The Relationship Between Burnout and Help-Seeking Behaviors, Concerns, and Attitudes of Residents

Effects of compassion satisfaction, burnout, and secondary traumatic stress on current drug use among healthcare workers: Differences by occupational level

Work-related stress has been well-examined among physicians, but little is known about how it might affect drug use or healthcare workers in lower-wage occupations characterized by high job demands and low occupational autonomy (e.g., medical assistants, nursing assistants). We collected data from a diverse sample of healthcare workers (N = 200) and separately examined the cross-sectional relationships between several work-related experiences (i.e., compassion satisfaction, burnout, and secondary traumatic stress) and measures of current drug use (i.e., non-medical use of prescription drugs [NMUPD], cannabis use, and illicit drug use). We then examined for differences in these relationships by occupational level (i.e., prescriber/administrator vs. other healthcare worker). In main effects models, greater burnout and secondary traumatic stress were both associated with higher odds of NMUPD, cannabis use, and illicit drug use (ps < 0.01). Greater compassion satisfaction was associated with lower odds of illicit drug use (p < 0.05), but not with NMUPD or cannabis use (ps > 0.05). There was a significant interaction between secondary traumatic stress and occupational level on NMUPD (p < 0.05) such that there was no relationship among prescribers/administrators, but the likelihood of NMUPD increased with greater secondary traumatic stress among other healthcare workers. Similar trend-level interactions were observed between secondary traumatic stress and occupational level on cannabis use (p < 0.10) and between burnout and occupational level on NMUPD. Burnout and secondary traumatic stress may contribute to drug use, and lower-wage healthcare workers may be especially vulnerable.

Barriers to accessing mental health resources as perceived by surgical compared to medical trainees

INTRODUCTION

Despite myriad wellness programs, training demands restrict resident access. This study aimed to evaluate barriers to accessing mental health resources(MHR) and determine if differences exist between medical(MT) and surgical trainees(ST).

METHODS

A cross-sectional survey was performed in one health system assessing awareness of and barriers to accessing MHR. Subjects were either ST(general surgery/surgical subspecialty) or MT(internal medicine/specialty). Descriptive and univariate statistics were performed.

RESULTS

There were 87 responders(19 ​%); 55(63.2 ​%)MT and 32(36.8 ​%)ST, with a median age of 30 years(IQR29-33). Women comprised (44)55 ​%. Most trainees(62; 71 ​%) perceive availability of time as the biggest barrier to accessing MHR(27(85 ​%) ST vs 35(64 ​%) MT; p ​= ​0.04), and (20)63%ST couldn't find additional weekly time regardless of their mental/emotional state(vs 19(35 ​%)) MT, p ​= ​0.01). Trainees don't share vulnerable emotions to avoid appearing weak (54(51 ​%)). They demonstrate statistically significant poor self-compassion regarding MHR utilization.

CONCLUSIONS

Trainees' lack of time, internal stigma, and poor self-compassion are significant barriers to accessing MHR. More than MT, ST would not schedule counseling despite their emotional state. Understanding the barriers keeping residents from pursuing MHR provides direction for targeted wellness initiatives.

Exploring Health-Seeking Behaviors Among Healthcare Workers and the General Population During the COVID-19 Pandemic: A Retrospective Quantitative Study

Background/objectives

Mental health issues are prevalent among healthcare workers, but help-seeking behavior in this groups remains under-researched. The purpose of this study was to explore predictors of and barriers to mental health help-seeking among healthcare workers in Canada, compared to workers from other sectors.

Design

This quantitative study analyzed cross-sectional data from Mental Health Research Canada (MHRC) from October 2022 to January 2024.

Methods

The total sample consisted of 8,191 workers from various sectors, including 419 healthcare workers. We examined prevalence of help-seeking, barriers to accessing mental health support, and predictors of help seeking using descriptive and inferential statistics. A multivariate logistic regression analysis was performed to explore the relationship between sociodemographic factors and help-seeking.

