More research is needed to support physicians' mental health, experts say

Researchers who have led work on stress, depression and wellbeing in physicians say progress is being made but more can be done, including addressing key research questions

doctor with head and neck in hands sitting down seeming depressed or stressed
Getty Images

Written by Kristen Drew, Medical University of South Carolina

It’s critical for hospital systems and medical schools to implement a set of established, evidence-based strategies in order to address the crisis in physician wellbeing, a team from the Medical University of South Carolina and the University of Michigan writes in a new article in the New England Journal of Medicine.

“This is really about the future of health care,” said Constance Guille, M.D., a professor in the department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina. 

“We need to think about what we’re doing now in order to create the healthiest workforce moving forward.”

Guille co-authored the review article with Srijan Sen, M.D., Ph.D.,  the Eisenberg Professor of Depression and Neurosciences at the University of Michigan Medical School, entitled “Burnout, Depression, and Diminished WellBeing among Physicians.” 

The article takes inventory of the physician wellbeing research and efforts to date, and provides a clear path for how healthcare systems can improve physician health and advance the research that is needed to propel the field forward. 

The authors and their teams have spent more than almost two decades studying the mental and physical health of over 28,000 physicians in their first year of post-medical school training, through the Intern Health Study

The study has helped to identify workload as the strongest and most consistent factor associated with wellbeing. 

The study has also identified other key drivers of resident depression and developed interventions to improve wellbeing.

SEE ALSO: Is it fixable? 

Sen, who is the director of the Eisenberg Family Depression Center at U-M, said, “The fundamental problem is that we are asking too few physicians to do too much work. In the population of resident physicians, reforms over the past 15 years have substantially reduced work hours. We have found that this work hour reduction has facilitated meaningful improvement in wellbeing. We believe further efforts to reduce workload and work hours is the key further wellbeing improvement among residents and among the broader physician population.”   

In addition to policies to reduce workload, the authors recommend policies that facilitate timely, confidential and accessible mental health treatment for physicians. 

We believe further efforts to reduce workload and work hours is the key further well-being improvement among residents and among the broader physician population."

-Srijan Sen, M.D., Ph.D.

The review also found that physicians in underrepresented groups, such as women and those from minority racial and ethnic groups, face distinctive stressors that affect wellbeing, such as discrimination, harassment, sexism and racism in medicine. 

Policies supporting changes in culture are needed to improve physician well-being and attract and retain the workforce to meet the needs of patients.   

SEE ALSO: The data says we need to talk about physician mental health early 

“Women and minorities need to be in the conversation about how we move forward because their experiences vary,” Guille said. 

“They are disproportionately affected by work-family conflict and institutional and individual discrimination that minorities and underrepresented groups face. Their perspective is critical in creating a healthier workplace and in turn better patient care,” Guille said. 

Many health systems have made efforts in recent years to improve physician well-being, largely related to reducing workloads and fostering a supportive culture. 

For example, MUSC and U-M have added nonphysician team members to complete tasks previously completed by physicians (e.g., entering information into patients’ electronic health records). 

The health systems have also appointed chief wellbeing officers to coordinate and enhance programs for physicians and other members of the health care workforce. 

Despite the progress, Guille and Sen say there is still much work to be done to ensure the wellbeing of physicians. 

Here are the next steps the authors recommend all health systems take:

  • Implement and prioritize interventions that target work hours and workload
  • Eliminate policies that discourage physicians from seeking treatment for mental health or substance use disorders
  • Implement policies and programs that improve parental and caregiving leave and increase access to childcare
  • Implement policies that support diversity, equity and inclusion and that target sexism and racism in medicine

In parallel, there is a need for greater scientific rigor in the field of physician burnout and wellbeing. 

Next steps for researchers are to employ valid assessments of wellbeing and depression, determine effective implementation and dissemination strategies for established interventions and develop and evaluate new targeted interventions to improve wellbeing for all physicians.

Sen said, “Our research on physicians in what is considered the most stressful year of a medical career can inform efforts to support physicians throughout their work lives, at a time when our nation needs them more than ever.”

Paper cited:Burnout, Depression, and Diminished Well-Being among Physicians,” NEJM. DOI: 10.1056/NEJMra2302878 

Sign up for Health Lab newsletters today. Get medical tips from top experts and learn about new scientific discoveries every week.

Sign up for the Health Lab PodcastAdd us wherever you listen to your favorite shows. 


More Articles About: Depression Health Care Delivery, Policy and Economics Graduate and postdoctoral education Mental Health Future Think All Research Topics
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of health care news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

In This Story
user Srijan Sen

Center Director

Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories Microscope
Health Lab
Nerve damage reduced in prediabetic mice with diet, exercise
A low calorie diet and high intensity exercise can reduce nerve damage in prediabetic mice, according to a Michigan Medicine study.
frozen dial with ice on it with red dial
Health Lab
Enzyme identified as new therapeutic target for “cold” tumors
A study identifies an enzyme as a new therapeutic target for “cold” tumors.
On left, a young boy in a wheelchair has his doctor standing to his left and his parent is standing to his right in a show of support. On the right side of the image, the boy is now an adult and is wondering about the cost of his care and if his questions will be answered.
Health Lab
Changing the definition of cerebral palsy
Cerebral palsy is defined as a childhood disorder, which fails to recognize adults living with the condition and the lack of care they receive once they age out of pediatric clinics.
kid screaming with fire coming out of mouth with smoke all around in grey and teddy bear panicked and parents legs on floor as if passed out or blown away
Health Lab
Does your child manage anger well?
One in seven parents think their child gets angrier than peers of the same age and four in 10 say their child has experienced negative consequences when angry, a national poll suggests. 
baby laying down with stethoscope over chest doctors hands
Health Lab
Comparing life threatening illness risk between two surgeries for infants with congenital heart disease
Newly presented data suggest that infants who receive a hybrid stage I palliation – a less invasive alternative for initial treatment – more commonly develop necrotizing enterocolitis compared to those who receive the standard Norwood operation, a complex open heart surgery.
pigs sick and chickens in background with blue background and green cells floating around
Health Lab
Why the bird flu’s jump to pigs is concerning
A Michigan Medicine virologist speaks about the implications of H5N1 influenza, or bird flu, and whether a new pandemic could be on the horizon.