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An Interactive Individualized Intervention to Promote Behavioral Change to Increase Personal Well-Being in US Surgeons

Shanafelt, Tait D. MD*; Kaups, Krista L. MD, MSc; Nelson, Heidi MD*; Satele, Daniel V. BS*; Sloan, Jeff A. PhD*; Oreskovich, Michael R. MD; Dyrbye, Lotte N. MD*

doi: 10.1097/SLA.0b013e3182a58fa4
Original Articles

Objective: Evaluate the utility of a computer-based, interactive, and individualized intervention for promoting well-being in US surgeons.

Background: Distress and burnout are common among US surgeons. Surgeons experiencing distress are unlikely to seek help on their own initiative. A belief that distress and burnout are a normal part of being a physician and lack of awareness of distress level relative to colleagues may contribute to this problem.

Methods: Surgeons who were members of the American College of Surgeons were invited to participate in an intervention study. Participating surgeons completed a 3-step, interactive, electronic intervention. First, surgeons subjectively assessed their well-being relative to colleagues. Second, surgeons completed the 7-item Mayo Clinic Physician Well-Being Index and received objective, individualized feedback about their well-being relative to national physician norms. Third, surgeons evaluated the usefulness of the feedback and whether they intended to make specific changes as a result.

Results: A total of 1150 US surgeons volunteered to participate in the study. Surgeons' subjective assessment of their well-being relative to colleagues was poor. A majority of surgeons (89.2%) believed that their well-being was at or above average, including 70.5% with scores in the bottom 30% relative to national norms. After receiving objective, individualized feedback based on the Mayo Clinic Physician Well-Being Index score, 46.6% of surgeons indicated that they intended to make specific changes as a result. Surgeons with lower well-being scores were more likely to make changes in each dimension assessed (all Ps < 0.001).

Conclusions: US surgeons do not reliably calibrate their level of distress. After self-assessment and individualized feedback using the Mayo Clinic Physician Well-Being Index, half of participating surgeons reported that they were contemplating behavioral changes to improve personal well-being.

We evaluated the utility of a computer-based, interactive, and individualized intervention, based on the Mayo Clinic Physician Well-Being Index (MPWBI), in US surgeons. The results indicate that surgeons do not reliably calibrate their own distress. After objective, individualized feedback on their well-being using the MPWBI, 47% of surgeons indicated that they intended to make specific changes to improve personal well-being.

*Mayo Clinic, Rochester, MN

University of California, San Francisco Fresno; and

University of Washington, Seattle

Reprints: Tait D. Shanafelt, MD, Mayo Clinic, 200 1st St SW # W4, Rochester, MN 55905. E-mail: shanafelt.tait@mayo.edu.

Supported by funding from the National Institutes of Health (ACOSOG CCOP U10 CA149950), the American College of Surgeons, and the Mayo Clinic Department of Medicine Program on Physician Well-Being.

Disclosure: T. Shanafelt and L. Dyrbye developed both the Medical Student Well-Being Index and Mayo Clinic Physician Well-Being Index. Mayo Clinic holds the copyright on these technologies and accordingly Mayo Clinic and Drs Shanafelt and Dyrbye have a potential financial interest in these technologies. The Medical Student Well-Being Index has been licensed to a commercial entity, although no royalties have been received to date. To obtain permission to use the index, please contact the corresponding author. The authors declare no conflicts of interest.

© 2014 by Lippincott Williams & Wilkins.