Results

Healthcare workers were more likely to seek mental help support compared to workers from other sectors (OR 1.73, 95% CI: 1.35, 2.20). Healthcare workers least likely to seek mental health support were male (OR 0.58, CI 0.52, 0.66), residing in Quebec (OR 0.49, 95% CI: 0.41, 0.59), or of older age (OR 0.40, 95% CI: 0.30, 0.52). Key barriers to mental health help-seeking identified among healthcare workers included concerns about exposure to COVID-19 (33%), preference for self-management (25%), concerns about the safety of care options (18%), and lack of knowledge on how or where to seek help (13%).

Conclusions

This study provides valuable insight into the barriers and predictors of mental help-seeking behavior among healthcare workers. Findings underscore the need for workplaces to foster safe, supportive, and inclusive environments to better support healthcare workers facing mental health challenges.

Covid-19 pandemic-related changes in teleworking, emotional exhaustion, and occupational burnout: a cross-sectional analysis of a cohort study

BACKGROUND

The COVID-19 pandemic prompted significant shifts to teleworking, raising questions about potential impacts on employee wellbeing. This study examined the association between self-reported changes to teleworking frequency (relative to before the pandemic) and two indicators of occupational burnout: emotional exhaustion and professionally diagnosed burnout.

METHODS

Data were derived from two samples from a digital cohort study based in Geneva, Switzerland: one population-based, and one from a sample of workers who were likely mobilized in the early stages of the COVID-19 pandemic. Emotional exhaustion was measured using the Maslach Burnout Inventory (EE-MBI), while self-reported diagnosed burnout was assessed by asking participants if they had received a professional diagnosis of occupational burnout within the previous 12 months. Participants were categorized based on self-reported telework frequency changes: "no change," "increase," "decrease," "never telework," and "not possible to telework." Adjusted regression models for each of the study samples were used to estimate associations between telework changes and burnout outcomes, accounting for sociodemographic, household, and work-related factors.

RESULTS

In the population-based sample of salaried employees (n = 1,332), the median EE-MBI score was 14 (interquartile range: 6-24), and 7.3% reported diagnosed burnout. Compared to those reporting no change in telework frequency (19% of the sample), those reporting a decrease (4%) and those reporting that teleworking was not possible (28.7%) had significantly higher emotional exhaustion scores (adjusted beta (aβ) 5.26 [95% confidence interval: 1.47, 9.04] and aβ 3.51 [0.44, 6.59], respectively) and additionally reported higher odds of diagnosed burnout (adjusted odds ratio (aOR) 10.59 [3.24, 34.57] and aOR 3.42 [1.22, 9.65], respectively). "Increased" (28.9%) and "never" (19.4%) telework statuses were not significantly associated with burnout outcomes. These trends were mirrored in the "mobilized-workers" sample, with the exception that those reporting that teleworking was not possible did not report significantly higher odds of diagnosed burnout compared to those reporting no change in telework frequency.

CONCLUSIONS

Decreased teleworking frequency and not having the possibility of telework were associated with higher emotional exhaustion and diagnosed burnout. As organizations reconsider their telework policies in a post-pandemic era, they should consider the impact of such organizational changes on employee wellbeing.

Evaluating the Impact of Gender and Race on Otolaryngology Resident Experiences Across the United States

OBJECTIVE

Otolaryngology residents often encounter work-related stress and challenges during training. Sociodemographic factors influence experiences during residency; however, the impact of race and gender on otolaryngology trainee well-being during residency remains understudied.

STUDY DESIGN

Online survey.

SETTING

US residency programs.

METHODS

An anonymous online survey consisting of 59 multiple-choice questions was sent to 104 directors of Accreditation Council for Graduate Medical Education otolaryngology residency programs to distribute to residents. Respondents were queried regarding demographics and experiences with bias. Residents self-identified gender and race. Black, Hispanic/Latinx, Middle Eastern/North African, and multiracial residents were categorized as underrepresented minorities (URM).

