87(6):815–9.

    Article  PubMed  Google Scholar 

  • Benson H. The relaxation response. New York: Harper Collins; 1975.

    Google Scholar 

  • Benson J, Magraith K. Compassion fatigue and burnout: the role of Balint groups. [Review]. Aust Fam Physician. 2005;34(6):497–8.

    PubMed  Google Scholar 

  • Brett TD, Arnold-Reed DE, Hince DA, Wood IK, Moorhead RG. Retirement intentions of general practitioners aged 45–65 years. [Research Support, Non-U.S. Gov’t]. Med J Aust. 2009;191(2):75–7.

    PubMed  Google Scholar 

  • Campbell J, Prochazka AV, Yamashita T, Gopal R. Predictors of persistent burnout in internal medicine residents: a prospective cohort study. [Research Support, Non-U.S. Gov’t]. Acad Med. 2010;85(10):1630–4.

    Article  PubMed  Google Scholar 

  • Caravella RA, Robinson LA, Wilets I, Weinberg M, Cabaniss DL, Cutler JL, et al. A qualitative study of factors affecting morale in psychiatry residency training. Acad Psychiatry. 2016;40(5):776–82.

    Article  PubMed  Google Scholar 

  • Chambers M, Colthart I, McKinstry B. Scottish general practitioners’ willingness to take part in a post-retirement retention scheme: questionnaire survey. [Research Support, Non-U.S. Gov’t]. BMJ. 2004;328(7435):329.

    Article  PubMed  PubMed Central  Google Scholar 

  • Charney DS, Southwick SM. Resilience: the science of mastering life’s greatest challenges. New York: Cambridge University Press; 2012.

    Google Scholar 

  • Chung H, Klein MC, Silverman D, Corson-Rikert J, Davidson E, Ellis P, et al. A pilot for improving depression care on college campuses: results of the College Breakthrough Series-Depression (CBS-D) project. [Research Support, Non-U.S. Gov’t Research Support, U.S. Gov’t, Non-P.H.S.]. J Am Coll Heal. 2011;59(7):628–39.

    Article  Google Scholar 

  • Cook AF, Arora VM, Rasinski KA, Curlin FA, Yoon JD. The prevalence of medical student mistreatment and its association with burnout. [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t]. Acad Med. 2014;89(5):749–54.

    Article  PubMed  PubMed Central  Google Scholar 

  • Creswell JD, Welch WT, Taylor SE, Sherman DK, Gruenewald TL, Mann T. Affirmation of personal values buffers neuroendocrine and psychological stress responses. [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t]. Psychol Sci. 2005;16(11):846–51.

    Article  PubMed  Google Scholar 

  • Drolet BC, Rodgers S. A comprehensive medical student wellness program—design and implementation at Vanderbilt School of Medicine. Acad Med. 2010;85(1):103–10.

    Article  PubMed  Google Scholar 

  • Dunn PM, Arnetz BB, Christensen JF, Homer L. Meeting the imperative to improve physician well-being: assessment of an innovative program. J Gen Intern Med. 2007;22(11):1544–52.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dyrbye LN, Shanafelt TD, Balch CM, Satele D, Sloan J, Freischlag J. Relationship between work-home conflicts and burnout among American surgeons: a comparison by sex. Arch Surg. 2011;146(2):211–7.

    Article  PubMed  Google Scholar 

  • Dyrbye LN, Satele D, Sloan J, Shanafelt TD. Utility of a brief screening tool to identify physicians in distress. [Evaluation Studies Research Support, Non-U.S. Gov’t]. J Gen Intern Med. 2013;28(3):421–7.

    Article  PubMed  Google Scholar 

  • Dyrbye LN, Eacker A, Durning SJ, Brazeau C, Moutier C, Massie FS, et al. The impact of stigma and personal experiences on the help-seeking behaviors of medical students with burnout. [Research Support, Non-U.S. Gov’t]. Acad Med. 2015;90(7):961–9.

    Article  PubMed  Google Scholar 

  • Eckleberry-Hunt J, Van Dyke A, Lick D, Tucciarone J. Changing the conversation from burnout to wellness: physician well-being in residency training programs. J Grad Med Educ. 2009;1(2):225–30.

