PHYSICIAN WELLNESS RESEARCH/SURVEYS
When we began our physician wellness efforts, it was apparent that assessment of physicians’ wellness status and contributing factors was necessary on a regular basis. Such evaluations help us to understand and to monitor the state of our medical staff and their most pressing concerns, as well as to provide a vehicle for assessing the effectiveness of pilot studies and creating evidence-based interventions.
To that end, our Director of Scholarship and Health Promotion, Mickey Trockel, MD, PhD, has led the development of two surveys to measure physician wellness and professional fulfillment: The Stanford Physician Wellness Survey and the Stanford House Staff Wellness Survey.
Creation of the Survey:
After review of existing survey options, and in conjunction with input from national experts on physician stress and wellness, a pilot survey was created by Dr. Trockel and his research team. This survey was taken by a sample of medical and house staff members, refined, and a shortened survey was then offered in 2013 to the entire medical staff.
For the 2016 survey new predictors of physician burnout and professional fulfillment were added and validated. This survey was then offered to the entire active medical staff at Stanford, allowing comparison of a subset who had taken both surveys.
Our survey focuses on the need for professional fulfillment rather than simply the avoidance of burnout. Some of the areas evaluated include perceived appreciation, personal/organization values alignment, peer supportiveness, perceived leadership support, control of schedule, Electronic Health Record experience, self-compassion, sleep-related impairment, and meaningfulness of clinical work. The 2016 survey also includes specific department leadership evaluations, and space for physicians to weigh and recommend promising interventions as actionable items.
Survey Dissemination at Stanford:
Results of each survey are shared with senior medical and hospital leadership, individual department chairs (reviewing in aggregate their department in comparison to other departments), and the entire medical staff. New for the 2016 survey, WellMD Center personnel will review these evaluations individually with department leaders and offer suggestions and resources.
In addition, a variety of projects have been undertaken at Stanford based on the results of the survey, including the creation of an official peer support program, a separate house staff wellness survey, and personal resilience training courses (such as Mindfulness-Based Stress Reduction) specifically geared for physicians. Surveys will be repeated periodically to monitor the ongoing state of the medical and housestaff and the impact of interventions.
Survey Dissemination Nationally:
Due to the interest in these surveys and in our desire to be a data repository for physician wellness, we have created a Physician Wellness Academic Consortium (PWAC) to support other academic institutions in their wellness needs. PWAC can assist medical organizations in longitudinal assessment of their medical providers and determination of internal need for interventions. The Consortium offers the survey to multiple provider types including medical staff, residents, fellows, nurse practitioners, and physician assistants.
Health for Healers Research Group:
This group brings together researchers and clinicians throughout Stanford who have an interest in physician wellness. Specific topics are discussed at monthly meetings, and have resulted in collaborative teams for a variety of projects including medical student stress reduction and reducing sleep impairment in physicians.