RESULTS

Sixty-one US otolaryngology residents responded to the survey, the majority of whom were women (60.7%) and white (62%). Many residents endorsed a belief that receipt of research and training opportunities was negatively impacted by bias due to race (29.5%) or gender (45.9%). More women (27%) than men (13%) reported maximal burnout, and fewer men (17.4%) than women (40.5%) expressed low confidence in ability to independently care for patients. More male (47.8%) and white (31.6%) residents strongly agreed they were thriving. 94.6% of women and 33.3% of URM residents reported being mistaken for a nonphysician, compared to 0% of white male respondents.

CONCLUSION

Otolaryngology residents perceived differential treatment based on race and gender, with women and URM residents experiencing greater exclusion and bias, as well as increased misidentification and decreased ability to thrive. Future work includes increasing sample size for generalizability and developing interventions that uphold equity in residency training environments.

The privilege and the pressure: judges' and magistrates' reflections on the sources and impacts of stress in judicial work

There is growing evidence that judges and magistrates experience both high stress and high satisfaction in their work; however, the subjective experience of judicial stress and the cultural and professional factors shaping that experience remain largely unexamined. This qualitative study builds upon earlier quantitative research with the Australian judiciary, by exploring judges' and magistrates' perceptions of the sources and impacts of judicial stress and their ideas for court responses. Thematic analysis of 59 in-depth interviews with judicial officers from five Australian courts revealed eight themes pertaining to the better understanding and management of occupational stress within the judiciary. Implications for courts and individual judicial officers are discussed.

Effectiveness of mindfulness-based interventions on the well-being of healthcare workers: a systematic review and meta-analysis

BACKGROUND

Growing evidence attests to the efficacy of mindfulness-based interventions (MBIs), but their effectiveness for healthcare workers remains uncertain.

AIMS

To evaluate the evidence for MBIs in improving healthcare workers' psychological well-being.

METHODS

A systematic literature search was conducted on Medline, Embase, Cumulative Index for Nursing and Allied Health Literature, PsycINFO and Cochrane Central Register of Controlled Trials up to 31 August 2022 using the keywords 'healthcare worker', 'doctor', 'nurse', 'allied health', 'mindfulness', 'wellness', 'workshop' and 'program'. Randomised controlled trials with a defined MBI focusing on healthcare workers and quantitative outcome measures related to subjective or psychological well-being were eligible for inclusion. R V.4.0.3 was used for data analysis, with the standardised mean difference as the primary outcome, employing DerSimonian and Laird's random effects model. Grading of Recommendations, Assessment, Development and Evaluation framework was used to evaluate the quality of evidence. Cochrane's Risk of Bias 2 tool was used to assess the risk of bias in the included studies.

RESULTS

A total of 27 studies with 2506 participants were included, mostly from the USA, involving various healthcare professions. MBIs such as stress reduction programmes, apps, meditation and training showed small to large effects on anxiety, burnout, stress, depression, psychological distress and job strain outcomes of the participants. Positive effects were also seen in self-compassion, empathy, mindfulness and well-being. However, long-term outcomes (1 month or longer postintervention) varied, and the effects were not consistently sustained.

CONCLUSIONS

MBIs offer short-term benefits in reducing stress-related symptoms in healthcare workers. The review also highlights limitations such as intervention heterogeneity, reduced power in specific subgroup analyses and variable study quality.

PROSPERO REGISTRATION NUMBER

CRD42022353340.

The Stigma of Burnout Impeding Formal Help: A Qualitative Study Exploring Residents' Experiences During Training

Purpose

Burnout is an occupational stress syndrome that gives rise to emotional exhaustion (EE) depersonalization (DP) and reduced personal accomplishment (PA). Increasing rates of burnout among health care professionals has been reported globally. Saudi Arabia appears to be among the highest in prevalence with reports of higher than 70%. Medical residents in training are the highest group at risk. The literature has repeatedly linked burnout among residents with poor academic performance on training exams, impaired quality of life, career choice regret and intentions to abandon medicine. In this study, we explore the factors that contribute to resident burnout, their experiences with burnout and how they choose to mitigate it.

