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Original Article
Mar 2012

Physicians' Needs in Coping With Emotional Stressors: The Case for Peer Support

Author Affiliations

Author Affiliations: Beth Israel Deaconess Medical Center (Dr Hu), Center for Surgery and Public Health (Drs Hu, Lipsitz, and Greenberg and Mr Hevelone) and Center for Professionalism and Peer Support (Dr Shapiro), Brigham and Women's Hospital, and Mongan Institute for Health Policy, Massachusetts General Hospital (Dr Weissman), Boston; and University of Utah Hospital, Salt Lake City (Dr Fix).

Arch Surg. 2012;147(3):212-217. doi:10.1001/archsurg.2011.312

Objective To design an evidence-based intervention to address physician distress, based on the attitudes toward support among physicians at our hospital.

Design, Setting, and Participants A 56-item survey was administered to a convenience sample (n = 108) of resident and attending physicians at surgery, emergency medicine, and anesthesiology departmental conferences at a large tertiary care academic hospital.

Main Outcome Measures Likelihood of seeking support, perceived barriers, awareness of available services, sources of support, and experience with stress.

Results Among the resident and attending physicians, 79% experienced either a serious adverse patient event and/or a traumatic personal event within the preceding year. Willingness to seek support was reported for legal situations (72%), involvement in medical errors (67%), adverse patient events (63%), substance abuse (67%), physical illness (62%), mental illness (50%), and interpersonal conflict at work (50%). Barriers included lack of time (89%), uncertainty or difficulty with access (69%), concerns about lack of confidentiality (68%), negative impact on career (68%), and stigma (62%). Physician colleagues were the most popular potential sources of support (88%), outnumbering traditional mechanisms such as the employee assistance program (29%) and mental health professionals (48%). Based on these results, a one-on-one peer physician support program was incorporated into support services at our hospital.

Conclusions Despite the prevalence of stressful experiences and the desire for support among physicians, established services are underused. As colleagues are the most acceptable sources of support, we advocate peer support as the most effective way to address this sensitive but important issue.