The wellbeing of physicians continues to be a significant concern in the healthcare industry, according to a recent statement from the Medical Director Emeritus of the Colorado Physician Health Program (CPHP). The director noted that despite expectations among medical students and trainees that their professional environments would value and support them, many find that physician wellbeing is not prioritized by their workplaces.
CPHP first identified work stress and burnout among its participants in 1995. A study conducted by the organization in 1999-2000 found that most participants experienced serious work-related stress. At that time, few institutions recognized or addressed this issue within their physician communities, and there was little academic interest.
The situation began to change after research led by Tait Shanafelt at the Mayo Clinic linked work stress with suicidal thoughts among doctors and increased medical errors. This prompted some hospitals, health maintenance organizations (HMOs), workplaces, and malpractice carriers to encourage physicians to develop greater resilience. However, CPHP maintained that physicians were already highly resilient and did not lack this quality. The organization continued to study work stress and develop interventions aimed at helping physicians manage it.
Efforts also expanded to include principles of wellness and work-life balance. CPHP evaluates several areas of wellness—emotional, physical, occupational, intellectual, social, spiritual, and financial—and works with participants to strengthen these aspects. According to the director: “Most of our participants report they are helped by this help.” However, he added: “One of the most important things we’ve learned is how little is accomplished when we only address resilience and wellness.”
The director emphasized that internal resources alone are insufficient to overcome challenges posed by workplace environments. He cited recognition from Shanafelt’s group that these problems are systemic rather than individual shortcomings in resilience. While recommendations for workplace changes have been made, they are not often implemented.
Ownership of healthcare institutions has become increasingly concentrated among large corporations whose main focus is profit and efficiency—often defined as operating with minimal resources rather than actual effectiveness. The director recalled a time before the 1980s when healthcare was expected to incur costs out of a sense of humanity rather than profit.
He observed: “Now, the fewer and larger the health care companies, the further down the list of priorities is the welfare of doctors. There is no sign that the pendulum is swinging the other way.” He also pointed out studies showing diminished patient care quality under venture capital ownership but noted some exceptions exist among certain healthcare companies and clinics.
Wellness committees, chief wellness officers, and ongoing research into burnout prevention have become more common in recent years. CPHP collaborates with these groups but finds data on their effectiveness discouraging. Improvements in physician wellbeing resulting from such initiatives tend to be marginal compared to broader workplace challenges.
According to the director: “What is often characterized as a struggle between clinicians and administrators is oversimplified; it is really a struggle between ownership and everyone else, and rarely addressed.”
