Research

Physician and healthcare professional well-being has been regularly featured in plenary sessions, workshops, and breakout sessions at the national meetings of a number of major professional societies. As a leader in physician well-being research, the WellMD & WellPhD Center has led or co-authored many recent studies and publications.

Publication Types

Foundational Original Research

Epidemiology of Occupational Well-being and Personal Consequences

Practicing Physicians

Menon, N. K., Shanafelt, T. D., Sinsky, C. A., Linzer, M., Carlasare, L., Brady, K. J. S., Stillman, M. J., & Trockel, M. T. (2020). Association of Physician Burnout With Suicidal Ideation and Medical Errors. JAMA Network Open, 3(12), e2028780–e2028780. https://doi.org/10.1001/jamanetworkopen.2020.28780

Shanafelt TD, West CP, Sinsky C, Trockel M, Tutty M, Satele DV, Carlasare LE, Dyrbye LN. Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2017. Mayo Clin Proc. 2019 Sep;94(9):1681-1694. https://pubmed.ncbi.nlm.nih.gov/30803733/

Shanafelt, T. D., Hasan, O., Hayes, S., Sinsky, C. A., Satele, D., Sloan, J., West, C. P., & Dyrbye, L. N. (2016). Parental satisfaction of U.S. physicians: Associated factors and comparison with the general U.S. working population. BMC Medical Education, 16(1), 228. https://doi.org/10.1186/s12909-016-0737-7

Oreskovich, M. R., Shanafelt, T., Dyrbye, L. N., Tan, L., Sotile, W., Satele, D., West, C. P., Sloan, J., & Boone, S. (2015). The prevalence of substance use disorders in American physicians. The American Journal on Addictions, 24(1), 30–38. https://doi.org/10.1111/ajad.12173

Dyrbye, L. N., Sotile, W., Boone, S., West, C. P., Tan, L., Satele, D., Sloan, J., Oreskovich, M., & Shanafelt, T. (2014). A survey of U.S. physicians and their partners regarding the impact of work-home conflict. Journal of General Internal Medicine, 29(1), 155–161. https://doi.org/10.1007/s11606-013-2581-3

Dyrbye, L. N., Varkey, P., Boone, S. L., Satele, D. V., Sloan, J. A., & Shanafelt, T. D. (2013). Physician satisfaction and burnout at different career stages. Mayo Clinic Proceedings, 88(12), 1358–1367. https://doi.org/10.1016/j.mayocp.2013.07.016

Shanafelt, T. D., Boone, S., Tan, L., Dyrbye, L. N., Sotile, W., Satele, D., West, C. P., Sloan, J., & Oreskovich, M. R. (2012). Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population. Archives of Internal Medicine, 172(18), 1377–1385. https://doi.org/10.1001/archinternmed.2012.3199

Dyrbye, L. N., West, C. P., Satele, D., Sloan, J. A., & Shanafelt, T. D. (2011). Work/Home conflict and burnout among academic internal medicine physicians. Archives of Internal Medicine, 171(13), 1207–1209. https://doi.org/10.1001/archinternmed.2011.289

Dyrbye, L. N., Shanafelt, T. D., Balch, C. M., Satele, D., Sloan, J., & Freischlag, J. (2011). Relationship between work-home conflicts and burnout among American surgeons: A comparison by sex. Archives of Surgery, 146(2), 211–217. https://doi.org/10.1001/archsurg.2010.310

Shanafelt, T. D., Balch, C. M., Dyrbye, L., Bechamps, G., Russell, T., Satele, D., Rummans, T., Swartz, K., Novotny, P. J., Sloan, J., & Oreskovich, M. R. (2011). Special report: Suicidal ideation among American surgeons. Archives of Surgery (Chicago, Ill.: 1960), 146(1), 54–62. https://doi.org/10.1001/archsurg.2010.292

Ahola, K., Väänänen, A., Koskinen, A., Kouvonen, A., & Shirom, A. (2010). Burnout as a predictor of all-cause mortality among industrial employees: A 10-year prospective register-linkage study. Journal of Psychosomatic Research, 69(1), 51–57. https://doi.org/10.1016/j.jpsychores.2010.01.002

Dyrbye, L. N., Thomas, M. R., Massie, F. S., Power, D. V., Eacker, A., Harper, W., Durning, S., Moutier, C., Szydlo, D. W., Novotny, P. J., Sloan, J. A., & Shanafelt, T. D. (2008). Burnout and Suicidal Ideation among U.S. Medical Students. Annals of Internal Medicine, 149(5), 334–341. https://doi.org/10.7326/0003-4819-149-5-200809020-00008

Physicians in Training

Ellis, R. J., Hewitt, D. B., Hu, Y.-Y., Johnson, J. K., Merkow, R. P., Yang, A. D., Potts, J. R., 3rd, Hoyt, D. B., Buyske, J., & Bilimoria, K. Y. (2019). An Empirical National Assessment of the Learning Environment and Factors Associated With Program Culture. Annals of Surgery, 270(4), 585–592. PubMed. https://doi.org/10.1097/SLA.0000000000003545

Desai, S. V., Asch, D. A., Bellini, L. M., Chaiyachati, K. H., Liu, M., Sternberg, A. L., Tonascia, J., Yeager, A. M., Asch, J. M., Katz, J. T., Basner, M., Bates, D. W., Bilimoria, K. Y., Dinges, D. F., Even-Shoshan, O., Shade, D. M., Silber, J. H., Small, D. S., Volpp, K. G., & Shea, J. A. (2018). Education Outcomes in a Duty-Hour Flexibility Trial in Internal Medicine. New England Journal of Medicine, 378(16), 1494–1508. https://doi.org/10.1056/NEJMoa1800965

