Should physician wellness be a quality indicator?

Dr. Joanne L. PerronJoanne L. Perron, MD, District IX Committee on Physician Work-Life Balance co-chair

There is ample evidence that physician burnout, psychological distress, or mental illness and the factors that contribute to these states have significant adverse impacts on the delivery of quality health care and patient safety. The underlying contributory elements include long work hours, emotionally charged work environments, rapid shifts in the health care landscape, bureaucratic rigmarole, and, finally, organizational culture that does not promote or support physician self-care efforts.

How many of us have continued to work during chemotherapy, shortened our maternity leave, or grieved the loss of a loved one while on call? Who among us can say we have never resented a colleague who demonstrated self-care because it had an impact on our work load? Physicians are more likely to commit suicide than the general population and suffer significant rates of depression and substance abuse. Furthermore, physicians ignore their own regular preventive care and delay medical care or self-treat in urgent circumstances. If we recommend stress reduction, exercise, healthy eating, or allowing time to heal after illness or surgery for our patients, then why not for ourselves?

The health and wellness of physicians is paramount to effective and optimal patient care. So, shouldn’t it be valued as much as financial productivity and measured along with all the other quality indicators in a health system? The authors of a 2009 article in The Lancet believe it should. If you’re interested in learning more about this topic, I suggest you read the article: “Physician wellness: A missing quality indicator.”

There are validated instruments to measure burnout and standardized questionnaires that can measure wellbeing in a health care setting. To date, however, there is only preliminary research into specific strategies that improve physician wellbeing. One of those strategies being evaluated and showing promise is training physicians in mindfulness. The District IX Committee on Physician Work-Life Balance will promote seminars and presentations by internal and external experts over the next few years. We look forward to your interest and participation.

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