Methods

A qualitative design was used to conduct this study in the city of Riyadh, Saudi Arabia. A total of 14 residents from surgical and non-surgical programs were interviewed through in-depth interviews. Interpretive thematic analysis was used in coding and generated coding templates. Categories were repetitively reviewed and revised, expanding to include new data as it emerged and collapsing to remove redundant codes. Categories were organized into the final themes and sub-themes.

Results

All participants demonstrated a shared thread of shame in reaching the level of burnout. Three main interlinked themes were identified: Burnout stigma cycle, amalgamated causes of burnout and self-coping with burnout. One of the concerning findings in our study is the participants' pursuit of self-coping strategies and the avoidance of formal help, creating a cycle of suffering in silence.

Conclusion

The literature has repeatedly reported high levels of burnout among residents in training. This study has added another dimension to those findings through the exploration of residents actual accounts and appears to link burnout with suboptimal training and working conditions. We have highlighted the pivotal role stigma and shame play in completely preventing residents from seeking professional help.

Differential effects of healthcare worker burnout on psychotropic medication use and misuse by occupational level

PURPOSE

Burnout has been well examined among physicians and other high-wage, high-autonomy healthcare positions. However, lower-wage healthcare workers with less workplace autonomy (e.g., medical assistants, nurses' aides) represent a substantial proportion of the workforce, but remain understudied. We aimed to examine the effects of burnout on psychotropic medication use and misuse and whether these effects differed by occupational level.

METHODS

In March 2022, we collected data from a diverse sample of US healthcare workers (N = 200) and examined the cross-sectional relationship between burnout and changes in prescribed psychotropic medication (i.e., starting, stopping, and/or having a change in the dose/frequency) during the COVID-19 pandemic. We also separately examined the relationship between burnout and psychotropic medication misuse (i.e., without a prescription, in greater amounts, more often, longer than prescribed, and/or for a reason other than prescribed). We stratified models by occupational level (prescribers/healthcare administrators vs. other healthcare workers).

RESULTS

Greater burnout was associated with higher odds of changes in prescribed psychotropic medication among prescribers/healthcare administrators (aOR = 1.23, 95% CI 1.01, 1.48), but not among other healthcare workers (aOR = 1.04, 95% CI 0.98, 1.10). Greater burnout was not associated with psychotropic medication misuse among prescribers/healthcare administrators (aOR = 0.96, 95% CI 0.82, 1.12) but was associated with increased odds of psychotropic medication misuse among other healthcare workers (aOR = 1.07, 95% CI 1.01, 1.14).

CONCLUSIONS

Potential disparities in help-seeking and healthcare access might manifest in non-medical use of prescription drugs among some healthcare workers, which has implications for worker safety and well-being.

Interface Between Motivational Interviewing and Burnout

Background

The contemporary challenges of improving patient engagement in chronic disease management and addressing the growing problem of physician burnout are commonly viewed as separate issues. However, there is extensive evidence that person-centered approaches to patient engagement, such as motivational interviewing (MI), are associated both with better outcomes for patients and improved well-being for clinicians.

Methods

We conducted an exploratory survey study to ascertain whether resident physicians who perceive that they embrace and utilize the MI approach also report less burnout. A total of 318 residents in several specialties were invited via email to complete a 10-question survey about patient engagement and the experience of burnout. Frequencies and percentages were calculated for all categorical/ordinal variables to describe survey participants and question responses. Correlation coefficients were obtained to assess relationships between all burnout and engagement questions.

Results

A total of 79 residents completed the survey (response rate of 24.8%). There was broad agreement about the importance of patient engagement and the use of the MI approach, and approximately 60% of residents indicated that burnout was a problem. Two items related to residents' perceived use of MI were correlated with feeling a sense of personal accomplishment, one of the protective factors against burnout.

Conclusion

Consistent with other studies indicating that person-centered approaches are associated both with better patient outcomes and provider wellbeing, our data suggest that residents' self-reported use of the MI approach in patient care may be related to less burnout. It appears that training in the MI approach in graduate medical education may be simultaneously good for patient outcomes and good for resident well-being.

