No abstract

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.

Significantly more research is needed to further define and measure wellness. Program directors should consider multiple burnout and wellness factors associated with burnout (or its absence) when designing treatment interventions. The aim should be to identify and bolster wellness factors that protect from burnout while minimizing the stressors that cause it.

Burnout among physicians and physicians-in-training is well established as a potential threat to the health and well-being of health care providers and patients. However, there are myriad problems with current burnout research and its ongoing measurement that threaten the validity of the conclusions. For example, researchers have used differing ways of defining and measuring burnout. Those who have used the Maslach Burnout Inventory vary in recommended use of the instrument and cutoff scores. As a result, the authors suggest that the term "burnout" may be misused and recommend some reconsideration of the meaning of burnout. The measurement and discussion of burnout have strong implications for interventions and policy alike. In this article, the authors review the problems with burnout research and ask important questions about the future directions of research efforts. The authors recommend a consistent measurement approach and perhaps moving toward a focus on physician wellness from a positive psychology perspective.