Developing institutional infrastructure for physician wellness: qualitative Insights from VA physicians
Abstract Background The prevalence and detrimental effect of physician burnout requires new strategies for supporting physicians. In this project, we describe the development, and assessment, of a “Balint-like” physician support group that provided social cohesion and delivered novel didactic curric...
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| Format: | Article |
| Language: | English |
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BMC
2020-01-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-019-4783-9 |
| _version_ | 1818727028168327168 |
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| author | Rachel Schwartz Tait D. Shanafelt Christophe Gimmler Lars Osterberg |
| author_facet | Rachel Schwartz Tait D. Shanafelt Christophe Gimmler Lars Osterberg |
| author_sort | Rachel Schwartz |
| collection | DOAJ |
| description | Abstract Background The prevalence and detrimental effect of physician burnout requires new strategies for supporting physicians. In this project, we describe the development, and assessment, of a “Balint-like” physician support group that provided social cohesion and delivered novel didactic curricula for building resilience. Methods The project began with a nine-month facilitated peer-support group for physicians that met every other week. Based on input from the first group, tailored content was developed to address physician wellness needs. These curricula were delivered to participants in the second nine-month Balint-like group. We then conducted semi-structured interviews with 7 hospitalists and 2 outpatient primary care physicians who participated in the Balint-like groups to explore the intervention’s value and to identify remaining unmet physician wellness needs. Using an inductive thematic analysis approach, we identified a set of institutional-, community- and individual-level factors affecting physician wellness and corresponding intervention opportunities. Results Physicians spoke of systems-level factors that contributed to distress, and proposed infrastructure, both physical and procedural, that they felt could better support physician wellness. They highlighted the emotional challenges of daily work, and the need for a forum by which to process these interactions in order to maintain their own wellness. Participants reported that participation in Balint-like groups provided this forum and served to help the physicians normalize struggles, reduce isolation and provide new strategies for navigating challenging interactions. Conclusions Institutional infrastructure, in the form of regular, psychologically-safe forums for processing with peers and learning relational strategies for preserving wellness, may mitigate physician distress. This project provides a model for how to develop and deliver a low-cost physician wellness program that can be tailored to the needs of individual clinical units. |
| first_indexed | 2024-12-17T22:07:35Z |
| format | Article |
| id | doaj.art-39f063468fb2494ea76645a023b846c7 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-17T22:07:35Z |
| publishDate | 2020-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-39f063468fb2494ea76645a023b846c72022-12-21T21:30:49ZengBMCBMC Health Services Research1472-69632020-01-012011910.1186/s12913-019-4783-9Developing institutional infrastructure for physician wellness: qualitative Insights from VA physiciansRachel Schwartz0Tait D. Shanafelt1Christophe Gimmler2Lars Osterberg3VA Palo Alto Health Care System, Center for Innovation to Implementation (Ci2i)WellMD and WellPhd Center, Stanford University School of MedicineStanford University School of MedicineStanford University School of MedicineAbstract Background The prevalence and detrimental effect of physician burnout requires new strategies for supporting physicians. In this project, we describe the development, and assessment, of a “Balint-like” physician support group that provided social cohesion and delivered novel didactic curricula for building resilience. Methods The project began with a nine-month facilitated peer-support group for physicians that met every other week. Based on input from the first group, tailored content was developed to address physician wellness needs. These curricula were delivered to participants in the second nine-month Balint-like group. We then conducted semi-structured interviews with 7 hospitalists and 2 outpatient primary care physicians who participated in the Balint-like groups to explore the intervention’s value and to identify remaining unmet physician wellness needs. Using an inductive thematic analysis approach, we identified a set of institutional-, community- and individual-level factors affecting physician wellness and corresponding intervention opportunities. Results Physicians spoke of systems-level factors that contributed to distress, and proposed infrastructure, both physical and procedural, that they felt could better support physician wellness. They highlighted the emotional challenges of daily work, and the need for a forum by which to process these interactions in order to maintain their own wellness. Participants reported that participation in Balint-like groups provided this forum and served to help the physicians normalize struggles, reduce isolation and provide new strategies for navigating challenging interactions. Conclusions Institutional infrastructure, in the form of regular, psychologically-safe forums for processing with peers and learning relational strategies for preserving wellness, may mitigate physician distress. This project provides a model for how to develop and deliver a low-cost physician wellness program that can be tailored to the needs of individual clinical units.https://doi.org/10.1186/s12913-019-4783-9Qualitative researchBalint groupBurnoutPhysician wellness |
| spellingShingle | Rachel Schwartz Tait D. Shanafelt Christophe Gimmler Lars Osterberg Developing institutional infrastructure for physician wellness: qualitative Insights from VA physicians BMC Health Services Research Qualitative research Balint group Burnout Physician wellness |
| title | Developing institutional infrastructure for physician wellness: qualitative Insights from VA physicians |
| title_full | Developing institutional infrastructure for physician wellness: qualitative Insights from VA physicians |
| title_fullStr | Developing institutional infrastructure for physician wellness: qualitative Insights from VA physicians |
| title_full_unstemmed | Developing institutional infrastructure for physician wellness: qualitative Insights from VA physicians |
| title_short | Developing institutional infrastructure for physician wellness: qualitative Insights from VA physicians |
| title_sort | developing institutional infrastructure for physician wellness qualitative insights from va physicians |
| topic | Qualitative research Balint group Burnout Physician wellness |
| url | https://doi.org/10.1186/s12913-019-4783-9 |
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