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Invited Commentary
April 2014

Physician Well-being: Addressing Downstream Effects, but Looking Upstream

Author Affiliations
  • 1Department of Pulmonary and Critical Care Medicine, Christus St Vincent Regional Medical Center, Santa Fe, New Mexico
JAMA Intern Med. 2014;174(4):533-534. doi:10.1001/jamainternmed.2013.13253

In this issue of JAMA Internal Medicine, West et al1 report results of a randomized clinical trial of an intervention to improve physicians’ psychological well-being. The intervention—a series of small-group discussions—showed success in 2 indicators of distress. But the results also constitute a warning about the growing demoralization of physicians.

The participants were 74 internal medicine physicians at the Mayo Clinic. West et al1 studied whether facilitated discussions in small groups, related to physician well-being and work experience, could reduce burnout and influence other measures of psychological health. (Burnout, characterized by a loss of enthusiasm for work, cynicism, and feelings of low accomplishment, is reported to affect almost half of US physicians.2) The physicians from both the intervention and control arms received 1 hour of paid time every 2 weeks, taken from clinical activities, to use for the discussions—or, in the control group, for any purpose they chose. The intervention lasted 9 months, with 1 year of follow-up.

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