Development of a Research Agenda to Identify Evidence-Based Strategies to Improve Physician Wellness and Reduce Burnout
Authors: Liselotte N. Dyrbye, Mickey Trockel, Erica Frank, Kristine Olson, Mark Linzer, Jane Lemaire, Stephen Swensen, Tait Shanafelt, Christine A. Sinsky
Journal: Annals of Internal Medicine (2017)

Ideas and Opinions16 May 2017Development of a Research Agenda to Identify Evidence-Based Strategies to Improve Physician Wellness and Reduce BurnoutLiselotte N. Dyrbye, MD, MHPE, Mickey Trockel, MD, PhD, Erica Frank, MD, MPH, Kristine Olson, MD, Mark Linzer, MD, Jane Lemaire, MD, Stephen Swensen, MD, MMM, Tait Shanafelt, MD, and Christine A. Sinsky, MDLiselotte N. Dyrbye, MD, MHPEFrom Mayo Clinic, Rochester, and Hennepin County Medical Center, Minneapolis, Minnesota; Stanford University, Stanford, California; University of British Columbia, Vancouver, British Columbia, Canada; Yale New Haven Hospital, New Haven, Connecticut; University of Calgary, Calgary, Alberta, Canada; and American Medical Association, Chicago, Illinois., Mickey Trockel, MD, PhDFrom Mayo Clinic, Rochester, and Hennepin County Medical Center, Minneapolis, Minnesota; Stanford University, Stanford, California; University of British Columbia, Vancouver, British Columbia, Canada; Yale New Haven Hospital, New Haven, Connecticut; University of Calgary, Calgary, Alberta, Canada; and American Medical Association, Chicago, Illinois., Erica Frank, MD, MPHFrom Mayo Clinic, Rochester, and Hennepin County Medical Center, Minneapolis, Minnesota; Stanford University, Stanford, California; University of British Columbia, Vancouver, British Columbia, Canada; Yale New Haven Hospital, New Haven, Connecticut; University of Calgary, Calgary, Alberta, Canada; and American Medical Association, Chicago, Illinois., Kristine Olson, MDFrom Mayo Clinic, Rochester, and Hennepin County Medical Center, Minneapolis, Minnesota; Stanford University, Stanford, California; University of British Columbia, Vancouver, British Columbia, Canada; Yale New Haven Hospital, New Haven, Connecticut; University of Calgary, Calgary, Alberta, Canada; and American Medical Association, Chicago, Illinois., Mark Linzer, MDFrom Mayo Clinic, Rochester, and Hennepin County Medical Center, Minneapolis, Minnesota; Stanford University, Stanford, California; University of British Columbia, Vancouver, British Columbia, Canada; Yale New Haven Hospital, New Haven, Connecticut; University of Calgary, Calgary, Alberta, Canada; and American Medical Association, Chicago, Illinois., Jane Lemaire, MDFrom Mayo Clinic, Rochester, and Hennepin County Medical Center, Minneapolis, Minnesota; Stanford University, Stanford, California; University of British Columbia, Vancouver, British Columbia, Canada; Yale New Haven Hospital, New Haven, Connecticut; University of Calgary, Calgary, Alberta, Canada; and American Medical Association, Chicago, Illinois., Stephen Swensen, MD, MMMFrom Mayo Clinic, Rochester, and Hennepin County Medical Center, Minneapolis, Minnesota; Stanford University, Stanford, California; University of British Columbia, Vancouver, British Columbia, Canada; Yale New Haven Hospital, New Haven, Connecticut; University of Calgary, Calgary, Alberta, Canada; and American Medical Association, Chicago, Illinois., Tait Shanafelt, MDFrom Mayo Clinic, Rochester, and Hennepin County Medical Center, Minneapolis, Minnesota; Stanford University, Stanford, California; University of British Columbia, Vancouver, British Columbia, Canada; Yale New Haven Hospital, New Haven, Connecticut; University of Calgary, Calgary, Alberta, Canada; and American Medical Association, Chicago, Illinois., and Christine A. Sinsky, MDFrom Mayo Clinic, Rochester, and Hennepin County Medical Center, Minneapolis, Minnesota; Stanford University, Stanford, California; University of British Columbia, Vancouver, British Columbia, Canada; Yale New Haven Hospital, New Haven, Connecticut; University of Calgary, Calgary, Alberta, Canada; and American Medical Association, Chicago, Illinois.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-2956 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Physician burnout, a syndrome characterized by emotional exhaustion, depersonalization, and decreased professional effectiveness, seems to be increasing (1, 2). A 2011 study involving more than 7000 physicians found that 41% had burnout and that burnout was more prevalent among physicians than the general U.S. working population (3). A 2014 follow-up study found that burnout rates had increased in physicians from all specialties, without similar changes in U.S. workers overall, suggesting that the increase has not paralleled general societal changes (1). Evidence-based strategies are needed to address this challenge. Few trials have evaluated interventions to reduce physician burnout (2), many questions ...References1. Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc. 2015;90:1600-13. [PMID: 26653297] doi:10.1016/j.mayocp.2015.08.023 CrossrefMedlineGoogle Scholar2. West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016;388:2272-81. [PMID: 27692469] doi:10.1016/S0140-6736(16)31279-X CrossrefMedlineGoogle Scholar3. Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172:1377-85. [PMID: 22911330] CrossrefMedlineGoogle Scholar4. Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet. 2009;374:1714-21. [PMID: 19914516] doi:10.1016/S0140-6736(09)61424-0 CrossrefMedlineGoogle Scholar5. Bodenheimer T, Sinsky C. From triple to quadruple aim: care of the patient requires care of the provider. Ann Fam Med. 2014;12:573-6. [PMID: 25384822] doi:10.1370/afm.1713 CrossrefMedlineGoogle Scholar6. Shanafelt TD, Mungo M, Schmitgen J, et al. Longitudinal study evaluating the association between physician burnout and changes in professional work effort. Mayo Clin Proc. 2016;91:422-31. [PMID: 27046522] doi:10.1016/j.mayocp.2016.02.001 CrossrefMedlineGoogle Scholar7. Erickson SM, Rockwern B, Koltov M; Medical Practice and Quality Committee of the American College of Physicians. Putting patients first by reducing administrative tasks in health care: a position paper of the American College of Physicians. Ann Intern Med. 2017. [Epub ahead of print]. doi:10.7326/M16-2697 LinkGoogle Scholar8. Shanafelt TD, Noseworthy JH. Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. Mayo Clin Proc. 2017;92:129-46. [PMID: 27871627] doi:10.1016/j.mayocp.2016.10.004 CrossrefMedlineGoogle Scholar9. Dyrbye LN, Satele D, Sloan J, Shanafelt TD. Utility of a brief screening tool to identify physicians in distress. J Gen Intern Med. 2013;28:421-7. [PMID: 23129161] doi:10.1007/s11606-012-2252-9 CrossrefMedlineGoogle Scholar10. Linzer M, Poplau S, Babbott S, et al. Worklife and wellness in academic general internal medicine: results from a national survey. J Gen Intern Med. 2016;31:1004-10. [PMID: 27138425] doi:10.1007/s11606-016-3720-4 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Mayo Clinic, Rochester, and Hennepin County Medical Center, Minneapolis, Minnesota; Stanford University, Stanford, California; University of British Columbia, Vancouver, British Columbia, Canada; Yale New Haven Hospital, New Haven, Connecticut; University of Calgary, Calgary, Alberta, Canada; and American Medical Association, Chicago, Illinois.Acknowledgment: The authors thank the members of the Joy in Medicine Research Summit (Appendix).Financial Support: The Physicians Foundation gave financial support to the American Medical Association meeting as well as to this article.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-2956.Corresponding Author: Liselotte N. Dyrbye, MD, MHPE, 200 First Street Southwest, Rochester, MN 55905; e-mail, dyrbye.[email protected]edu.Current Author Addresses: Drs. Dyrbye, Swensen, and Shanafelt: 200 First Street Southwest, Rochester, MN 55905.Dr. Trockel: 2749 Carolina Avenue, Redwood City, CA 94061.Dr. Frank: 3164 Dolphin Drive, Nanoose Bay, British Columbia V9P 9J2, Canada.Dr. Olson: 51 Lawncrest Road, New Haven, CT 06515.Dr. Linzer: Hennepin County Medical Center (Purple 7), 701 Park Avenue South, Minneapolis, MN 55415.Dr. Lemaire: University of Calgary, Health Sciences Centre, 3330 Hospital Drive Northwest, Calgary, Alberta T2N 4N1, Canada.Dr. Sinsky: 330 North Wabash Avenue, Suite 39300, Chicago, IL 60611.Author Contributions: Conception and design: L.N. Dyrbye, M. Trockel, E. Frank, S. Swensen, T. Shanafelt, C.A. Sinsky.Analysis and interpretation of the data: K. Olson, J. Lemaire.Drafting of the article: L.N. Dyrbye, M. Linzer, C.A. Sinsky.Critical revision for important intellectual content: L.N. Dyrbye, M. Trockel, E. Frank, M. Linzer, J. Lemaire, S. Swensen, T. Shanafelt, C.A. Sinsky.Final approval of the article: L.N. Dyrbye, M. Trockel, E. Frank, K. Olson, M. Linzer, J. Lemaire, S. Swensen, T. Shanafelt, C.A. Sinsky.Administrative, technical, or logistic support: L.N. Dyrbye.Collection and assembly of data: L.N. Dyrbye, K. Olson, M. Linzer, J. Lemaire.This article was published at Annals.org on 18 April 2017. 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