    Article  PubMed  PubMed Central  Google Scholar 

  • Eisen A, Kushner H, McLeod M, Queen E, Gordon J, Ford JL. An integrated approach to addressing addiction and depression in college students. [Research Support, Non-U.S. Gov’t]. J Am Coll Heal. 2009;57(4):455–6.

    Article  Google Scholar 

  • Enns MW, Cox BJ, Sareen J, Freeman P. Adaptive and maladaptive perfectionism in medical students: a longitudinal investigation. [Comparative Study Research Support, Non-U.S. Gov’t]. Med Educ. 2001;35(11):1034–42.

    Article  CAS  PubMed  Google Scholar 

  • Ey S, Moffit M, Kinzie JM, Choi D, Girard DE. “If you build it, they will come”: attitudes of medical residents and fellows about seeking services in a resident wellness program. J Grad Med Educ. 2013;5(3):486–92.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fang DZ, Young CB, Golshan S, Moutier C, Zisook S. Burnout in premedical undergraduate students. Acad Psychiatry. 2012;36(1):11–6.

    Article  PubMed  Google Scholar 

  • Fortney L, Luchterhand C, Zakletskaia L, Zgierska A, Rakel D. Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians: a pilot study. [Clinical Trial Research Support, Non-U.S. Gov’t]. Ann Fam Med. 2013;11(5):412–20.

    Article  PubMed  PubMed Central  Google Scholar 

  • Frei E, Stamm M, Buddeberg-Fischer B. Mentoring programs for medical students—a review of the PubMed literature 2000–2008. BMC Med Educ. 2010;10:32.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gentile JP, Roman B. Medical student mental health services: psychiatrists treating medical students. Psychiatry. 2009;6(5):38–45.

    PubMed  PubMed Central  Google Scholar 

  • Geurts S, Rutte C, Peeters M. Antecedents and consequences of work-home interference among medical residents. Soc Sci Med. 1999;48(9):1135–48.

    Article  CAS  PubMed  Google Scholar 

  • Gold KJ, Andrew LB, Goldman EB, Schwenk TL. “I would never want to have a mental health diagnosis on my record”: a survey of female physicians on mental health diagnosis, treatment, and reporting. Gen Hosp Psychiatry. 2016;43:51–7.

    Article  PubMed  Google Scholar 

  • Goodman MJ, Schorling JB. A mindfulness course decreases burnout and improves well-being among healthcare providers. Int J Psychiatry Med. 2012;43(2):119–28.

    Article  PubMed  Google Scholar 

  • Gottman J, Silver N. The seven principles for making marriage work: a practical guide from the country’s foremost relationship expert. New York: Harmony Books; 2015.

    Google Scholar 

  • Grant A, Rix A, Winter P, Mattick K, Jones D. Support for medical students with mental health problems: a conceptual model. Acad Psychiatry. 2015;39(1):16–21.

    Article  PubMed  Google Scholar 

  • Guille C, Zhao Z, Krystal J, Nichols B, Brady K, Sen S. Web-based cognitive behavioral therapy intervention for the prevention of suicidal ideation in medical interns: a randomized clinical trial. [randomized controlled trialresearch support, N.I.H., Extramural Research Support, Non-U.S. Gov’t]. JAMA Psychiat. 2015;72(12):1192–8.

    Article  Google Scholar 

  • Gustafsson Sendén M, Løvseth LT, Schenck-Gustafsson K, Fridner A. What makes physicians go to work while sick: a comparative study of sickness presenteeism in four European countries (HOUPE). Swiss Med Wkly. 2013;143:w13840.

    PubMed  Google Scholar 

  • Gustafsson Sendén M, Schenck-Gustafsson K, Fridner A. Gender differences in Reasons for Sickness Presenteeism - a study among GPs in a Swedish health care organization. Ann Occup Environ Med. 2016:28:50.

    Google Scholar 

  • Hankir AK, Northall A, Zaman R. Stigma and mental health challenges in medical students. [Case Reports Review]. BMJ Case Rep. 2014a;2014:bcr2014205226.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hankir A, Zaman R, Evans-Lacko S. The Wounded Healer: an effective anti-stigma intervention targeted at the medical profession? Psychiatr Danub. 2014b;26(Suppl 1):89–96.

