2019 HSC Section 2 - Practice Management

Special Communication Clinical Review & Education

The Business Case for Investing in Physician Well-being

risk to the organization. Understanding the business case to reduce burnout and promote engagement as well as over- coming the misperception that nothing meaningful can be done are key steps for organizations to begin to take action. Im-

provement is possible, investment is justified, and return on investment measurable. Addressing this issue is not only the organization’s ethical responsibility, it is also the fiscally respon- sible one.

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ARTICLE INFORMATION Accepted for Publication: July 7, 2017. Published Online: September 25, 2017. doi: 10.1001/jamainternmed.2017.4340

Conflict of Interest Disclosures: Dr Shanafelt is co-inventor of the Physician Well-being Index, Medical Student Well-being Index, and Well-being Index. Mayo Clinic holds the copyright for these instruments and has licensed them for use outside Mayo Clinic. Dr Shanafelt receives a portion of any royalties paid to Mayo Clinic. No other disclosures are reported. REFERENCES 1 . Ramirez AJ, Graham J, Richards MA, Cull A, Gregory WM. Mental health of hospital consultants: the effects of stress and satisfaction at work. Lancet . 1996;347(9003):724-728 . 2 . Ramirez AJ, Graham J, Richards MA, et al. Burnout and psychiatric disorder among cancer clinicians. Br J Cancer . 1995;71(6):1263-1269 . 3 . Shanafelt TD, Sloan JA, Habermann TM. The well-being of physicians. Am J Med . 2003;114(6): 513-519 . 4 . Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med . 2012;172(18):1377-1385 . 5 . Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc . 2015;90 (12):1600-1613 . 6 . Shanafelt TD, Balch CM, Bechamps G, et al. Burnout and medical errors among American surgeons. Ann Surg . 2010;251(6):995-1000 . 7 . Dyrbye LN, Massie FS Jr, Eacker A, et al. Relationship between burnout and professional conduct and attitudes among US medical students. JAMA . 2010;304(11):1173-1180 . 8 . Jager AJ, Tutty MA, Kao AC. Association between physician burnout and identification with medicine as a calling. Mayo Clin Proc . 2017;92(3): 415-422 . 9 . Ahola K, Väänänen A, Koskinen A, Kouvonen A, Shirom A. Burnout as a predictor of all-cause mortality among industrial employees: a 10-year prospective register-linkage study. J Psychosom Res . 2010;69(1):51-57 . 10 . Oreskovich MR, Shanafelt T, Dyrbye LN, et al. The prevalence of substance use disorders in American physicians. Am J Addict . 2015;24(1):30-38. 11 . Oreskovich MR, Kaups KL, Balch CM, et al. Prevalence of alcohol use disorders among American surgeons. Arch Surg . 2012;147(2):168-174 . 12 . Shanafelt TD, Balch CM, Dyrbye L, et al. Special report: suicidal ideation among American surgeons. Arch Surg . 2011;146(1):54-62 . 13 . Pompili M, Innamorati M, Narciso V, et al. Burnout, hopelessness and suicide risk in medical doctors. Clin Ter . 2010;161(6):511-514 .

(Reprinted) JAMA Internal Medicine December 2017 Volume 177, Number 12

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