Impact of coaching on physician wellness: A systematic review

Abstract

Physician wellness is critical for patient safety and quality of care. Coaching has been successfully and widely applied across many industries to enhance well-being but has only recently been considered for physicians. This review aimed to summarize the existing evidence on the effect of coaching by trained coaches on physician well-being, distress and burnout. MEDLINE, Embase, ERIC, PsycINFO and Web of Science were searched without language restrictions to December 21, 2022. Studies of any design were included if they involved physicians of any specialty undergoing coaching by trained coaches and assessed at least one measure along the wellness continuum. Pairs of independent reviewers determined reference eligibility. Risk of bias was assessed using the Cochrane Risk of Bias Tools for Randomized Controlled Trials (RCTs) and for Non-randomized Studies of Interventions (ROBINS-I). Meta-analysis was not possible due to heterogeneity in study design and outcome measures as well as inconsistent reporting. The search retrieved 2531 references, of which 14 were included (5 RCTs, 2 non-randomized controlled studies, 4 before-and-after studies, 2 mixed-methods studies, 1 qualitative study). There were 1099 participants across all included studies. Risk of bias was moderate or serious for non-RCTs, while the 5 RCTs were of lower risk. All quantitative studies reported effectiveness of coaching for at least one outcome assessed. The included qualitative study reported a perceived positive impact of coaching by participants. Evidence from available RCTs suggests coaching for physicians can improve well-being and reduce distress/burnout. Non-randomized interventional studies have similar findings but face many limitations. Consistent reporting and standardized outcome measures are needed.

Implementing coaching programmes for healthcare professionals—A review of the barriers and facilitators

“…Relevant characteristics of coaching interventions including publication details, study characteristics, occupational group, intervention, and outcome was extracted. Coaching is an evidence‐based intervention, 14 therefore, while outcome measures (e.g., effectiveness, feasibility, etc.) were extracted, they were not reported on, rather the focus lies with ‘type 3 evidence: implementation and context’ 33 .…”

“…For instance, randomised-control trials 12 show the role of coaching to prevent exhaustion and emotional distress 13 as well as to promote self-efficacy and work-life balance. 14 In the Cleveland Clinic, peer-based coaching was associated with improved physician retention, yielding a potential cost saving of 133 million dollars. 15 Given its dual-benefits, coaching is increasingly being viewed as an important tool to, 'shift organisational culture with a new narrative around meaning and purpose', 16 broadly aligning with O'Connor & Cavangh's 17 'ripple effect'.…”

“…Through efficacy research, coaching has demonstrated benefits on both an individual‐ and organisational‐level. For instance, randomised‐control trials 12 show the role of coaching to prevent exhaustion and emotional distress 13 as well as to promote self‐efficacy and work‐life balance 14 . In the Cleveland Clinic, peer‐based coaching was associated with improved physician retention, yielding a potential cost saving of 133 million dollars 15 .…”

Do physicians need tragic optimism?

“…Mindfulness is beneficial in increasing equanimity, for intra‐ and interpersonal skills and decreasing anxiety and perceived stress 1 . Coaching may be beneficial but needs further research 14 …”

ESA/ASA Jubilee Symposium Surgical Education

“…A 2023 systematic review of studies including surgeons and non-surgeons, trainees and physicians in practice found that coaching for physicians was associated with an improvement in wellness and reduction in burnout. 7 Many of these studies utilized professional coaches, often from outside of health care, which can be cost-prohibitive. However, surgeons are able to learn to use coaching principles to engage in coaching interactions with both trainees and peers.…”