An interactive individualized intervention to promote behavioral change to increase personal well-being in US surgeons

Abstract

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.

FIGURE 1

Example of individualized feedback provided to surgeons completing the online self-assessment using the MPWBI. QOL indicates quality of life.

FIGURE 2

Distribution of MPWBI scores. The figure shows the distribution of MPWBI scores (x axis) of the participating surgeons (dark gray bars; n=1150) relative to a normative sample of approximately 7000 US physicians (light gray bars). Higher scores indicate greater levels of distress. MPWBI indicates Mayo Physician Well-Being Index.

FIGURE 3

Feedback regarding well-being relative other physicians and intent to make changes to promote well-being. MPWBI scores are shown on the x axis (higher scores indicate greater levels of distress). The proportion of surgeons who indicated they were considering making changes to reduce burnout (A), reduce fatigue (B), promote work-life balance (C), and promote career satisfaction (D) as a direct result of the individualized feedback received is shown on the y axis of each figure. Feedback of higher levels of distress relative to physician norms was correlated with higher likelihood of considering making changes in each dimension. MPWBI indicates Mayo Physician Well-Being Index; WLB, work-life balance.

FIGURE 4

MPWBI score and intent to make changes. MPWBI scores are shown on the x axis (higher scores indicate greater levels of distress) of each figure. A, The proportion of surgeons who indicated they were considering making changes in at least 1 of the 4 dimensions assessed (Fig. 3) as a direct result of the individualized feedback they received is shown on the y axis. B, The median number of changes (range = 1–4) being considered is shown on the y axis. MPWBI indicates Mayo Physician Well-Being Index.