Rotenstein, L. S., Ramos, M. A., Torre, M., Segal, J. B., Peluso, M. J., Guille, C., Sen, S., & Mata, D. A. (2016). Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: A systematic review and meta-analysis. Jama, 316(21), 2214–2236. https://doi.org/10.1001/jama.2016.17324

Dyrbye, L. N., Eacker, A., Durning, S. J., Brazeau, C., Moutier, C., Massie, F. S., Satele, D., Sloan, J. A., & Shanafelt, T. D. (2015). The impact of stigma and personal experiences on the help-seeking behaviors of medical students with burnout. Academic Medicine, 90(7), 961–969.

Brazeau, C. M., Shanafelt, T., Durning, S. J., Massie, F. S., Eacker, A., Moutier, C., Satele, D. V., Sloan, J. A., & Dyrbye, L. N. (2014). Distress among matriculating medical students relative to the general population. Academic Medicine : Journal of the Association of American Medical Colleges, 89(11), 1520–1525. https://doi.org/10.1097/ACM.0000000000000482

Volpp, K. G., Shea, J. A., Small, D. S., Basner, M., Zhu, J., Norton, L., Ecker, A., Novak, C., Bellini, L. M., Dine, C. J., Mollicone, D. J., & Dinges, D. F. (2012). Effect of a protected sleep period on hours slept during extended overnight in-hospital duty hours among medical interns: A randomized trial. JAMA, 308(21), 2208–2217. PubMed. https://doi.org/10.1001/jama.2012.34490

West, C. P., Shanafelt, T. D., & Kolars, J. C. (2011). Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. JAMA : The Journal of the American Medical Association, 306(9), 952–960. https://doi.org/10.1001/jama.2011.1247

Dyrbye, L. N., Massie, F. S., Eacker, A., Harper, W., Power, D., Durning, S. J., Thomas, M. R., Moutier, C., Satele, D., Sloan, J., & Shanafelt, T. D. (2010). Relationship between burnout and professional conduct and attitudes among US medical students. JAMA : The Journal of the American Medical Association, 304(11), 1173–1180. https://doi.org/10.1001/jama.2010.1318

Dyrbye, L. N., Thomas, M. R., Power, D. V., Durning, S., Moutier, C., Massie, F. S., Harper, W., Eacker, A., Szydlo, D. W., Sloan, J. A., & Shanafelt, T. D. (2010). Burnout and serious thoughts of dropping out of medical school: A multi-institutional study. Academic Medicine : Journal of the Association of American Medical Colleges, 85(1), 94–102. https://doi.org/10.1097/ACM.0b013e3181c46aad

Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2006). Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med, 81(4), 354–373. https://doi.org/10.1097/00001888-200604000-00009

Healthcare Quality and Economic Effects of Physician Well-being

Physician Well-being and Healthcare Quality

Trockel, M. T., Menon, N. K., Rowe, S. G., Stewart, M. T., Smith, R., Lu, M., Kim, P. K., Quinn, M. A., Lawrence, E., Marchalik, D., Farley, H., Normand, P., Felder, M., Dudley, J. C., & Shanafelt, T. D. (2020). Assessment of Physician Sleep and Wellness, Burnout, and Clinically Significant Medical Errors. JAMA Network Open, 3(12), e2028111–e2028111. https://doi.org/10.1001/jamanetworkopen.2020.28111

Welle, D., Trockel, M. T., Hamidi, M. S., Hickson, G. B., Menon, N. K., Shanafelt, T. D., & Cooper, W. O. (2020). Association of Occupational Distress and Sleep-Related Impairment in Physicians With Unsolicited Patient Complaints. Mayo Clinic Proceedings, 95(4), 719-726. https://doi.org/10.1016/j.mayocp.2019.09.025

Lemaire, J. B., Ewashina, D., Polachek, A. J., Dixit, J., & Yiu, V. (2018). Understanding how patients perceive physician wellness and its links to patient care: A qualitative study. PLOS ONE, 13(5), e0196888. https://doi.org/10.1371/journal.pone.0196888

Windover, A. K., Martinez, K., Mercer, M. B., Neuendorf, K., Boissy, A., & Rothberg, M. B. (2018). Correlates and Outcomes of Physician Burnout Within a Large Academic Medical Center. JAMA Intern Med, 178(6), 856–858. https://doi.org/10.1001/jamainternmed.2018.0019

Riskin, A., Erez, A., Foulk, T. A., Riskin-Geuz, K. S., Ziv, A., Sela, R., Pessach-Gelblum, L., & Bamberger, P. A. (2017). Rudeness and Medical Team Performance. Pediatrics, 139(2). https://doi.org/10.1542/peds.2016-2305

Welp, A., Meier, L. L., & Manser, T. (2014). Emotional exhaustion and workload predict clinician-rated and objective patient safety. Front Psychol, 5, 1573. https://doi.org/10.3389/fpsyg.2014.01573

Shanafelt TD, Balch CM, Bechamps G, Russell T, Dyrbye L, Satele D, Collicott P, Novotny PJ, Sloan J, Freischlag J. Burnout and medical errors among American surgeons. Ann Surg. 2010 Jun;251(6):995-1000. https://pubmed.ncbi.nlm.nih.gov/19934755/

