Physician wellbeing programs: a means of control
In January, the American College of Surgeons announced its new surgeon well-being initiative. It has lofty goals:
[The ACS] recognizes the need to foster well-being, resilience, and work-life integration for all surgeons, regardless of their career stage. Fostering the growth of both the surgical expertise and the person as a whole is paramount.
On the face of it, this sounds awesome—resilience, well-being, work-life integration, and fostering growth of the person as a whole.
It also feels tremendously necessary. An exceptionally large proportion of physicians hate their jobs: nearly half of all US physicians plan to leave their current practice in the next three years, and, of these, nearly half plan to leave medicine altogether, for good. Over 60% of physicians are burnt out, a proportion that has gone through the roof since the start of the Covid-19 pandemic (that number was 40% in 2018).
It gets worse.
Fifty-five percent of physicians have known someone who has considered, attempted, or died by suicide, and 20% of physicians report knowing someone who has fallen into these categories just since the pandemic began. Every year, between 300 and 400 physicians in the US will commit suicide, which is twice the rate of suicide in the national population.
Medicine is a difficult, and often depressing, profession, a fact the pandemic has only exacerbated. It’s no surprise, then, that scientific interest in physician wellness has grown exponentially in the last thirty years:
Against this backdrop, the ACS initiative feels welcome and desperately needed.
There’s precious little evidence that physician wellness programs work
Unfortunately, physician wellness programs don’t work. At least, not in the way you’d hope they do, not in a way that increases actual physician wellness.
Let’s start with the data, which isn’t great. In a study of the effects of a wellness initiative at a large training center in Texas, Bisgaard, et al, found no statistically significant improvement in…