Resources on Clinician Wellness
Brown, S, Gunderman, RB. (2006). Enhancing the professional fulfillment of physicians. Acad Med, 81/6, 577-82.
- Lessons from nonmedical industries, why physician fulfillment matters, enhancing physician fulfillment.
Henry LG, Henry JD. (2002). The soul of a physician: Doctors speaking about passion, resilience and hope. AMA Press.
- Essays based on interviews with dozens of physicians about areas of emphasis in their lives and work that evoke meaning and passion: “reformers/activists,” “innovators,” “teachers/managers,” “artistic-oriented caregivers,” and others.
Krasner MS, Epstein RM et al (2009). Association of an educational program in mindful communication with burnout, empathy and attitudes among primary care physicians. JAMA, 302(12), 1284-93.
- 8 week program with 70 primary care physicians, covering mindfulness meditation, self-awareness exercises, narratives about meaningful clinical experiences etc. Benefits at 2, 12 and 15 months in mindfulness, burnout, empathy and other measures. See HERE
Lawson, K. (2011). Demystifying mindfulness. Minn Med, Jan. See HERE
- First of two articles I’ll highlight from a special issue of Minnesota Medicine on physician burnout/wellness. This article suggests specific practices related to mindfulness (“focus on one thing at a time,” “take a meal break without your computer, phone or reading material,” “practice gratitude, at the end of the day acknowledging one thing you are grateful for” etc.) which support well-being.
Longenecker R, Zink T, Florence J. (2012). Teaching and learning resilience: building adaptive capacity for rural practice. A report and subsequent analysis of a workshop conducted at the Rural Medical Educators Conference, Savannah, Georgia, May 18, 2010. J Rural Health, 28(2):122-7. See HERE.
- Ideas growing out of a day-long meeting of rural medical educators. Themes of hardship as an opportunity for growth and adaptability (flexibility, “bending without breaking”) being more important than hardiness. Recognition and emphasis also that resilience is “both an individual and community property;” that finding and nurturing supportive community is indispensable to sustainability of rural practice.
Manahan, B. (2011). Eight suggestions for promoting physician well-being; Ways to make medicine more satisfying for doctors and better for their health. Minn Med, Jan. See HERE
- Second of two articles from the special issue of Minnesota Medicine on physician burnout/wellness. This is a very different article, not suggesting wellness practices per se, but rather some healthful and freeing perspectives on being a doctor and practicing medicine. “”View medicine as a calling, as well as a business.” “Emphasize both the art and the science of medicine.” “ Set realistic expectations about what medicine can do for patients.” “Accept illness and death as a normal part of life.” And several others.
Puchalski CM, Guenther M. (2012). Restoration and re-creation: spirituality in the lives of healthcare professionals. Curr Opin Support Palliat Care, 6(2):254-8. See HERE.
- Medicine and other healing professions as vocations. Spiritual reflection and development, “broadly defined,” can help clinicians to maintain the perspective and energy of their vocation and to be more resilient in the face of professional and personal challenges. Nice description of sixteen spiritual/reflective practices… mentors, group participation, reading of sacred texts, gratitude practices, journaling, the arts and others.
Shanafelt TD. (2009). Enhancing meaning at work: A prescription for preventing physician burnout and promoting patient-centered care. JAMA, 302(12), 1338-40.
- Editorial comments about meaning as powerful, individually-understood factor that promotes well-being among medical professionals. “Often centers on being a healer, developing expertise, being a teacher, or making scientific discoveries.”
Shanafelt TD, Novotny P. (2005). The well-being and personal wellness promotion strategies of medical oncologists in the North Central Cancer Treatment Group. Oncology, 68(1), 23-32.
- 241 oncologists; well-being associated with developing an approach/philosophy to dealing with death and end-of-life care, using recreation/hobbies/exercise, taking a positive outlook and incorporating a philosophy of balance between personal and professional life.