Linzer, M., Manwell, L. B., Williams, E. S., Bobula, J. A., Brown, R. L., Varkey, A. B., Man, B., McMurray, J. E., Maguire, A., Horner-Ibler, B., & Schwartz, M. D. (2009). Working Conditions in Primary Care: Physician Reactions and Care Quality. Annals of Internal Medicine, 151(1), 28–36. https://doi.org/10.7326/0003-4819-151-1-200907070-00006

Halbesleben, J. R., & Rathert, C. (2008). Linking physician burnout and patient outcomes: Exploring the dyadic relationship between physicians and patients. Health Care Manage Rev, 33(1), 29–39. https://doi.org/10.1097/01.HMR.0000304493.87898.72

Grepmair, L., Mitterlehner, F., Loew, T., Bachler, E., Rother, W., & Nickel, M. (2007). Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: A randomized, double-blind, controlled study. Psychotherapy and psychosomatics, 76(6), 332-338. https://doi.org/10.1159/000107560

Jain, M., Miller, L., Belt, D., King, D., & Berwick, D. M. (2006). Decline in ICU adverse events, nosocomial infections and cost through a quality improvement initiative focusing on teamwork and culture change. Quality and Safety in Health Care, 15(4), 235. https://doi.org/10.1136/qshc.2005.016576

Taffinder, N. J., McManus, I. C., Gul, Y., Russell, R. C., & Darzi, A. (1998). Effect of sleep deprivation on surgeons’ dexterity on laparoscopy simulator. Lancet, 352(9135), 1191. https://doi.org/10.1016/s0140-6736(98)00034-8

Medical Student and Resident Well-being and Healthcare quality/outcomes

Pereira-Lima, K., Gupta, R. R., Guille, C., & Sen, S. (2019). Residency Program Factors Associated With Depressive Symptoms in Internal Medicine Interns: A Prospective Cohort Study. Academic Medicine : Journal of the Association of American Medical Colleges, 94(6), 869–875. PubMed. https://doi.org/10.1097/ACM.0000000000002567

Dyrbye, L. N., Burke, S. E., Hardeman, R. R., Herrin, J., Wittlin, N. M., Yeazel, M., Dovidio, J. F., Cunningham, B., White, R. O., Phelan, S. M., Satele, D. V., Shanafelt, T. D., & van Ryn, M. (2018). Association of Clinical Specialty With Symptoms of Burnout and Career Choice Regret Among US Resident Physicians. JAMA, 320(11), 1114–1130. https://doi.org/10.1001/jama.2018.12615

Mata, D. A., Ramos, M. A., Bansal, N., Khan, R., Guille, C., Di Angelantonio, E., & Sen, S. (2015). Prevalence of Depression and Depressive Symptoms Among Resident Physicians: A Systematic Review and Meta-analysis. JAMA, 314(22), 2373–2383. https://doi.org/10.1001/jama.2015.15845

Sen, S., Kranzler, H. R., Didwania, A. K., Schwartz, A. C., Amarnath, S., Kolars, J. C., Dalack, G. W., Nichols, B., & Guille, C. (2013). Effects of the 2011 duty hour reforms on interns and their patients: A prospective longitudinal cohort study. JAMA Internal Medicine, 173(8), 657–663. PubMed. https://doi.org/10.1001/jamainternmed.2013.351

Sen, S., Kranzler, H. R., Krystal, J. H., Speller, H., Chan, G., Gelernter, J., & Guille, C. (2010). A prospective cohort study investigating factors associated with depression during medical internship. Archives of General Psychiatry, 67(6), 557–565. https://doi.org/10.1001/archgenpsychiatry.2010.41

West, C. P., Tan, A. D., Habermann, T. M., Sloan, J. A., & Shanafelt, T. D. (2009). Association of resident fatigue and distress with perceived medical errors. JAMA : The Journal of the American Medical Association, 302(12), 1294–1300. https://doi.org/10.1001/jama.2009.1389

West, C. P., Huschka, M. M., Novotny, P. J., Sloan, J. A., Kolars, J. C., Habermann, T. M., & Shanafelt, T. D. (2006). Association of Perceived Medical Errors With Resident Distress and Empathy: A Prospective Longitudinal Study. JAMA, 296(9), 1071–1078. https://doi.org/10.1001/jama.296.9.1071

Bellini, L. M., Baime, M., & Shea, J. A. (2002). Variation of mood and empathy during internship. Jama, 287(23), 3143-6.

Shanafelt, T. D., Bradley, K. A., Wipf, J. E., & Back, A. L. (2002). Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med, 136(5), 358-67. https://doi.org/10.7326/0003-4819-136-5-200203050-00008

Physician Well-being and the Adequacy of the Physician Workforce

Windover, A. K., Martinez, K., Mercer, M. B., Neuendorf, K., Boissy, A., & Rothberg, M. B. (2018). Correlates and Outcomes of Physician Burnout Within a Large Academic Medical Center. JAMA Internal Medicine, 178(6), 856–858. https://doi.org/10.1001/jamainternmed.2018.0019

Sinsky, C. A., Dyrbye, L. N., West, C. P., Satele, D., Tutty, M., & Shanafelt, T. D. (2017). Professional Satisfaction and the Career Plans of US Physicians. Mayo Clinic Proceedings, 92(11), 1625–1635. https://doi.org/10.1016/j.mayocp.2017.08.017