Otolaryngology resident familiarity with surgical instruments and preoperative setup: A pilot study

OBJECTIVE

This study was designed to determine otolaryngology (ORL) residents' ability to prepare the operating room independently for ORL surgical cases and their familiarity with ORL surgical instruments and related equipment.

METHODS

A 24-question, one-time, anonymous survey was distributed to otolaryngology-head and neck surgery program directors for distribution among their residents in the United States in November 2022. Residents in every post-graduate year were surveyed. Spearman's ranked correlation and Mann-Whitney U test were used.

RESULTS

The response rate among program directors was 9.5 % (11/116 programs), while the response rate among residents was 51.5 % (88/171 residents). A total of 88 survey responses were completed. 61 % of ORL residents who responded were able to name most instruments used in surgical cases. The most recognized surgical instruments by ORL residents were microdebrider (99 %) and alligator forceps (98 %); the least recognized were bellucci micro scissors (72 %) and pituitary forceps (52 %); and all instruments except the microdebrider showed significantly increased recognition with increasing post graduate training year (PGY), p ≤ 0.05. ORL residents were most able to set up independently the electrocautery (77 %) and laryngoscope suspension (73 %), while they were least able to set up the robot laser (6.8 %) and coblator (26 %) independently. All instruments showed significant positive correlations with increasing PGY; the strongest correlation was found in laryngoscope suspension, r = 0.74. 48 % of ORL residents reported that there were times when surgical techs and nurses were not available. Only 54 % of ORL residents reported being able to set up instruments when alone in the operating room, including 77.8 % of PGY-5 residents. Only 8 % of residents reported receiving education related to surgical instruments from their residency program, while 85 % thought that ORL residencies should have courses or educational materials about surgical instruments.

CONCLUSION

ORL residents' familiarity with surgical instruments and preoperative setup improved throughout their training. However, specific instruments had much lower recognition than others and a lower ability for independent setup. Nearly half of ORL residents reported being unable to set up surgical instruments in the absence of surgical staff. Implementation of surgical instrument education may improve these deficiencies.

Encouraging Mental Health Care in Family Medicine Residents

INTRODUCTION

Residency training is associated with stress and burnout that can contribute to poor mental health. However, residents are less likely to utilize mental health services due to perceived barriers such as lack of time and concerns about confidentiality, among others.1 There is a need to promote help-seeking behavior and improve access to mental health services during residency training.

METHODS

In order to decrease barriers to seeking mental health care and promote well-being among residents, the University of California Irvine Family Medicine Residency Program (UCI FMRP) implemented a program that included confidential, regular, mental health check-ins between residents and a psychiatrist. We gathered data on help-seeking behavior from an internally conducted electronic survey of 29 residents regarding perceived barriers to seeking mental health care in June, 2020.

RESULTS

The internal survey results from 24 respondents out of 29 residents demonstrated that the program supported help-seeking behavior among the residents, with 33% of the residents requesting additional sessions with the psychiatrist and another 13% seeking external mental health resources.

CONCLUSION

Providing additional, confidential, on-site support may be one method of decreasing stigma, increasing access to care, and normalizing conversations around mental health in residency.

A Perspective on Wellness in Anesthesiology Residency Programs: A Multi-Strategy Approach

Addressing resident wellness is an important topic given the high risk for burnout and depression in resident physicians compared with the general U.S. population. This article provides an overview of various approaches to help conceptualize and intervene on resident wellness, based on the 9-strategies framework to improve wellness laid out by Shanafelt and colleagues. This article outlines the most relevant literature in each strategy followed by the authors' experience within their anesthesiology residency program.

Proxy Detection of Resident Burnout by Program Directors and Domestic Partners

BACKGROUND

Resident burnout is associated with increased incidence of depression, suicide, and poor patient outcomes, yet identification of it is difficult. This study was designed to compare how well program directors (directors) and a resident's spouse or domestic partner (partner) can serve as a proxy to identify burnout in the resident.

STUDY DESIGN

An electronic survey, including the Maslach Burnout Inventory, was distributed to residents, their partners, and directors of all ACGME-accredited residencies at a single university-affiliated hospital. Burnout rates were compared with McNemar's test. Emotional exhaustion and depersonalization rates were compared with Spearman's correlation.

