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Effect of a Professional Coaching Intervention on the Well-being and Distress of PhysiciansA Pilot Randomized Clinical Trial

Educational Objective
To explore the effect of individualized coaching on the well-being of physicians.
1 Credit CME
Key Points

Question  Does professional coaching result in measurable reductions in burnout and measurable improvements in quality of life, resilience, job satisfaction, engagement, and fulfillment in physicians?

Findings  In this pilot randomized clinical trial of 88 physicians, participants who received professional coaching had a significant reduction in emotional exhaustion and overall symptoms of burnout, as well as improvements in overall quality of life and resilience.

Meaning  Professional coaching may be an effective strategy to reduce burnout and improve well-being for physicians.

Abstract

Importance  Burnout symptoms among physicians are common and have potentially serious ramifications for physicians and their patients. Randomized studies testing interventions to address burnout have been uncommon.

Objective  To explore the effect of individualized coaching on the well-being of physicians.

Design, Setting, and Participants  A pilot randomized clinical trial involving 88 practicing physicians in the departments of medicine, family medicine, and pediatrics who volunteered for coaching was conducted between October 9, 2017, and March 27, 2018, at Mayo Clinic sites in Arizona, Florida, Minnesota, and Wisconsin. Statistical analysis was conducted from August 24, 2018, to March 25, 2019.

Interventions  A total of 6 coaching sessions facilitated by a professional coach.

Main Outcomes and Measures  Burnout, quality of life, resilience, job satisfaction, engagement, and meaning at work using established metrics. Analysis was performed on an intent-to-treat basis.

Results  Among the 88 physicians in the study (48 women and 40 men), after 6 months of professional coaching, emotional exhaustion decreased by a mean (SD) of 5.2 (8.7) points in the intervention group compared with an increase of 1.5 (7.7) points in the control group by the end of the study (P < .001). Absolute rates of high emotional exhaustion at 5 months decreased by 19.5% in the intervention group and increased by 9.8% in the control group (−29.3% [95% CI, −34.0% to −24.6%]) (P < .001). Absolute rates of overall burnout at 5 months also decreased by 17.1% in the intervention group and increased by 4.9% in the control group (−22.0% [95% CI, −25.2% to −18.7%]) (P < .001). Quality of life improved by a mean (SD) of 1.2 (2.5) points in the intervention group compared with 0.1 (1.7) points in the control group (1.1 points [95% CI, 0.04-2.1 points]) (P = .005), and resilience scores improved by a mean (SD) of 1.3 (5.2) points in the intervention group compared with 0.6 (4.0) points in the control group (0.7 points [95% CI, 0.0-3.0 points]) (P = .04). No statistically significant differences in depersonalization, job satisfaction, engagement, or meaning in work were observed.

Conclusions and Relevance  Professional coaching may be an effective way to reduce emotional exhaustion and overall burnout as well as improve quality of life and resilience for some physicians.

Trial Registration  ClinicalTrials.gov identifier: NCT03207581

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Article Information

Accepted for Publication: May 13, 2019.

Corresponding Author: Liselotte N. Dyrbye, MD, MHPE, Department of Medicine, Program on Physician Well-Being, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (dyrbye.liselotte@mayo.edu).

Published Online: August 5, 2019. doi:10.1001/jamainternmed.2019.2425

Author Contributions: Mr Satele had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Dyrbye, Shanafelt, West.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Dyrbye.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Satele.

Administrative, technical, or material support: Dyrbye, Shanafelt, Gill.

Supervision: Dyrbye.

Conflict of Interest Disclosures: Drs Dyrbye and Shanafelt reported being the coinventors of and receiving royalties for the Physician Well-Being Index, Medical Student Well-Being Index, Nurse Well-Being Index, and the Well-Being Index. No other disclosures were reported.

Funding/Support: Funding for this study was provided by the Mayo Clinic Department of Medicine Program on Physician Well-Being and the Physician Foundation.

Role of the Funder/Sponsor: The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See Supplement 2.

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