Shanafelt TD, Sloane, JA, Habermann, TM. (2003). The well-being of physicians. Am J Med, 114/April 15, 513-9.
- Reviews individual strategies employed by physicians, as well as institutional and organizational factors that can support physician well-being. See HERE.
Shanafelt TD, West CP et al. (2008). Principles to promote physician satisfaction and work-life balance. Minnesota Med, December, 41-3.
- Principles for professional satisfaction and work-life integration from the Mayo Clinic Department of Medicine: meaningful work; challenges commensurate with skills, interests and resources; opportunities for professional development; a culture that cultivates professionalism and professional satisfaction; autonomy and flexible scheduling; a culture that values and encourages life outside of work; and a culture of wellness.
Sotile WM, Sotile MO. (2002). The resilient physician: Effective emotional management for doctors and their medical organizations. AMA Press.
- Intrapersonal approaches to resilience for physicians, and interpersonal approaches to managing institutional challenges and creating positive interpersonal culture. Psychological consultant authors have published previous work (which they include here) on medical marriages.
Souba WW. (2002). Academic medicine and the search for meaning and purpose. Acad Med, 77(2):139-44.
- Case for “renewal of health care system” by having dialogue in under- and post-graduate medical education about what it means to be an academic physician and where one finds meaning and purpose. See HERE.
Stevenson AD, Phillips CB, Anderson KJ. (2011). Resilience among doctors who work in challenging areas: a qualitative study. Br J Gen Pract, 61(588). See HERE.
- Qualitative study in Australia with primary care physicians who work in areas of social disadvantage. Personal factors associated with resilience included commitment to social justice in choosing this work, appreciation and respect for patients, and abilities to create sustainable work arrangements. Also, mindset of being able to “celebrate small gains,” rather than being overwhelmed by enormity of social problems.
Swetz KM, Harrington SE et al. (2009). Strategies for avoiding burnout in hospice and palliative medicine: peer advice for physicians on achieving longevity and fulfillment. J Palliat Med, 12(9), 773-7.
- Wellness strategies of 40 hospice and palliative care physicians (in order of response); physical well-being, professional relationships, taking a transcendental perspective, talking with others, hobbies, clinical variety, personal relationships, personal boundaries, time away from work, passion for one's work, realistic expectations and use of humor and laughter, and remembering patients. See HERE
Tarantino B, Earley M, Audia D et al (2013). Qualitative and quantitative evaluation of a pilot integrative coping and resiliency program for healthcare professionals. EXPLORE, 9(1), 44-7.
- Beneficial outcomes for 84 participants (largely nurses and NPs) of “Healing Pathways” course, including Reiki, guided imagery, yoga, toning, meditation, intuitive scanning, creative expression and mentorship. See HERE.
Weiner, EL. (2001). A qualitative study of physicians’ own wellness promotion practices. WJM, 174/January, 19-23.
- Thematic analysis of survey responses points to relationships, religion or spirituality, self-care practices, work attitudes and value-based approaches to life. See HERE.
West CP, Dyrbye LN et al. (2009). Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals. J Gen Int Med, 24(12), 1318-21.
- Single item measures tell the tale as well as longer inventories. Emotional exhaustion; “I feel burned out from my work.” Depersonalization: “I have become more callous toward people since I took this job.” See HERE
Zwack J, Schweitzer J. (2013). If every fifth physician is affected by burnout, what about the other four? Resilience strategies of experienced physicians. Acad Med, 88(3), 382-9.
- Compilation of interview data from 200 physicians in Germany. “Job-related gratifications,” (e.g., pt relationships) “resilience practices” (e.g., meaningful contact with colleagues) and “resilience atti5tudes” (e.g., acceptance and self-awareness. Nice description and examples of the resilience practices and attitudes. See HERE.
Institute for the Study of Health and Illness, Meaning in Medicine. (http://www.meaninginmedicine.org/home.html).
- Portal for Rachel Naomi Remen initiatives… Meaning in Medicine, Arts and Healing, and related links.