    PubMed  Google Scholar 

  • Hansen V, Pit SW, Honeyman P, Barclay L. Prolonging a sustainable working life among older rural GPs: solutions from the horse’s mouth. [Research Support, Non-U.S. Gov’t]. Rural Remote Health. 2013;13(2):2369.

    PubMed  Google Scholar 

  • Haskins J, Carson JG, Chang CH, Kirshnit C, Link DP, Navarra L, et al. the suicide prevention, depression awareness, and clinical engagement program for Faculty and Residents at the University of California, Davis Health System. [Research Support, Non-U.S. Gov’t]. Acad Psychiatry. 2016;40(1):23–9.

    Article  PubMed  Google Scholar 

  • Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: model, processes and outcomes. [Meta-Analysis]. Behav Res Ther. 2006;44(1):1–25.

    Article  PubMed  Google Scholar 

  • Hayes SC, Levin ME, Plumb-Vilardaga J, Villatte JL, Pistorello J. Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy. [Review]. Behav Ther. 2013;44(2):180–98.

    Article  PubMed  Google Scholar 

  • Hlubocky FJ, Back AL, Shanafelt TD. Addressing burnout in oncology: why cancer care clinicians are at risk, what individuals can do, and how organizations can respond. Am Soc Clin Oncol Educ Book. 2016;35:271–9.

    Article  PubMed  Google Scholar 

  • Hoff T, Scott S. The gendered realities and talent management imperatives of women physicians. Health Care Manag Rev. 2016;41(3):189–99.

    Article  Google Scholar 

  • Irving JA, Dobkin PL, Park J. Cultivating mindfulness in health care professionals: a review of empirical studies of mindfulness-based stress reduction (MBSR). [Research Support, Non-U.S. Gov’t]. Complement Ther Clin Pract. 2009;15(2):61–6.

    Article  PubMed  Google Scholar 

  • Jackson ER, Shanafelt TD, Hasan O, Satele DV, Dyrbye LN. Burnout and alcohol abuse/dependence among U.S. medical students. Acad Med. 2016;91(9):1251–6.

    Article  PubMed  Google Scholar 

  • Jolly S, Griffith KA, DeCastro R, Stewart A, Ubel P, Jagsi R. Gender differences in time spent on parenting and domestic responsibilities by high-achieving young physician-researchers. Ann Intern Med. 2014;160(5):344–53.

    Article  PubMed  PubMed Central  Google Scholar 

  • Joyce CM, Wang WC, McDonald HM. Retirement patterns of Australian doctors aged 65 years and older. [Research Support, Non-U.S. Gov’t]. Aust Health Rev. 2015;39(5):582–7.

    Article  PubMed  Google Scholar 

  • Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psychiatry. 1982;4(1):33–47.

    Article  CAS  PubMed  Google Scholar 

  • Kabat-Zinn J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York: Bantam Dell; 2013.

    Google Scholar 

  • Kalet A, Krackov S, Rey M. Mentoring for a new era. Acad Med. 2002;77(11):1171–2.

    Article  PubMed  Google Scholar 

  • Kashiwagi DT, Varkey P, Cook DA. Mentoring programs for physicians in academic medicine: a systematic review. [Review]. Acad Med. 2013;88(7):1029–37.

    Article  PubMed  Google Scholar 

  • Kemper KJ, Mo X, Khayat R. Are mindfulness and self-compassion associated with sleep and resilience in health professionals? J Altern Complement Med. 2015;21(8):496–503.

    Article  PubMed  PubMed Central  Google Scholar 

  • Keyes CL. Promoting and protecting mental health as flourishing: a complementary strategy for improving national mental health. Am Psychol. 2007;62(2):95–108.

    Article  PubMed  Google Scholar 

  • Killingsworth MA, Gilbert DT. A wandering mind is an unhappy mind. Science. 2010;330(6006):932.

    Article  CAS  PubMed  Google Scholar 

  • Klein M. Sexual intelligence: what we really want from sex—and how to get it. New York: Harper Collins; 2013.