Shanafelt, T. D., Mungo, M., Schmitgen, J., Storz, K. A., Reeves, D., Hayes, S. N., Sloan, J. A., Swensen, S. J., & Buskirk, S. J. (2016). Longitudinal Study Evaluating the Association Between Physician Burnout and Changes in Professional Work Effort. Mayo Clinic Proceedings, 91(4), 422–431. https://doi.org/10.1016/j.mayocp.2016.02.001

Shanafelt, T. D., Sinsky, C., Dyrbye, L. N., & West, C. P. (2016). Potential Impact of Burnout on the U.S. Physician Workforce. Mayo Clinic Proceedings, Nov;91(11):1667-1668. https://doi.org/10.1016/j.mayocp.2016.08.016

Physician Well-being and Healthcare Economics

Dyrbye, L. N., West, C. P., Hunderfund, A. L., Sinsky, C. A., Trockel, M., Tutty, M., Carlasare, L., Satele, D., & Shanafelt, T. (2020). Relationship Between Burnout, Professional Behaviors, and Cost-Conscious Attitudes Among US Physicians. Journal of General Internal Medicine, 35(5), 1465–1476. https://doi.org/10.1007/s11606-019-05376-x

Han, S., Shanafelt, T. D., Sinsky, C. A., Awad, K. M., Dyrbye, L. N., Fiscus, L. C., Trockel, M. & Goh, J. (2019). Estimating the attributable cost of physician burnout in the United States. Annals of internal medicine, 170(11), 784-790. https://doi.org/10.7326/M18-1422

Hamidi, M. S., Bohman, B., Sandborg, C., Smith-Coggins, R., de Vries, P., Albert, M. S., Murphy, M. L., Welle, D., & Trockel, M. T. (2018). Estimating institutional physician turnover attributable to self-reported burnout and associated financial burden: A case study. BMC Health Services Research, 18(1), 851. https://doi.org/10.1186/s12913-018-3663-z

Determinants of Physician Occupational Distress and Well-being

Demographic variables, cultural factors, medical practice policy and procedures, incentives, and payer mix

Personal and Demographic Factors Associated with Distress and Well-being

Garcia, L. C., Shanafelt, T. D., West, C. P., Sinsky, C. A., Trockel, M. T., Nedelec, L., Maldonado, Y. A., Tutty, M., Dyrbye, L. N., & Fassiotto, M. (2020). Burnout, Depression, Career Satisfaction, and Work-Life Integration by Physician Race/Ethnicity. JAMA Network Open, 3(8), e2012762–e2012762. https://doi.org/10.1001/jamanetworkopen.2020.12762

West, C. P., Dyrbye, L. N., Sinsky, C., Trockel, M., Tutty, M., Nedelec, L., Carlasare, L. E., & Shanafelt, T. D. (2020). Resilience and Burnout Among Physicians and the General US Working Population. JAMA Network Open, 3(7), e209385–e209385. https://doi.org/10.1001/jamanetworkopen.2020.9385

Lemaire, J. B., & Wallace, J. E. (2014). How physicians identify with predetermined personalities and links to perceived performance and wellness outcomes: A cross-sectional study. BMC Health Serv Res, 14, 616. https://doi.org/10.1186/s12913-014-0616-z

Gabbard, G. O. (1985). The role of compulsiveness in the normal physician. JAMA : The Journal of the American Medical Association, 254(20), 2926–2929. https://doi.org/10.1001/jama.1985.03360200078031

Practice Characteristics Associated with Distress and Well-being

Hu, Y.-Y., Ellis, R. J., Hewitt, D. B., Yang, A. D., Cheung, E. O., Moskowitz, J. T., Potts, J. R., Buyske, J., Hoyt, D. B., Nasca, T. J., & Bilimoria, K. Y. (2019). Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training. New England Journal of Medicine, 381(18), 1741–1752. https://doi.org/10.1056/NEJMsa1903759

Dyrbye, L., Herrin, J., West, C. P., Wittlin, N. M., Dovidio, J. F., Hardeman, R., Burke, S. E., Phelan, S., Onyeador, I. N., Cunningham, B., & van Ryn, M. (2019). Association of Racial Bias With Burnout Among Resident Physicians. JAMA Network Open, 2(7), e197457–e197457. https://doi.org/10.1001/jamanetworkopen.2019.7457

Sinsky, C., Colligan, L., Li, L., Prgomet, M., Reynolds, S., Goeders, L., Westbrook, J., Tutty, M., & Blike, G. (2016). Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties. Ann Intern Med. https://doi.org/10.7326/M16-0961

Shanafelt, T. D., Dyrbye, L. N., Sinsky, C., Hasan, O., Satele, D., Sloan, J., & West, C. P. (2016). Relationship Between Clerical Burden and Characteristics of the Electronic Environment With Physician Burnout and Professional Satisfaction. Mayo Clin Proc, 91(7), 836–848. https://doi.org/10.1016/j.mayocp.2016.05.007

Shanafelt, T. D., Gorringe, G., Menaker, R., Storz, K. A., Reeves, D., Buskirk, S. J., Sloan, J. A., & Swensen, S. J. (2015). Impact of Organizational Leadership on Physician Burnout and Satisfaction. Mayo Clinic Proceedings, 90(4), 432–440. https://doi.org/10.1016/j.mayocp.2015.01.012

Shanafelt, T. D., Wang, H., Leonard, M., Hawn, M., McKenna, Q., Majzun, R., Minor, L., & Trockel, M. (2021). Assessment of the Association of Leadership Behaviors of Supervising Physicians With Personal-Organizational Values Alignment Among Staff Physicians. JAMA Network Open, 4(2), e2035622–e2035622. https://doi.org/10.1001/jamanetworkopen.2020.35622

