Update on Addressing Mental Health and Burnout in Physicians: What Is the Role for Psychiatry?

被引:20
作者
McFarland, Daniel C. [1 ]
Hlubocky, Fay [2 ]
Riba, Michelle [3 ]
机构
[1] Mem Sloan Kettering Canc Ctr, Dept Psychiat & Behav Sci, 641 Lexington Ave, New York, NY 10604 USA
[2] Univ Chicago, Dept Med, Hematol Oncol Sect, Ctr Comprehens Canc, Chicago, IL 60637 USA
[3] Univ Michigan, Dept Psychiat, Rogel Canc Ctr, Ann Arbor, MI 48109 USA
关键词
Burnout; Depression; Psychiatry; Physician mental health; Physicians; Suicide; Empathy; JOB-SATISFACTION; SUICIDE; PROFESSIONALS; PREVALENCE; DEPRESSION; STRESS; RISK; PERCEPTION; ENGAGEMENT; MORTALITY;
D O I
10.1007/s11920-019-1100-6
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Purpose of Review To highlight an emerging understanding of burnout and physician mental health. This review will provide a discussion of conceptual and diagnostic issues of the burnout syndrome with its relevance to psychiatry, and how psychiatry may interface with other medical disciplines to provide support in creating burnout prevention and treatment programs. Recent Findings Descriptive data of burnout correlations and risk factors are available while an understanding of burnout best practices is lacking but growing. Two recent meta-analyses provide efficacy data along with key subgroup analyses that point to greater efficacy among systemic/organizational over individual level interventions. Among individual interventions, groups work better than individual therapy and the incorporation of Mindfulness-Based Stress Reduction and/or Cognitive Behavioral Therapy modalities provide greater efficacy over other therapies. Ultimately, addressing burnout will be an iterative process specific to institutional cultures and therefore should be thought of as quality improvement initiatives involving leadership to adopt the quadruple aim of physician wellness and to seek institution-specific collaboration and feedback. Psychiatry is uniquely positioned to help change institutional cultures regarding the burnout syndrome, which has been labeled a national crisis. Combinatorial strategies that combine efficacious individual-level interventions with systemic-level interventions that enhance workflow will likely provide the most sustainable model for preventing and treating burnout. Psychiatry should be involved, especially at the level of the liaison psychiatrist to assist with how these types of interventions may be best implemented in specific institutions.
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页数:8
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