Signed: Kristen Drew, Medical University of South Carolina
A team from the Medical University of South Carolina and the University of Michigan says in a new paper that it’s important for hospital systems and medical schools to implement a series of established, evidence-based strategies to address the physician health crisis. I’m writing. Article from the New England Journal of Medicine.
“This is really about the future of medicine,” says Dr. Constance Gill, professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina. “We need to think about what we are doing now to create the healthiest workforce going forward.”
Gillet co-authored a review paper titled “Burnout, Depression, and Poor Health Among Physicians” with Srijan Sen, MD, Eisenberg Professor of Depression and Neuroscience at the University of Michigan Medical School. .
This article takes stock of research and efforts to date on physician health and provides clarity on how health systems can improve physician health and advance the research needed to advance the field. It shows you the path.
For nearly two decades, the authors and their team have studied the mental and physical health of more than 28,000 physicians in their first year of post-medical training through the Intern Health Study.
This study helped identify workload as the strongest and most consistent factor associated with happiness. The study also identified other key contributors to resident depression and developed interventions to improve well-being.
“We’ve seen a lot of research in this area,” said Sen, director of UM’s Eisenberg Center for Family Depression. “The fundamental problem is that we are asking too few doctors to do too much work.Reforms over the past 15 years have significantly reduced the working hours of resident doctors. We believe further efforts to reduce workload and working hours are key to further improving the well-being of residents and the wider physician population. .”
In addition to policies that reduce workload, the authors recommend policies that encourage timely, confidential, and accessible mental health treatment for physicians.
The review also highlighted how doctors from underrepresented groups, such as women and doctors from underrepresented racial and ethnic groups, are exposed to the unique stresses that impact their health, including discrimination, harassment, sexism, and racism in healthcare. It has also become clear that there are some contributing factors. Improving physician health outcomes and attracting and retaining a workforce that meets patient needs requires policies that support cultural change.
“Women and minorities have different experiences and need to be part of the conversation about how we move forward,” Gill said. “They are disproportionately affected by the work-family conflict, systemic and individual discrimination that minorities and underrepresented groups face. “This is critical to creating better patient care,” Gill said.
Many health systems have made efforts in recent years to improve physician health outcomes, primarily related to reducing workloads and fostering a collaborative culture. For example, MUSC and UM added non-physician team members to complete tasks previously completed by physicians, such as entering information into a patient’s electronic health record. The health system also appointed a chief welfare officer to coordinate and strengthen programs for physicians and other members of the health care workforce.
Despite the progress, Gill and Sen say there is still much work to be done to ensure the health of physicians.
The next steps the authors recommend for all health systems are:
Implement and prioritize interventions targeting work hours and workload Eliminate policies that prevent physicians from accessing treatment for mental health and substance use disorders Improve parental and caregiver leave and access to child care Implement policies and programs that support diversity, equity, and inclusion and that increase gender discrimination and racial discrimination in health care
At the same time, more scientific rigor is needed in the field of physician burnout and health. The next step for researchers is to adopt validated assessments of well-being and depression, determine effective implementation and dissemination strategies for established interventions, and develop new targets to improve the well-being of all physicians. developing and evaluating targeted interventions.
Dr. Sen said, “Our study of physicians during what is considered the most stressful year of their careers is an important step forward in the profession of physicians at a time when our country needs them more than ever. We can provide information that will be useful in efforts to support physicians throughout their lives.”
Citation: Burnout, Depression, and Poor Health Among Physicians, NEJM, DOI: 10.1056/NEJMra2302878, https://www.nejm.org/doi/full/10.1056/NEJMra2302878
