On Physician Well Being: You’ll get by with a Little Help from your Friends

1. On Physician Well Being: You’ll get by with a Little Help from your Friends Jean E. Wallace(Department of Sociology) Jane Lemaire (Department of Medicine) University of Calgary

2. Presentation Learning Objectives • Demonstrating the utility of a mixed methods approach to studying physician well being • Identifying factors that positively and negatively affect physician well being • Appreciating the importance of physicians seeking help from others when they encounter stressful working conditions

3. Recent studies show: • Half of physicians are experiencing extremely stressful work or severe burnout • 17% report their mental health as fair or poor

4. Why are physician stress and burnout so high? • Doctors are not very good at looking after themselves • Doctors often cope by denial or avoidance • Doctors are not very good at seeking help from others • Doctors feel stigmatized by their colleagues if they need/seek help

5. To identify positive and negative determinants of physician well being To explore whether support from others buffers negative determinants of physician well being Purpose of the Study

6. What constitutes well being for practicing physicians? “…to have a quality of life, you have to have a life outside medicine. That’s the bottom line! [laughs]”

7. Interview Data and Methods • In-depth interviews with 54 members of the Department of Medicine (DOM) at the University of Calgary • Questions about quality of life, job satisfaction, stress and coping • Used to identify positive and negative determinants of physician well being

8. Questionnaire Data and Methods • Short questionnaire sent to all members of the DOM and residents (N=275) • We received 182 surveys (RR=66%) • Questions about job stress, coping, well being • Used to statistically test the impact of certain determinants of physician well being and whether support/resources buffer negative factors

9. Excessive work hours and work-to-family conflict Work overload and emotional stress/demands of patient care What factors are negatively related to physician well being?

10. “Oh, being at three places at once, so the time pressure of, you know, being late in clinic, having patients waiting. You’re an hour behind, they’re getting grumpy, you have to take a phone call, you can’t stay on schedule. Then the unpredictability of the workday, on the ends, so getting home on time, I find that most stressful.”

11. “The hours. My youngest son when he was about three-years old, he said to me one day “Mommy, I wish you were just a mommy and not a doctor”.”

12. “So patient care I think can be very stressful. And if you’re a conscientious doctor, it’s stressful -- have I made the right decision? The right diagnosis? The right treatment? And there’s always the guilt when people get a side effect.”

13. What factors are positively related to physician well being? • Support from spouse • Support from coworkers • Positive patient interactions

14. “I talk to my husband. He's a good person to talk to. If it's still at work, I'll talk to colleagues. We've got a really good group, three individual colleagues are good sources there, and then at home, my husband is a good source.”

15. “I think when I meet a sick patient, they are on the verge of life and death, at the end, from the work I do, I can discharge them home, they are happy and healthy. That’s like the happiest time in the job, in my professional life.”

16. Does support from others buffer the negative determinants on physician well being? Yes, especially support from spouse and coworkers, but also from positive patient interactions

17. Both positive & negative aspects of patient care are key Supportive coworkers and spouses are key Unexpected findings: work hours and work-to-family conflict appear unimportant Conclusions