    Google Scholar 

  • Krasner MS, Epstein RM, Beckman H, Suchman AL, Chapman B, Mooney CJ, et al. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. [Clinical Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t]. JAMA. 2009;302(12):1284–93.

    Article  CAS  PubMed  Google Scholar 

  • Kushner RF, Kessler S, McGaghie WC. Using behavior change plans to improve medical student self-care. [Evaluation Studies Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t]. Acad Med. 2011;86(7):901–6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Leary KA, DeRosier ME. Factors promoting positive adaptation and resilience during the transition to college. Psychology. 2012;3(12A):1215–22.

    Article  Google Scholar 

  • Lebensohn P, Dodds S, Benn R, Brooks AJ, Birch M, Cook P, et al. Resident wellness behaviors: relationship to stress, depression, and burnout. Fam Med. 2013;45(8):541–9.

    PubMed  Google Scholar 

  • Lederman LC, Stewart LP, Russ T. Addressing college drinking through curriculum infusion: a study of the use of experience-based learning in the communication classroom. Commun Educ. 2007;56(4):476–94.

    Article  Google Scholar 

  • Lefebvre DC. Perspective: resident physician wellness: a new hope. [Review]. Acad Med. 2012;87(5):598–602.

    Article  PubMed  Google Scholar 

  • Linzer M, Baier Manwell L, Mundt M, Williams E, Maguire A, McMurray J, et al. Organizational climate, stress, and error in primary care: the MEMO Study. In: Henriksen K, Battles JB, Marks ES, Lewin DI, editors. Advances in patient safety: from research to implementation, Research Findings, vol. 1. Rockville: Agency for Healthcare Research and Quality; 2005.

    Google Scholar 

  • Luchterhand C, Rakel D, Haq C, Grant L, Byars-Winston A, Tyska S, et al. Creating a culture of mindfulness in medicine. [Research Support, Non-U.S. Gov’t]. WMJ. 2015;114(3):105–9.

    PubMed  Google Scholar 

  • Ludwig DS, Kabat-Zinn J. Mindfulness in medicine. JAMA. 2008;300(11):1350–2.

    Article  CAS  PubMed  Google Scholar 

  • Luthar SS, Crossman EJ, Small P. Resilience and adversity. In: Lamb M, editor. Handbook of child psychology and developmental science. 7th ed. Hoboken: Wiley; 2015.

    Google Scholar 

  • Luthar SS, Curlee A, Tye SJ. Engelman J, Stonnington, CM. Fostering Resilience Among Mothers Under Stress: “AuthenticConnections Groups” for Medical Professionals. Women’s Health Issues. 2017. In press.

    Google Scholar 

  • Martin-Asuero A, Garcia-Banda G. The Mindfulness-based Stress Reduction program (MBSR) reduces stress-related psychological distress in healthcare professionals. Span J Psychol. 2010;13(2):897–905.

    Article  PubMed  Google Scholar 

  • Mavor KI, McNeill KG, Anderson K, Kerr A, O’Reilly E, Platow MJ. Beyond prevalence to process: the role of self and identity in medical student well-being. Med Educ. 2014;48(4):351–60.

    Article  PubMed  Google Scholar 

  • Mayer AP, Blair JE, Ko MG, Patel SI, Files JA. Long-term follow-up of a facilitated peer mentoring program. [Multicenter Study]. Med Teach. 2014;36(3):260–6.

    Article  PubMed  Google Scholar 

  • McClafferty H, Brown OW. Physician health and wellness. Pediatrics. 2014;134(4):830–5.

    Article  PubMed  Google Scholar 

  • McCrory K. Tackling burnout in employed physicians. Fam Pract Manag. 2016;23(4):7–8.

    PubMed  Google Scholar 

  • Montgomery A. The inevitability of physician burnout: implications for interventions. Burnout Res. 2014;1(1):50–6.

    Article  Google Scholar 

  • Montgomery AJ, Bradley C, Rochfort A, Panagopoulou E. A review of self-medication in physicians and medical students. Occup Med (Lond). 2011;61(7):490–7.

