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Well-being Programs for Physicians and the Role of the “Doctors' Mess”

Well-being Programs for Physicians and the Role of the “Doctors' Mess” To the Editor We commend Salles and colleagues1 on their comprehensive well-being program, which is laudable in its scope. The issue of physicians’ well-being is one shared across the Atlantic.2 Increasing strain on health care organizations increases the risk of physician burnout. We provide evidence for another physician wellness program and discuss the concept of the “doctors’ mess.” There is a paucity of studies that demonstrate the clinical effectiveness of physician well-being courses. The Mayo Clinic hosts a series of physician wellness courses and used a single-center randomized clinical trial3 to demonstrate efficacy. West and colleagues3 compared alternate weekly 1-hour small-group sessions over a 9-month period for physicians (n = 35) with no intervention for physicians (n = 37) who had an hour of free time as a control. There was no difference (P > .05) in a number of self-rated measures, including burnout, stress, and quality of life, directly after the intervention or 3 and 12 months after the intervention. The meaningfulness of work and engagement at work increased (P < .05) while depersonalization decreased (P < .05) 3 and 12 months after the intervention. This study3 indicates the partial efficacy of this physician wellness course but is limited by the small sample size and short time for follow-up. In comparison, Salles and colleagues1 note qualitative improvements in the biopsychosocial and professional well-being for a longer follow-up of 4 years for an unknown sample size. The activities described by Salles and colleagues1 closely mimic those that organically develop from a facility in British hospitals called the doctors’ mess. The concept of the “mess” is shared in military settings. Historically, these institutions are set up and run by a committee of interns. These often serve as hubs for social interaction between physicians.4 Its inclusive culture enables private discussion, informal peer mentorship, careers advice, and recreation time.5 A monthly subscription of $16 (£10), the price dependent on location, provides refreshments that are invaluable during long shifts (eg, hot beverages and biscuits) in addition to kitchen utilities (eg, refrigerators and microwave ovens). Recreation is provided in the form of tabletop games such as Ping-Pong and electronic devices such as Sky television, and sometimes game consoles. In our hospital, this mess hall is almost like a “club,” hosting regular social activities and friendly sporting competitions among junior colleagues and sometimes with attending physicians or surgeons. Achieving a healthy work-life balance is getting more difficult; resources such as the “doctors’ mess” are the last standing havens from the challenging daily work life of a physician. Back to top Article Information Corresponding Author: Dipesh P. Gopal, BMBS, Department of Pediatrics, West Suffolk Hospital, Hardwick Lane, Bury St Edmunds, Suffolk IP33 2QZ, England (dipeshgopal@doctors.org.uk). Published Online: November 25, 2015. doi:10.1001/jamasurg.2015.4202. Conflict of Interest Disclosures: None reported. Editorial Note: This letter was shown to the corresponding author of the original article, who declined to reply on behalf of the authors. References 1. Salles A, Liebert CA, Greco RS. Promoting balance in the lives of resident physicians: a call to action. JAMA Surg. 2015;150(7):607-608.PubMedGoogle ScholarCrossref 2. Gerada C. The wounded healer—why we need to rethink how we support doctors. BMJ Careers website. http://careers.bmj.com/careers/advice/The_wounded_healer%E2%80%94why_we_need_to_rethink_how_we_support_doctors. Published July 14, 2015. Accessed July 26, 2015. 3. West CP, Dyrbye LN, Rabatin JT, et al. Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial. JAMA Intern Med. 2014;174(4):527-533.PubMedGoogle ScholarCrossref 4. Blundell A, Puthucheary Z. The doctors’ mess should be the hub of the hospital. BMJ. 2002;325(7356):S23.PubMedGoogle ScholarCrossref 5. Raw J. The doctors’ mess: the unsung resource. BMJ. 2003;327:689. doi:10.1136/bmj.327.7416.689.Google ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Surgery American Medical Association

Well-being Programs for Physicians and the Role of the “Doctors' Mess”