Sinsky, C. A., Willard-Grace, R., Schutzbank, A. M., Sinsky, T. A., Margolius, D., & Bodenheimer, T. (2013). In search of joy in practice: A report of 23 high-functioning primary care practices. Annals of Family Medicine, 11(3), 272–278. https://doi.org/10.1370/afm.1531

Balch, C. M., Oreskovich, M. R., Dyrbye, L. N., Colaiano, J. M., Satele, D. V., Sloan, J. A., & Shanafelt, T. D. (2011). Personal Consequences of Malpractice Lawsuits on American Surgeons. Journal of the American College of Surgeons, 213(5), 657–667. https://doi.org/10.1016/j.jamcollsurg.2011.08.005

Shanafelt, T. D., West, C. P., Sloan, J. A., Novotny, P. J., Poland, G. A., Menaker, R., Rummans, T. A., & Dyrbye, L. N. (2009). Career fit and burnout among academic faculty. Arch Intern Med, 169(10), 990–995. https://doi.org/10.1001/archinternmed.2009.70

Intervention Trials, Meta-analyses, and Systematic Reviews

Trials of Interventions to Promote Physician Well-being

Dyrbye, L. N., Shanafelt, T. D., Gill, P. R., Satele, D. V., & West, C. P. (2019). Effect of a Professional Coaching Intervention on the Well-being and Distress of Physicians: A Pilot Randomized Clinical Trial. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2019.2425

Mizumoto, R., Cristaudo, A. T., & Hendahewa, R. (2016). A surgeon-led model to improve operating theatre change-over time and overall efficiency: A randomised controlled trial. Int J Surg, 30, 83–89. https://doi.org/10.1016/j.ijsu.2016.04.033

Swensen, S., Kabcenell, A., & Shanafelt, T. (2016). Physician-Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience. Journal of Healthcare Management, 61(2), 105–127. https://doi.org/10.1097/00115514-201603000-00008.

Guille, C., Zhao, Z., Krystal, J., Nichols, B., Brady, K., & Sen, S. (2015). Web-Based Cognitive Behavioral Therapy Intervention for the Prevention of Suicidal Ideation in Medical Interns: A Randomized Clinical Trial. JAMA Psychiatry, 72(12), 1192–1198. https://doi.org/10.1001/jamapsychiatry.2015.1880

Amutio, A., Martínez-Taboada, C., Hermosilla, D., & Delgado, L. C. (2015). Enhancing relaxation states and positive emotions in physicians through a mindfulness training program: A one-year study. Psychology, Health & Medicine, 20(6), 720–731. https://doi.org/10.1080/13548506.2014.986143

Cheng, S.-T., Tsui, P. K., & Lam, J. H. M. (2015). Improving mental health in health care practitioners: Randomized controlled trial of a gratitude intervention. Journal of Consulting and Clinical Psychology, 83(1), 177–186. https://doi.org/10.1037/a0037895

Linzer, M., Poplau, S., Grossman, E., Varkey, A., Yale, S., Williams, E., Hicks, L., Brown, R. L., Wallock, J., Kohnhorst, D., & Barbouche, M. (2015). A Cluster Randomized Trial of Interventions to Improve Work Conditions and Clinician Burnout in Primary Care: Results from the Healthy Work Place (HWP) Study. Journal of General Internal Medicine, 30(8), 1105–1111. PubMed. https://doi.org/10.1007/s11606-015-3235-4

West, C., Dyrbye, L., Satele, D., & Shanafelt, T. (2015). A randomized controlled trial evaluating the effect of COMPASS (COlleagues Meeting to Promote and Sustain Satisfaction) small group sessions on physician well-being, meaning, and job satisfaction. J Gen Intern Med, 30(suppl 2), 45.

West, C. P., Dyrbye, L. N., Rabatin, J. T., Call, T. G., Davidson, J. H., Multari, A., Romanski, S. A., Hellyer, J. M., Sloan, J. A., & Shanafelt, T. D. (2014). Intervention to promote physician well-being, job satisfaction, and professionalism: A randomized clinical trial. JAMA Internal Medicine, 174(4), 527–533. https://doi.org/10.1001/jamainternmed.2013.14387

Shanafelt, T. D., Kaups, K. L., Nelson, H., Satele, D. V., Sloan, J. A., Oreskovich, M. R., & Dyrbye, L. N. (2014). An interactive individualized intervention to promote behavioral change to increase personal well-being in US surgeons. Annals of Surgery, 259(1), 82–88. https://doi.org/10.1097/SLA.0b013e3182a58fa4

Krasner, M. S., Epstein, R. M., Beckman, H., Suchman, A. L., Chapman, B., Mooney, C. J., & Quill, T. E. (2009). Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians. JAMA, 302(12), 1284–1293. https://doi.org/10.1001/jama.2009.1384

Systematic Reviews and Meta-analyses of Interventions to Promote Physician Well-being

Zhang, X., Song, Y., Jiang, T., Ding, N., & Shi, T. (2020). Interventions to reduce burnout of physicians and nurses: An overview of systematic reviews and meta-analyses. Medicine, 99(26). https://doi.org/10.1097/MD.0000000000020992

Scheepers, R. A., Emke, H., Epstein, R. M., & Lombarts, K. M. J. M. H. (2020). The impact of mindfulness-based interventions on doctors’ well-being and performance: A systematic review. Medical Education, 54(2), 138–149. https://doi.org/10.1111/medu.14020