    Article  CAS  Google Scholar 

  • Moutier C, Norcross W, Jong P, Norman M, Kirby B, McGuire T, et al. The suicide prevention and depression awareness program at the University of California, San Diego School of Medicine. [Research Support, Non-U.S. Gov’t]. Acad Med. 2012;87(3):320–6.

    Article  PubMed  Google Scholar 

  • Nusbaum NJ. Commentary: physician retirement and physician shortages. J Community Health. 2009;34(5):353–6.

    Article  PubMed  Google Scholar 

  • Peisah C, Gautam M, Goldstein MZ. Medical masters: a pilot study of adaptive ageing in physicians. Australas J Ageing. 2009;28(3):134–8.

    Article  PubMed  Google Scholar 

  • Perlman RL, Ross PT, Lypson ML. Understanding the medical marriage: physicians and their partners share strategies for success. [Research Support, Non-U.S. Gov’t]. Acad Med. 2015;90(1):63–8.

    Article  PubMed  Google Scholar 

  • Pit SW, Hansen V. Factors influencing early retirement intentions in Australian rural general practitioners. [Research Support, Non-U.S. Gov’t]. Occup Med. 2014;64(4):297–304.

    Article  CAS  Google Scholar 

  • Prinz P, Hertrich K, Hirschfelder U, de Zwaan M. Burnout, depression and depersonalisation—psychological factors and coping strategies in dental and medical students. GMS Z Med Ausbild. 2012;29(1):Doc10.

    PubMed  PubMed Central  Google Scholar 

  • Pritchard ME, Wilson GS, Yamnitz B. What predicts adjustment among college students? A longitudinal panel study. J Am Coll Heal. 2007;56(1):15–21.

    Article  Google Scholar 

  • Reed DA, Shanafelt TD, Satele DW, Power DV, Eacker A, Harper W, et al. Relationship of pass/fail grading and curriculum structure with well-being among preclinical medical students: a multi-institutional study. [Comparative Study Multicenter Study]. Acad Med. 2011;86(11):1367–73.

    Article  PubMed  Google Scholar 

  • Regehr C, Glancy D, Pitts A, LeBlanc VR. Interventions to reduce the consequences of stress in physicians: a review and meta-analysis. J Nerv Ment Dis. 2014;202(5):353–9.

    Article  PubMed  Google Scholar 

  • Ripp JA, Fallar R, Korenstein D. A randomized controlled trial to decrease job burnout in first-year internal medicine residents using a facilitated discussion group intervention. J Grad Med Educ. 2016;8(2):256–9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rosvold EO, Bjertness E. Physicians who do not take sick leave: hazardous heroes? [Research Support, Non-U.S. Gov’t]. Scand J Public Health. 2001;29(1):71–5.

    Article  CAS  PubMed  Google Scholar 

  • Rucker L, Shapiro J, Fornwalt C, Hundal K, Reddy S, Singson Z, et al. Using focus groups to understand causes for morale decline after introducing change in an IM residency program. BMC Med Educ. 2014;14:132.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schernhammer ES, Colditz GA. Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). [Comparative Study Meta-Analysis]. Am J Psychiatry. 2004;161(12):2295–302.

    Article  PubMed  Google Scholar 

  • Schmitz GR, Clark M, Heron S, Sanson T, Kuhn G, Bourne C, et al. Strategies for coping with stress in emergency medicine: early education is vital. J Emerg Trauma Shock. 2012;5(1):64–9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schrijver I, Brady KJ, Trockel M. An exploration of key issues and potential solutions that impact physician wellbeing and professional fulfillment at an academic center. PeerJ. 2016;4:e1783.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. [Research Support, Non-U.S. Gov’t]. JAMA. 2010;304(11):1181–90.

    Article  CAS  PubMed  Google Scholar 

  • Seritan A, Hunt J, Shy A, Rea M, Worley L. The state of medical student wellness: a call for culture change. Acad Psychiatry. 2012;36(1):7–10.

    Article  PubMed  Google Scholar 

  • Shanafelt TD, Sloan JA, Habermann TM. The well-being of physicians. Am J Med. 2003;114(6):513–9.

    Article  PubMed  Google Scholar 

  • Shanafelt TD, Balch CM, Bechamps GJ, Russell T, Dyrbye L, Satele D, et al. Burnout and career satisfaction among American surgeons. Ann Surg. 2009a;250(3):463–71.

