Background The existing literature either does not address physician wellness or defines it as a lack of burnout. The goal of this article is to call attention to this important gap in the literature and provide ideas for how to fill it. We need a culture change, and we propose that this change begin within graduate medical education. Methods We describe a case example of culture change and definitions of wellness at William Beaumont Hospitals, Troy Family Medicine Residency Program, a community-based, university-affiliated program in suburban Detroit, Michigan. Results We developed a toolbox of practical steps to create a culture that emphasizes wellness. We present a general timeline illustrating necessary steps toward accomplishing a true cultural change. Discussion The time has come for academic medicine to move beyond a simple discussion of physician burnout. To do this, we must first develop a shared definition of physician wellness followed by interventional strategies to bolster it. The benefits of cultural change include providing a more positive educational environment for residents and faculty, raising awareness of burnout and its symptoms, decreasing the stigma associated with admitting burnout symptoms, enabling the development of prevention strategies, and creating a more positive, strength-based approach to understanding the toll of physician-patient relationships on physicians.

The culture of medicine is undergoing revolutionary change. Physicians are pulled in many directions involving the practice of medicine, the business of medicine, and the technology of medicine. Financial incentives and career promotions may be dependent upon such things as patient satisfaction scores, as well as adherence to guidelines for admissions and diagnostic testing. Of course, these metrics are monitored closely by hospitals, insurance companies, and the federal government. The resultant seemingly endless paperwork, deadlines, and multiple demands may result in a sense of time famine for physicians. Unfortunately, these expectations and demands can subsequently diminish the passion for medicine. Moreover, physicians are at high risk for significant physical and emotional exhaustion, often leading to a sense of demoralization. Physicians can ultimately lose sight of their reasons for choosing the field of medicine. Indeed, they can lose the inspiration and "meaning" derived from work in medicine all together. How, then, does one buffer oneself against such perils, and maintain the original passion and meaning in a chosen career of service to others? This article will describe one program's approach to promoting resilience and maintaining meaning during the residency training years through the establishment of a Meaning in Family Medicine Group. The conceptual background, approach to curriculum development, goals and objectives, resident feedback, and suggestions about how to carry this curriculum beyond the residency training years will be discussed.

The profession of psychology has grown substantially over the last 20 years, yet throughout the United States, there are disparities in practice expansion. One notable disparity is in the domain of hospital practice. Why do psychologists lack parity in various hospital settings? The purpose of this article is to draw attention to the issue of professional inequities psychologists face in inpatient medical facilities, and to question why more has not been achieved. The article provides a theoretical foundation in support of full medical staff membership for psychologists, key principles or "how to" guide for obtaining medical staff membership, and a case example that describes an innovative, primary care solution that worked in a large hospital system. The article concludes with a frank look at obstacles that psychologists continue to face and discussion regarding how to navigate these barriers.

No abstract

No abstract