Strategies Can Effectively Reduce Physician Burnout

Both individual-focused and structural or organizational strategies can result in clinically meaningful reductions in burnout among physicians, according to a new review and meta-analysis.

Researchers identified 2617 articles, of which 15 randomized trials including 716 physicians and 37 cohort studies with 2914 physicians met inclusion criteria. Across interventions, overall burnout rates decreased from 54% to 44%, emotional exhaustion score decreased from 23.82 points to 21.17 points, and depersonalization score decreased from 9.05 to 8.41. High emotional exhaustion rates decreased from 38% to 24%, and high depersonalization rates decreased from 38% to 34%.

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“I would not say there were any major surprises, but it is very reassuring to know that there are quite a number of proven, effective approaches in the literature to guide both individual physicians and organizations seeking to improve physician wellbeing and reduce burnout,” said study lead author Colin P. West, MD, PhD, FACP, divisions of general internal medicine and biomedical statistics and informatics, departments of internal medicine and health sciences research, Mayo Clinic, Rochester, Minnesota. “These solutions are not a cure-all, but they can have meaningful impact to improve physician wellbeing.”

The literature indicates that both individual-focused (including mindfulness training, stress management, and physician discussion groups) and structural or organizational strategies (including locally developed practice modifications and duty hour restrictions) can result in clinically meaningful reductions in burnout among physicians.

Having studied these issues for more than a decade, Dr West’s research team members are partnering with health care institutions and leadership organizations to expand their knowledge of these topics and help improve wellbeing across the medical profession, he said. They will continue to study the prevalence of, contributors to, and consequences of burnout, as well as interventions to address these problems.

For example, further research must establish which interventions are most effective in specific physician practices, as well as how individual and organizational solutions might be combined to deliver even greater improvements in physician wellbeing than those achieved with solutions involving only 1 of these categories, Dr West said. Further research on how long intervention effects are sustained also is needed.

“Burnout is prevalent, and front-line physicians such as those in primary care are at particularly high risk,” Dr West said. “The key take-home message for me is there are effective interventions out there. We need to grow the menu of options further, but we have a starting point and can make inroads now.”

—Mike Bederka

Reference:

West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis [published online September 28, 2016]. Lancet. doi:10.1016/S0140-6736(16)31279-X.