    PubMed  Google Scholar 

  • Shanafelt TD, West CP, Sloan JA, Novotny PJ, Poland GA, Menaker R, et al. Career fit and burnout among academic faculty. [Comparative Study]. Arch Intern Med. 2009b;169(10):990–5.

    Article  PubMed  Google Scholar 

  • Shanafelt TD, Kaups KL, Nelson H, Satele DV, Sloan JA, Oreskovich MR, et al. An interactive individualized intervention to promote behavioral change to increase personal well-being in US surgeons. [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t]. Ann Surg. 2014;259(1):82–8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Shanafelt TD, Gorringe G, Menaker R, Storz KA, Reeves D, Buskirk SJ, et al. Impact of organizational leadership on physician burnout and satisfaction. [Research Support, Non-U.S. Gov’t]. Mayo Clin Proc. 2015;90(4):432–40.

    Article  PubMed  Google Scholar 

  • Shanafelt TD, Dyrbye LN, Sinsky C, Hasan O, Satele D, Sloan J, et al. Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction. Mayo Clin Proc. 2016;91(7):836–48.

    Article  PubMed  Google Scholar 

  • Shiralkar MT, Harris TB, Eddins-Folensbee FF, Coverdale JH. A systematic review of stress-management programs for medical students. Acad Psychiatry. 2013;37(3):158–64.

    Article  PubMed  Google Scholar 

  • Silver, M. P., & Williams, S. A. (2016). Reluctance to retire: a qualitative study on work identity, intergenerational conflict, and retirement in academic medicine. The Gerontologist.

    Google Scholar 

  • Silver MP, Hamilton AD, Biswas A, Warrick NI. A systematic review of physician retirement planning. Hum Resour Health. 2016;14(1):67.

    Article  PubMed  PubMed Central  Google Scholar 

  • Skowronski GA, Peisah C. The greying intensivist: ageing and medical practice—everyone’s problem. Med J Aust. 2012;196(8):505–7.

    Article  PubMed  Google Scholar 

  • Sommers LS, Launer J, editors. Clinical uncertainty in primary care: the challenge of collaborative engagement. New York: Springer; 2013.

    Google Scholar 

  • Sood A, Prasad K, Schroeder D, Varkey P. Stress management and resilience training among department of medicine faculty: a pilot randomized clinical trial. J Gen Intern Med. 2011;26(8):858–61.

    Article  PubMed  PubMed Central  Google Scholar 

  • Spataro BM, Tilstra SA, Rubio DM, McNeil MA. The toxicity of self-blame: sex differences in burnout and coping in internal medicine trainees. J Women’s Health (Larchmt). 2016;25(11):1147–52.

    Article  Google Scholar 

  • Strong EA, De Castro R, Sambuco D, Stewart A, Ubel PA, Griffith KA, et al. Work-life balance in academic medicine: narratives of physician-researchers and their mentors. [Research Support, N.I.H., Extramural]. J Gen Intern Med. 2013;28(12):1596–603.

    Article  PubMed  PubMed Central  Google Scholar 

  • Swensen S, Kabcenell A, Shanafelt T. Physician-organization collaboration reduces physician burnout and promotes engagement: the mayo clinic experience. J Healthc Manag. 2016;61(2):105–27.

    PubMed  Google Scholar 

  • Thomas NK. Resident burnout. [Review]. JAMA. 2004;292(23):2880–9.

    Article  CAS  PubMed  Google Scholar 

  • Thompson D, Goebert D, Takeshita J. A program for reducing depressive symptoms and suicidal ideation in medical students. [Research Support, Non-U.S. Gov’t]. Acad Med. 2010;85(10):1635–9.

    Article  PubMed  Google Scholar 

  • Thompson G, McBride RB, Hosford CC, Halaas G. Resilience among medical students: the role of coping style and social support. [Research Support, Non-U.S. Gov’t]. Teach Learn Med. 2016;28(2):174–82.