Tawfik, D. S., Scheid, A., Profit, J., Shanafelt, T., Trockel, M., Adair, K. C., Sexton, J. B., & Ioannidis, J. P. A. (2019). Evidence Relating Health Care Provider Burnout and Quality of Care: A Systematic Review and Meta-analysis. Annals of Internal Medicine. https://doi.org/10.7326/M19-1152

Panagioti, M., Panagopoulou, E., Bower, P., Lewith, G., Kontopantelis, E., Chew-Graham, C., Dawson, S., Marwijk, H. van, Geraghty, K., & Esmail, A. (2017). Controlled Interventions to Reduce Burnout in Physicians: A Systematic Review and Meta-analysis. JAMA Internal Medicine, 177(2), 195–205. https://doi.org/10.1001/jernmed.2016.7674

Murray, M., Murray, L., & Donnelly, M. (2016). Systematic review of interventions to improve the psychological well-being of general practitioners. BMC Family Practice, 17(1), 36. https://doi.org/10.1186/s12875-016-0431-1

West, C. P., Dyrbye, L. N., Erwin, P. J., & Shanafelt, T. D. (2016). Interventions to prevent and reduce physician burnout: A systematic review and meta-analysis. Lancet, 388(10057), 2272–2281. https://doi.org/10.1016/S0140-6736(16)31279-X

Assessment of Physician Occupational Well-being

All Articles

Brady, K. J. S., & Trockel, M. T. (n.d.). Establishing a Cross-walk between Common Measures of Burnout. Under Review.

Trockel, M. T., Hamidi, M. S., Menon, N. K., Rowe, S. G., Dudley, J. C., Stewart, M. T., Geisler, C. Z., Bohman, B. D., & Shanafelt, T. D. (2019). Self-valuation: Attending to the Most Important Instrument in the Practice of Medicine. Mayo Clinic Proceedings, 94(10), 2022–2031. https://doi.org/10.1016/j.mayocp.2019.04.040 [NKM1]

Trockel, M., Bohman, B., Lesure, E., Hamidi, M. S., Welle, D., Roberts, L., & Shanafelt, T. (2018). A Brief Instrument to Assess Both Burnout and Professional Fulfillment in Physicians: Reliability and Validity, Including Correlation with Self-Reported Medical Errors, in a Sample of Resident and Practicing Physicians. Academic Psychiatry, 42(1), 11–24. https://doi.org/10.1007/s40596-017-0849-3

Brady, K. J. S., Trockel, M. T., Khan, C. T., Raj, K. S., Murphy, M. L., Bohman, B., Frank, E., Louie, A. K., & Roberts, L. W. (2018). What Do We Mean by Physician Wellness? A Systematic Review of Its Definition and Measurement. Academic Psychiatry: The Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, 42(1), 94–108. https://doi.org/10.1007/s40596-017-0781-6

Foundational Perspective Articles and Reviews

Physician Occupational Well-being and Quality of Patient Care

Kancherla Binal S., Upender Raghu, Collen Jacob F., Rishi Muhammad Adeel, Sullivan Shannon S., Ahmed Omer, Berneking Michael, Flynn-Evans Erin E., Peters Brandon R., Abbasi-Feinberg Fariha, Aurora R. Nisha, Carden Kelly A., Kirsch Douglas B., Kristo David A., Malhotra Raman K., Martin Jennifer L., Olson Eric J., Ramar Kannan, Rosen Carol L., … Gurubhagavatula Indira. (2020). Sleep, fatigue and burnout among physicians: An American Academy of Sleep Medicine position statement. Journal of Clinical Sleep Medicine, 16(5), 803–805. https://doi.org/10.5664/jcsm.8408

West, C. P., Dyrbye, L. N., & Shanafelt, T. D. (2018). Physician burnout: Contributors, consequences and solutions. J Intern Med, 283(6), 516–529. https://doi.org/10.1111/joim.12752

Gunderman, R. B. (2017). Poor care is the root of physician disengagement. NEJM Catalyst, 3(1). https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0553

Wallace, J. E., Lemaire, J. B., & Ghali, W. A. (2009). Physician wellness: a missing quality indicator. The Lancet, 374(9702), 1714-1721. https://doi.org/10.1016/S0140-6736(09)61424-0

Davis, M., Detre, T., Ford, D. E., Hansbrough, W., Hendin, H., Laszlo, J., Litts, D. A., Mann, J., Mansky, P. A., & Michels, R. (2003). Confronting depression and suicide in physicians: A consensus statement. JAMA, 289(23), 3161–3166. https://doi.org/10.1001/jama.289.23.3161

Making the Business Case to Improve Physician Well-being

Shanafelt, T., Swensen, S. J., Woody, J., Levin, J., & Lillie, J. (2018). Physician and Nurse Well-Being: Seven Things Hospital Boards Should Know. Journal of Healthcare Management, 63(6), 363–369. https://doi.org/10.1097/JHM-D-18-00209

Shanafelt, T., Goh, J., & Sinsky, C. (2017). The Business Case for Investing in Physician Well-being. JAMA Internal Medicine, 177(12), 1826–1832. https://doi.org/10.1001/jamainternmed.2017.4340

Organizational Approaches to Making Progress

Shanafelt Tait, Stolz Sherilyn, Springer Jill, Murphy Daniel, Bohman Bryan, & Trockel Mickey. (2020). A Blueprint for Organizational Strategies To Promote the Well-being of Health Care Professionals. NEJM Catalyst, 1(6). https://doi.org/10.1056/CAT.20.0266