JAMA Surgery , Volume 151 (4) – Apr 1, 2016

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Publisher
American Medical Association
Copyright
Copyright © 2016 American Medical Association. All Rights Reserved.
ISSN
2168-6254
eISSN
2168-6262
DOI
10.1001/jamasurg.2015.4202
Publisher site
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Abstract

To the Editor We commend Salles and colleagues1 on their comprehensive well-being program, which is laudable in its scope. The issue of physicians’ well-being is one shared across the Atlantic.2 Increasing strain on health care organizations increases the risk of physician burnout. We provide evidence for another physician wellness program and discuss the concept of the “doctors’ mess.” There is a paucity of studies that demonstrate the clinical effectiveness of physician well-being courses. The Mayo Clinic hosts a series of physician wellness courses and used a single-center randomized clinical trial3 to demonstrate efficacy. West and colleagues3 compared alternate weekly 1-hour small-group sessions over a 9-month period for physicians (n = 35) with no intervention for physicians (n = 37) who had an hour of free time as a control. There was no difference (P > .05) in a number of self-rated measures, including burnout, stress, and quality of life, directly after the intervention or 3 and 12 months after the intervention. The meaningfulness of work and engagement at work increased (P < .05) while depersonalization decreased (P < .05) 3 and 12 months after the intervention. This study3 indicates the partial efficacy of this physician wellness course but is limited by the small sample size and short time for follow-up. In comparison, Salles and colleagues1 note qualitative improvements in the biopsychosocial and professional well-being for a longer follow-up of 4 years for an unknown sample size. The activities described by Salles and colleagues1 closely mimic those that organically develop from a facility in British hospitals called the doctors’ mess. The concept of the “mess” is shared in military settings. Historically, these institutions are set up and run by a committee of interns. These often serve as hubs for social interaction between physicians.4 Its inclusive culture enables private discussion, informal peer mentorship, careers advice, and recreation time.5 A monthly subscription of $16 (£10), the price dependent on location, provides refreshments that are invaluable during long shifts (eg, hot beverages and biscuits) in addition to kitchen utilities (eg, refrigerators and microwave ovens). Recreation is provided in the form of tabletop games such as Ping-Pong and electronic devices such as Sky television, and sometimes game consoles. In our hospital, this mess hall is almost like a “club,” hosting regular social activities and friendly sporting competitions among junior colleagues and sometimes with attending physicians or surgeons. Achieving a healthy work-life balance is getting more difficult; resources such as the “doctors’ mess” are the last standing havens from the challenging daily work life of a physician. Back to top Article Information Corresponding Author: Dipesh P. Gopal, BMBS, Department of Pediatrics, West Suffolk Hospital, Hardwick Lane, Bury St Edmunds, Suffolk IP33 2QZ, England (dipeshgopal@doctors.org.uk). Published Online: November 25, 2015. doi:10.1001/jamasurg.2015.4202. Conflict of Interest Disclosures: None reported. Editorial Note: This letter was shown to the corresponding author of the original article, who declined to reply on behalf of the authors. References 1. Salles A, Liebert CA, Greco RS. Promoting balance in the lives of resident physicians: a call to action. JAMA Surg. 2015;150(7):607-608.PubMedGoogle ScholarCrossref 2. Gerada C. The wounded healer—why we need to rethink how we support doctors. BMJ Careers website. http://careers.bmj.com/careers/advice/The_wounded_healer%E2%80%94why_we_need_to_rethink_how_we_support_doctors. Published July 14, 2015. Accessed July 26, 2015. 3. West CP, Dyrbye LN, Rabatin JT, et al. Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial. JAMA Intern Med. 2014;174(4):527-533.PubMedGoogle ScholarCrossref 4. Blundell A, Puthucheary Z. The doctors’ mess should be the hub of the hospital. BMJ. 2002;325(7356):S23.PubMedGoogle ScholarCrossref 5. Raw J. The doctors’ mess: the unsung resource. BMJ. 2003;327:689. doi:10.1136/bmj.327.7416.689.Google ScholarCrossref

Journal

JAMA SurgeryAmerican Medical Association

Published: Apr 1, 2016

References

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