RESULTS

The response rate by respondent type was 33% (292 of 876) for residents, 48% (55 of 114) for partners, and 57% (13 of 23) for directors. Residents' self-reported burnout rate was 51% (148 of 292), while partners' proxy predicted burnout rate was 25% (14 of 55), and directors' was 5% (9 of 174). There was moderate correlation of partners' prediction of resident emotional exhaustion (ρ = 0.537, p < 0.01), depersonalization (ρ = 0.501, p < 0.01), and personal accomplishment (ρ = 0.416, p < 0.01). There was poor correlation of directors' prediction of residents' emotional exhaustion (ρ = 0.361, p < 0.01) and depersonalization (ρ = 0.223, p < 0.01). Partners had a 50% sensitivity, 94% specificity, 86% positive predictive value, and 71% negative predictive value in predicting resident burnout. Directors had a 6% sensitivity, 96% specificity, 56% positive predictive value, and 54% negative predictive value in predicting resident burnout.

CONCLUSIONS

Directors are not skilled in detecting burnout in their trainees. Partners are an underused group for detecting burnout and may represent an important target audience for awareness of available resources to benefit residents.

Accessibility to Digital Mental Health Services among the General Public throughout COVID-19: Trajectories, Influencing Factors and Association with Long-Term Mental Health Symptoms

Digital mental health services (DMHSs) have great potential for mitigating the mental health burden related to COVID-19, but public accessibility (ease of acquiring services when needed) to DMHSs during the pandemic is largely unknown. Accessibility to DMHSs was tracked longitudinally among a nationwide sample of 18,804 adults in China from before to one year after COVID-19 outbreak. Unconditional and conditional latent growth curve models and latent growth mixture models were fitted to explore the overall growth trend, influencing factors, and latent trajectory classes of accessibility to DMHSs throughout COVID-19. Generalized estimating equation models and generalized linear mixed models were employed to explore the association between accessibility to DMHSs and long-term mental health symptoms. We found that people generally reported increased difficulty in accessing DMHSs from before to one year after COVID-19 outbreak. Males, youngsters, individuals with low socioeconomic status, and individuals greatly affected by COVID-19 reported greater difficulty in accessing DMHSs. Four DMHS accessibility trajectory classes were identified: “lowest–great increase” (6.3%), “moderate low–slight increase” (44.4%), “moderate high–slight decrease” (18.1%) and “highest–great decrease” (31.2%). Trajectory classes reporting greater difficulty in accessing DMHSs were at higher risk for long-term mental symptoms. In conclusion, an overall increase in difficulty in accessing DMHSs is observed throughout COVID-19, and heterogeneity exists in DMHS accessibility trajectories. Our results suggest that easy access to DMHSs should be consistently facilitated. Moreover, access gaps should be reduced across demographic groups, and target populations for service allocation should alter as the pandemic evolves.

The Sustained Psychological Impact of the COVID-19 Pandemic on Health Care Workers One Year after the Outbreak-A Repeated Cross-Sectional Survey in a Tertiary Hospital of North-East Italy

This study aimed to evaluate the mental health outcomes of health care workers (HCWs) of the Verona academic hospital trust (Italy) one year after the outbreak of COVID-19 and to identify predicted risk factors. A web-based survey was conducted from mid-April to mid-May 2021 on hospital workers one year after the first evaluation performed during the lock-down phase of the COVID-19 pandemic. Post-traumatic stress, general anxiety, depression, and burnout were assessed by using, respectively, the impact of event scale (IES-R), the self-rating anxiety scale (SAS), the patient health questionnaire (PHQ-9) and the Maslach burnout inventory-general survey (MBI-GS). Multivariate logistic regression analysis was performed to identify factors associated with each of the four mental health outcomes one year after the COVID-19 outbreak. A total of 1033 HCWs participated. The percentage of HCWs scoring above the cut-off increased from 2020 to 2021 in all of the outcome domains (anxiety, 50.1% vs. 55.7, p < 0.05; depression, 26.6% vs. 40.6%, p < 0.001; burnout, 28.6% vs. 40.6%, p < 0.001; chi-square test), with the exception of post-traumatic distress. There was also an increase when stratifying by occupation and workplace, with a greater increase for depression and burnout. Multivariate analysis revealed that, one year after the COVID-19 outbreak, nurses were at the greatest risk of anxiety and depression, whereas residents were at the greatest risk of burnout (in terms of low professional efficacy). Working in intensive care units was associated with an increased risk of developing severe emotional exhaustion and a cynical attitude towards work.