    Article  PubMed  Google Scholar 

  • UK National Health Service. (2016). Warwick-Edinburgh mental well-being scale. http://www.nhs.uk/tools/documents/self_assessments_js/assessment.html?XMLpath=/tools/documents/self_assessments_js/packages/&ASid=43&syndicate=undefined. Accessed 2 Feb 2017

  • Vaillant GE. Triumphs of experience: the men of the Harvard grant study. Cambridge: Belknap Press of Harvard University Press; 2012.

    Book  Google Scholar 

  • Van Greuningen M, Heiligers PJ, Van der Velden LF. Motives for early retirement of self-employed GPs in the Netherlands: a comparison of two time periods. [Comparative Study Research Support, Non-U.S. Gov’t]. BMC Health Serv Res. 2012;12:467.

    Article  PubMed  PubMed Central  Google Scholar 

  • Warnecke E, Quinn S, Ogden K, Towle N, Nelson MR. A randomised controlled trial of the effects of mindfulness practice on medical student stress levels. [Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov’t]. Med Educ. 2011;45(4):381–8.

    Article  PubMed  Google Scholar 

  • Weight CJ, Sellon JL, Lessard-Anderson CR, Shanafelt TD, Olsen KD, Laskowski ER. Physical activity, quality of life, and burnout among physician trainees: the effect of a team-based, incentivized exercise program. [linical Trial Research Support, Non-U.S. Gov’t]. Mayo Clin Proc. 2013;88(12):1435–42.

    Article  PubMed  Google Scholar 

  • West CP, Dyrbye LN, Rabatin JT, Call TG, Davidson JH, Multari A, et al. Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial. [Randomized Controlled Trial Research Support, Non-U.S. Gov’t]. JAMA Intern Med. 2014;174(4):527–33.

    Article  PubMed  Google Scholar 

  • West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016;388(10057):2272–81.

    Article  PubMed  Google Scholar 

  • Whitehouse WG, Dinges DF, Orne EC, Keller SE, Bates BL, Bauer NK, et al. Psychosocial and immune effects of self-hypnosis training for stress management throughout the first semester of medical school. [Clinical Trial Controlled Clinical Trial Research Support, Non-U.S. Gov’t Research Support, U.S. Gov’t, P.H.S.]. Psychosom Med. 1996;58(3):249–63.

    Article  CAS  PubMed  Google Scholar 

  • Wild K, Scholz M, Ropohl A, Brauer L, Paulsen F, Burger PH. Strategies against burnout and anxiety in medical education—implementation and evaluation of a new course on relaxation techniques (Relacs) for medical students. [Evaluation Studies]. PLoS One. 2014;9(12):e114967.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Williams D, Tricomi G, Gupta J, Janise A. Efficacy of burnout interventions in the medical education pipeline. Acad Psychiatry. 2015;39(1):47–54.

    Article  PubMed  Google Scholar 

  • Worley LL. Instilling happiness into medical school. The University of Arkansas College of Medicine’s Medical Student Mental Health Program. J Ark Med Soc. 1998;94(9):391–3.

    CAS  PubMed  Google Scholar 

  • Worley LL. Our fallen peers: a mandate for change. Acad Psychiatry. 2008;32(1):8–12.

    Article  PubMed  Google Scholar 

  • Yu JH, Chae SJ, Chang KH. The relationship among self-efficacy, perfectionism and academic burnout in medical school students. Korean J Med Educ. 2016;28(1):49–55.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zautra AJ, Arewasikporn A, Davis MC. Resilience: promoting well-being through recovery, sustainability, and growth. Res Hum Dev. 2010;7(3):221–38.

    Article  Google Scholar 

  • Zwack J, Schweitzer J. If every fifth physician is affected by burnout, what about the other four? Resilience strategies of experienced physicians. [Research Support, Non-U.S. Gov’t]. Acad Med. 2013;88(3):382–9.

    Article  PubMed  Google Scholar 

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Correspondence to Linda L. M. Worley M.D. .

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Worley, L.L.M., Stonnington, C.M. (2017). Self-Care, Resilience, and Work-Life Balance. In: Brower, K., Riba, M. (eds) Physician Mental Health and Well-Being. Integrating Psychiatry and Primary Care. Springer, Cham. https://doi.org/10.1007/978-3-319-55583-6_11

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