Physician wellness is key to a quality health care system

Posted November 17, 2009
By Jordanna Heller

When doctors are sick, tired or burnt out, the performance of a health-care system may not be at its best. University of Calgary scientists describe the consequences unwell physicians have for health systems and why those systems should routinely measure physician wellness. Their work is published in the most recent edition of the leading international medical journal, The Lancet.

“Traditionally health-care organizations assess their performance using patient-based indicators of quality of care, such as post-operative survival rates.” says lead author Jean Wallace, PhD, a sociology professor in the Faculty of Social Sciences and member of the Calgary Institute for Population and Public Health (CIPPH) at the Faculty of Medicine. “We are proposing a paradigm shift by introducing physician wellness as a necessary quality indicator of a health care system.”

In their work, called a narrative review, Wallace along with co-authors Drs. Jane Lemaire and William Ghali assessed the work stresses faced by physicians, the barriers to attending to their wellness, the harmful consequences of unwell physicians to physicians themselves, their patients and health care systems, and made suggestions about how to change things.

“Because the practice of medicine is very stressful, the risk of ill health for physicians is very high” says Lemaire, an internist and clinical professor in the Department of Medicine. “There is ample evidence that excessive work stress and burnout may lead to substance abuse, relationship problems, depression and even death for physicians.  Despite these serious consequences, physicians are not always able to tend to many of their wellness needs”. 

“There is growing evidence that unwell physicians may negatively impact health care systems in many ways including workplace productivity and efficiency and quality of patient care and patient safety” says Ghali, also an internist, and a professor in the Departments of Medicine and Community Health Science member of CIPPH. “We need to develop valid and reliable measures of physician wellness and gather evidence about how best to intervene if suboptimal performance is identified.”

Wallace, Lemaire and Ghali reviewed over 100 high calibre scientific studies from around the world to reach their conclusions. Wallace and Lemaire’s physician wellness research and program development benefit from ongoing support and collaboration with Alberta Health Services (AHS) and the University of Calgary. During the writing of this review, Wallace was supported with a Killam Resident Fellowship.

Link to the review:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61424-0/fulltext

Link to the podcast interview with lead author Jean Wallace, PhD:
http://podcast.thelancet.com/audio/lancet/2009/9702_14november.mp3