Docs’ outlook brightens with employer-provided intervention

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A program for physicians that included participation in small groups to focus on ways to prevent burnout and increase empowerment helped improve meaningfulness and engagement, according to a study published online Feb. 10 in JAMA Internal Medicine.

“Despite the documented prevalence and clinical ramifications of physician distress, few rigorous studies have tested interventions to address the problem,” explained the investigators, led by Colin P. West, MD, PhD, of the Mayo Clinic in Rochester, Minn.

To test their hypothesis that an intervention featuring a small-group curriculum would improve physicians’ overall outlook, West and colleagues randomized 74 Mayo Clinic physicians between September 2010 and June 2012 to two groups. Physicians in the intervention group participated in 19 biweekly small-group discussion sessions that included content related to mindfulness, reflection, shared experience and learning over a nine-month period.

The Mayo Clinic provided an hour of paid time every other week (protected time) for these sessions. Physicians in the control group received protected time, but did not participate in the small groups and used their time as they chose.

They administered surveys to assess how physicians view their jobs to both groups at the start of the study, every three months during the study as well as three months and 12 months after the study. They also administered surveys to 350 physicians not involved in the study for comparison.

In the intervention group, empowerment and engagement at work increased by 5.3 points while it declined in the control group by 0.5 points by three months after the study concluded. The improvement persisted one year after the study.

Participants in the intervention group also decreased their high depersonalization (15.5 percent in the intervention group at three months vs. an increase of 0.8 percent in the control group. This difference also persisted at 12 months after the study. There were no statistically significant differences in stress, symptoms of depression, overall quality of life or job satisfaction.

When taking the nontrial group into account, the rate of physicians who thought their work had meaning decreased in the control group and the nontrial group (6.3 percent and 13.4 percent decreases) vs. an increase of 6.3 percent in the intervention group. Rates of depersonalization, emotional exhaustion and burnout decreased a lot in the intervention group, decreased a little in the control group and increased in the nontrial group.

The authors argued that their study points to the potential benefits of such programs offered by institutions. “Such a comprehensive approach has the potential to replace a culture of distress among physicians with a culture of thriving and flourishing,” they wrote.