Shanafelt, T., Ripp, J., & Trockel, M. (2020). Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. JAMA, 323(21), 2133–2134. https://doi.org/10.1001/jama.2020.5893

Ripp, J., & Shanafelt, T. (2020). The Health Care Chief Wellness Officer: What the Role Is and Is Not. Academic Medicine, 95(9), 1354–1358. https://doi.org/10.1097/ACM.0000000000003433

Grant, R. W., & Goitein, L. (2020). Primary Care Practitioners’ Perspectives on Burnout and What to Do About It. JAMA Internal Medicine, 180(3), 345–346. https://doi.org/10.1001/jamainternmed.2019.6322

Trockel, M., Corcoran, D., Minor, L. B., & Shanafelt, T. D. (2020). Advancing Physician Well-Being: A Population Health Framework. Mayo Clinic Proceedings. https://doi.org/10.1016/j.mayocp.2020.02.014

Menon, N. K., Trockel, M. T., Hamidi, M. S., & Shanafelt, T. D. (2019, November). Developing a portfolio to support physicians’ efforts to promote well-being: one piece of the puzzle. Mayo Clinic Proceedings, 94(11), 2171-2177. https://doi.org/10.1016/j.mayocp.2019.09.010

Shanafelt, T., Trockel, M., Ripp, J., Murphy, M. L., Sandborg, C., & Bohman, B. (2019). Building a Program on Well-Being: Key Design Considerations to Meet the Unique Needs of Each Organization. Academic Medicine, 94(2), 156–161. https://doi.org/10.1097/ACM.0000000000002415

National Academies of Sciences, Engineering, and Medicine; National Academy of Medicine; Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being, & Shanafelt, T. (2019). Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. National Academies Press (US). http://www.ncbi.nlm.nih.gov/books/NBK552618/

Shanafelt, T. D., Dyrbye, L. N., & West, C. P. (2017). Addressing Physician Burnout: The Way Forward. JAMA, 317(9), 901–902. https://doi.org/10.1001/jama.2017.0076

Shanafelt, T. D., & Noseworthy, J. H. (2017). Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout. Mayo Clinic Proceedings, 92(1), 129–146. https://doi.org/10.1016/j.mayocp.2016.10.004

Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry : Official Journal of the World Psychiatric Association, 15(2), 103–111. https://doi.org/10.1002/wps.20311

Shipman, S. A., & Sinsky, C. A. (2013). Expanding primary care capacity by reducing waste and improving the efficiency of care. Health Aff (Millwood), 32(11), 1990–1997. https://doi.org/10.1377/hlthaff.2013.0539

Bakker Arnold B. & Demerouti Evangelia. (2007). The Job Demands‐Resources model: State of the art. Journal of Managerial Psychology, 22(3), 309–328. https://doi.org/10.1108/02683940710733115

Leadership and Physician Well-being

Shanafelt, T., Trockel, M., Rodriguez, A., & Logan, D. (2020). Wellness-Centered Leadership: Equipping Health Care Leaders to Cultivate Physician Well-Being and Professional Fulfillment. Academic Medicine, Publish Ahead of Print. https://doi.org/10.1097/ACM.0000000000003907

Stoller, J. K. (2018). Developing Physician Leaders: A Perspective on Rationale, Current Experience, and Needs. Chest, 154(1), 16–20. https://doi.org/10.1016/j.chest.2017.12.014

Seppälä, E. (2016, April 8). Good Bosses Create More Wellness than Wellness Plans Do. Harvard Business Review, Organizational Culture. https://hbr.org/2016/04/good-bosses-create-more-wellness-than-wellness-plans-do

Lobas, J. G. (2006). Leadership in academic medicine: Capabilities and conditions for organizational success. The American Journal of Medicine, 119(7), 617–621. https://doi.org/10.1016/j.amjmed.2006.04.005

Souba, W. W. (2004). New ways of understanding and accomplishing leadership in academic medicine. Journal of Surgical Research, 117(2), 177–186. https://doi.org/10.1016/j.jss.2004.01.020

Changing Our Professional Culture

Shanafelt, T. D., Schein, E., Minor, L. B., Trockel, M., Schein, P., & Kirch, D. (2019). Healing the Professional Culture of Medicine. Mayo Clinic Proceedings, 94(8), 1556–1566. https://doi.org/10.1016/j.mayocp.2019.03.026

Bohman, B., Dyrbye, L., Sinsky, C., Linzer, M., Olson, K.., Babbott, S., Murphy, M., Purpur de

Vries, P., Hamidi, M., Trockel, M. (2017). Physician Well-being: the reciprocity of practice efficiency, culture of wellness and personal resilience, NEJM Catalyst, 3(4). https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0429

Valantine, H., & Sandborg, C. I. (2013). Changing the culture of academic medicine to eliminate the gender leadership gap: 50/50 by 2020. Academic Medicine : Journal of the Association of American Medical Colleges, 88(10), 1411–1413. https://doi.org/10.1097/ACM.0b013e3182a34952

Suchman, A. L. (2011). Organizations as machines, organizations as conversations: two core metaphors and their consequences. Medical Care, S43-S48. http://www.jstor.org/stable/23053720