Burnout and Perceptions of Stigma and Help-Seeking Behavior Among Pediatric Fellows

BACKGROUND AND OBJECTIVES

Although burnout has been studied extensively among students and residents, in few studies have researchers examined burnout among fellowship trainees. We measured burnout among fellows in our freestanding children's hospital and evaluated fellows' perceptions of stigma around (and willingness to seek treatment for) psychological distress. The objectives are as follows: to (1) measure burnout among pediatric fellows, (2) assess fellows' perceptions of stigma around help seeking for mental illness, and (3) examine the relationship between burnout and willingness to seek behavioral health counseling.

METHODS

We distributed a 48-item inventory to all 288 fellows in our pediatric center. Items included the Maslach Burnout Inventory and Likert-type matrices to assess attitudes toward behavioral health treatment and associated stigma. We used 2-sampled t-tests to associate burnout with willingness to seek mental health treatment.

RESULTS

A total of 152 fellows (52%) responded, of whom 53% met the threshold for burnout. Most reported believing that their program directors (78%), attending physicians (72%), and patients (82%) hold negative attitudes about mental illness and its treatment; 68% believed that employers would reject their application if they knew they sought counseling. Fellows with burnout were more likely to believe that others in the clinical learning environment hold negative views of help seeking for behavioral health (odds ratio 1.2-1.9).

CONCLUSIONS

Just over one-half of the pediatric fellows in our center meet the threshold for burnout. They also experience significant workplace-based stigma around help seeking for psychological distress. Fellows with burnout are more likely than their peers to perceive significant stigma around help seeking for their distress, making them a particularly at-risk learner population.

Seeking Help in the "Perfect Storm": Why Residents and Faculty Access an On-Site Wellness Program

Background

In the face of significant distress among physicians, access to counseling is critical.

Objective

An on-site wellness program for physicians-in-training and faculty was assessed by examining (a) were participants representative of those eligible for services and (b) demographic and trainee vs. faculty differences in burnout, distress, suicide risk, and presenting concerns of participants who utilized services.

Methods

From 2013–2018, 73% (N = 468; 316 residents/fellows, 152 faculty) of individuals seeking services also consented to research. At intake, participants completed a distress measure (ACORN) and two items from the Maslach Burnout Inventory (MBI), and clinicians categorized presenting concerns and suicide risk. Using Chi-square analyses, participants’ characteristics were compared to physicians eligible for treatment. The association between demographics, faculty vs. trainee status, specialty, and distress, burnout, suicide risk, and presenting concerns was evaluated with ANOVAs and logistic regressions.

Results

Women, trainees, and primary care physicians were more likely to access services. On the ACORN, 63% were in the clinical range (M =1.7, SD =0.6). On the MBI, 36% scored in the clinical range. Clinicians rated 9% of participants with suicide risk. Neither gender, racial/ethnic minority status, nor specialty were associated with distress, burnout or suicide risk. Trainees reported greater distress than faculty (F (1,447) = 8.42, P = .004, ηp2 = .018). Participants reported multiple presenting concerns (M = 3.0, SD = 1.18) with faculty more commonly endorsing work-related issues. Trainees more commonly reported new or worsening psychological symptoms, performance and family concerns.

Conclusions

Two physician groups which often report higher levels of burnout and distress when surveyed, women physicians and residents/fellows, were the most likely to get professional help in an on-site wellness program. Physician wellness programs need to be prepared to address work and personal stressors and different levels of distress and risk.