Implementation of an Organization-Based Couples Health Promotion Program to Improve Physician Well-Being
Authors: Jessica M. Gold, Tait D. Shanafelt, Hanhan Wang, Jo Townson, Sherilyn Stolz, Nikitha Menon, Mickey Trockel
Journal: JAMA Network Open (2025)

Importance Physicians work long, often unpredictable hours and experience multiple work-related stressors, which may adversely affect their personal relationships. Objective To assess the associations of a couples’ workshop for physicians and their partners with burnout, self-valuation, and impact of work on personal relationships (IWPR). Design, Setting, and Participants In this cohort study, participants were grouped into an immediate intervention group and a delayed intervention control group, which were later compared. The participants in the intervention group gathered at a resort near Stanford University in October 2022, whereas the participants in the control group were invited to participate in a May 2023 workshop. Invited participants included Stanford Medicine physicians and their partners. Eligible physicians worked in a department or division considered frontline during the COVID-19 pandemic or had unfavorable IWPR scores on an institution-wide survey. The data were analyzed from June 14, 2024, to October 1, 2024. Intervention The intervention group participated in a 2-day workshop for couples and were offered 3 evening sessions. All sessions emphasized positive psychology principles and incorporated didactic, reflection, and unstructured content focused on strengthening relationships. Main Outcomes and Measures The main outcome was IWPR score, measured at baseline (immediately preceding the workshop for the intervention group and at registration for the control group) and 6 months later. IWPR was measured with a survey asking 4 questions about how work had affected personal relationships during the past year, and the responses included not at all true, somewhat true, moderately true, very true, and completely true (with scores assigned as 0, 1, 2, 3, and 4, respectively). Other outcome measures included burnout and self-valuation (with a lower score being favorable for burnout and a higher score being favorable for self-valuation). Results Of 47 intervention group participants and 69 control group participants, 22 (46.8%) and 40 (57.9%), respectively, were women ( P = .32). Paired assessments (at baseline and 6 months) were completed by 38 of 47 (80.9%) physicians in the intervention group and 53 of 69 (76.8%) in the control group. Between baseline and 6-month follow-up, participants in the intervention group showed a mean (SD) improvement of 1.59 (2.66) points (Cohen d = 0.54 [95% CI, 0.23-0.85]; P &amp;amp;lt; .001) in IWPR, 1.22 (1.47) points (Cohen d = 0.68 [95% CI, 0.39-0.98]; P &amp;amp;lt; .001) in burnout, and –1.25 points (2.09) (Cohen d = 0.68 [95% CI, –0.97 to –0.25]; P &amp;amp;lt; .001) in self-valuation. Statistically significant changes in these measures were not observed in the control participants. In mixed-effects modeling comparing the intervention and control groups, being in the intervention group was associated with a 1.25-point improvement in IWPR (Glass d = −0.45 [95% CI, −0.12 to −0.79]; P = .01), a 1.24-point improvement in burnout (Glass d = −0.70 [95% CI, −0.37 to −1.03]; P &amp;amp;lt; .001), and a 0.97-point improvement in self-valuation (Glass d = 0.47 [95% CI, 0.09-0.86]; P = .02). Conclusions and Relevance In this cohort study of an organizationally sponsored intervention consisting of a couples’ workshop designed to mitigate the adverse IWPR for physicians, participation was associated with statistically significant improvements in IWPR, burnout, and self-valuation. Further development of interventions to mitigate adverse IWPR among physicians is warranted.