Publications By Year

2021

Hlubocky, F. J., Symington, B. E., McFarland, D. C., Gallagher, C. M., Dragnev, K. H., Burke, J. M., Lee, R. T., El-Jawahri, A., Popp, B., Rosenberg, A. R., Thompson, M. A., Dizon, D. S., Srivastava, P., Patel, M. I., Kamal, A. H., Daugherty, C. K., Back, A. L., Dokucu, M. E., & Shanafelt, T. D. (2021). Impact of the COVID-19 Pandemic on Oncologist Burnout, Emotional Well-Being, and Moral Distress: Considerations for the Cancer Organization’s Response for Readiness, Mitigation, and Resilience. JCO Oncology Practice, OP.20.00937. https://doi.org/10.1200/OP.20.00937
Khorfan, R., Hu, Y.-Y., Agarwal, G., Eng, J., Riall, T., Choi, J., Are, C., Shanafelt, T., Bilimoria, K. Y., & Cheung, E. O. (2021). The Role of Personal Accomplishment in General Surgery Resident Wellbeing. Annals of Surgery. PubMed. https://doi.org/10.1097/sla.0000000000004768
Shanafelt, T. D., Wang, H., Leonard, M., Hawn, M., McKenna, Q., Majzun, R., Minor, L., & Trockel, M. (2021). Assessment of the Association of Leadership Behaviors of Supervising Physicians With Personal-Organizational Values Alignment Among Staff Physicians. JAMA Network Open, 4(2), e2035622–e2035622. https://doi.org/10.1001/jamanetworkopen.2020.35622

2020

Schwartz, R., Shanafelt, T. D., Gimmler, C., & Osterberg, L. (2020). Developing institutional infrastructure for physician wellness: Qualitative Insights from VA physicians. BMC Health Services Research, 20(1), 1–9. https://doi.org/10.1186/s12913-019-4783-9
Lehto, R. H., Heeter, C., Forman, J., Shanafelt, T., Kamal, A., Miller, P., & Paletta, M. (2020). Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective. International Journal of Environmental Research and Public Health, 17(17), 6147. https://doi.org/10.3390/ijerph17176147
Marshall, A. L., Dyrbye, L. N., Shanafelt, T. D., Sinsky, C. A., Satele, D., Trockel, M., Tutty, M., & West, C. P. (2020). Disparities in Burnout and Satisfaction With Work-Life Integration in U.S. Physicians by Gender and Practice Setting. Academic Medicine: Journal of the Association of American Medical Colleges, 95(9), 1435–1443. https://doi.org/10.1097/ACM.0000000000003521
Olson, K., Shanafelt, T., & Southwick, S. (2020). Pandemic-Driven Posttraumatic Growth for Organizations and Individuals. JAMA. https://doi.org/10.1001/jama.2020.20275
Dyrbye, L. N., West, C. P., Kelsey, E. A., Gossard, A. A., Satele, D., & Shanafelt, T. (2020). A national study of personal accomplishment, burnout, and satisfaction with work–life integration among advance practice nurses relative to other workers. Journal of the American Association of Nurse Practitioners, Online Now. https://doi.org/10.1097/JXX.0000000000000517
Ripp, J., & Shanafelt, T. (2020). In Reply to Egener. Academic Medicine, 95(11). https://doi.org/10.1097/ACM.0000000000003668
Shanafelt, T., Stolz, S., Springer J., Murphy, D., Bohman, B., & Trockel, M. (2020). A Blueprint for Organizational Strategies To Promote the Well-being of Health Care Professionals. NEJM Catalyst, 1(6). https://doi.org/10.1056/CAT.20.0266
Shanafelt, T., Farley, H., Wang, H., & Ripp, J. (2020). Responsibilities and Job Characteristics of Health Care Chief Wellness Officers in the United States. Mayo Clinic Proceedings, 95(11), 2563–2566. https://doi.org/10.1016/j.mayocp.2020.09.004
Fassiotto, M., Valantine, H., Shanafelt, T., & Maldonado, Y. (2020). Everyday Heroism: Maintaining Organizational Cultures of Wellness and Inclusive Excellence Amid Simultaneous Pandemics. Academic Medicine, Publish Ahead of Print. https://doi.org/10.1097/ACM.0000000000003905
Melnick, E. R., Harry, E., Sinsky, C. A., Dyrbye, L. N., Wang, H., Trockel, M. T., West, C. P., & Shanafelt, T. (2020). Perceived Electronic Health Record Usability as a Predictor of Task Load and Burnout Among US Physicians: Mediation Analysis. Journal of Medical Internet Research, 22(12), e23382. https://doi.org/10.2196/23382
Menon, N. K., Shanafelt, T. D., Sinsky, C. A., Linzer, M., Carlasare, L., Brady, K. J. S., Stillman, M. J., & Trockel, M. T. (2020). Association of Physician Burnout With Suicidal Ideation and Medical Errors. JAMA Network Open, 3(12), e2028780–e2028780. https://doi.org/10.1001/jamanetworkopen.2020.28780
Shanafelt, T., Trockel, M., Rodriguez, A., & Logan, D. (2020). Wellness-Centered Leadership: Equipping Health Care Leaders to Cultivate Physician Well-Being and Professional Fulfillment. Academic Medicine, Publish Ahead of Print. https://doi.org/10.1097/ACM.0000000000003907
Trockel, M. T., Menon, N. K., Rowe, S. G., Stewart, M. T., Smith, R., Lu, M., Kim, P. K., Quinn, M. A., Lawrence, E., Marchalik, D., Farley, H., Normand, P., Felder, M., Dudley, J. C., & Shanafelt, T. D. (2020). Assessment of Physician Sleep and Wellness, Burnout, and Clinically Significant Medical Errors. JAMA Network Open, 3(12), e2028111–e2028111. https://doi.org/10.1001/jamanetworkopen.2020.28111

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