Reducing Physician Burnout with Wellness Coaching

Physician-to-physician coaching model offers support for the challenges of being a health care provider.
UMass Memorial Medical Center physician, Tara Kumaraswami, walking on a bridge

Photo above: Tara Kumaraswami, MD, MPH, walks in Elm Park in Worcester. “My coach helped me find the direction I wanted to go, but truly the answers are within the coachee.”

A 12-month clinical trial of a one-on-one wellness coaching program for clinicians reduced participants’ burnout scores by 31% and improved their overall wellness, as measured by a validated self-assessment tool.

As head of the Clinician Experience Office, Steven Bird, MD, FACEP, FACMT, spends many of his waking hours advocating for clinical staff to take better care of themselves and studying ways to enhance their well-being, including developing and launching a free wellness coaching program for them. Yet when he looked at his own calendar in early November 2021, he saw he had not planned for a single day off through the end of the calendar year. The irony was not lost on him.

“I’m like many of my fellow clinicians — not always the best model for self-care and at risk for burnout,” he said. Bird divides his time equally between roles as an emergency physician at UMass Memorial Health and as Clinician Experience Officer supporting clinicians throughout UMass Memorial Health and UMass Chan Medical School, where he also serves as Professor of Emergency Medicine. The Clinician Experience Office, established in 2019 by UMass Memorial Medical Center, UMass Memorial Medical Group and the UMass Chan Medical School, is designed to advance clinician wellness and professional fulfillment.

“We typically think that we should have compassion for others — for our patients and their families — but it can also be for us,” Bird said. “Wellness coaching for physicians by physicians works. Sometimes we need support to manage the difficult circumstances and feelings that come with being a health care provider, and it can be helpful to work with someone who has deep understanding of the situation and environment you’re working in.”

Coaching has significant impact

To offer his colleagues that support, Bird developed a one-on-one wellness program and recruited five UMass Memorial and UMass Chan physicians to join him for a nine-month coaching training program. In January 2021, the team began offering the free coaching program, which was set up as a 12-month clinical trial, largely based on a 2019 JAMA Internal Medicine article, "Effect of Professional Coaching Intervention on the Well-being and Distress of Physicians" by Lotte N. Dyrbye, MD, and Tait D. Shanafelt, MD, at the Mayo Clinic. Bird also drew on data from the Healthcare Professional Well-being Academic Consortium (PWAC), which uses assessment, program evaluation and scholarship to advance well-being among health care professionals. UMass Memorial/UMass Chan Clinician Experience Office is one of 22 U.S. academic medical centers and affiliates that are members of PWAC.

During 2021, 66 clinicians signed up for the wellness coaching program, and 54 completed three-months sessions.

Now, the results of the trial are in. As measured by the Well-Being Index (WBI), a validated self-assessment tool created by the Mayo Clinic, participant burnout scores decreased by 31% compared to those who were in the control group. There are separate WBI assessment tools for physicians and advanced practice providers. 

“The coaching had a statistically significant impact on those who completed all sessions with their coaches,” Bird said. The program has been well-received and now has more applicants than the coaching program can serve, since it’s limited by the number of coaches available. He hopes to grow the program and reduce the dropout rate.

Success requires time commitment

“A wellness coaching program is based on positive psychology, but it’s a two-way street. It takes work,” Bird said, adding that some of those who dropped out of the 2021 session found they didn’t have the time to devote to the work. “Our coaches facilitate participants finding what will help them feel well. It’s not necessarily going to address burnout directly. They can institute behavioral change to help achieve what they want in life and in their career.”

Program participants, 80% of whom were women, included physicians, advanced practice providers, residents and fellows. All were asked to:

  • Commit to a three-month coaching cohort
  • Complete a well-being assessment 
  • Identify goals to improve their personal and professional lives
  • Virtually meet with their wellness coach every two weeks

Giving back: From coachee to coach

For Tara Kumaraswami, MD, MPH, Obstetrics and Gynecology Residency Program Director and Assistant Professor of Obstetrics and Gynecology, the program was worth the time and effort. When she found herself struggling with the isolation of practicing medicine during a pandemic, she requested coaching.

“There’s something to be said for taking care of yourself. And we often don’t do that. The coaching program offers the opportunity to take the time — an hour — to focus on what’s going on in your life, with someone at your side to guide you through the experience,” she said, adding that she was matched with a coach she had been acquainted with in medical school. “Sometimes you need someone to listen — someone who knows what you’re going through. So you know you’re not the only one having that experience.”

Kumaraswami worked with her coach to focus on what she was accomplishing as a residency program director and OB/GYN generalist and to add more physical activity to her life.

“It was good to talk about the positives, not only the negative things that were happening at the time,” she said. “It’s not about venting or complaining. My coach helped me find the direction I wanted to go, but truly the answers are within the coachee.”

In 2022, she joined the program as a coach and is now helping colleagues find their own answers, just as her coach helped her.

Continued need to address mental health

While Kumaraswami is open about her own need for coaching, she recognizes that there’s continued stigma around mental health care among clinicians and appreciates that the program protects the identities of participants. A 2017 study, published in Mayo Clinic Proceedings, reported that close to 40% of physicians would be reluctant to seek mental health care — out of concern for possible repercussions to their medical licensure.

“It’s important for people to feel secure in talking about their stresses and concerns, and that’s not always easy for health care professionals,” said Bird. “While there is less stigma in seeking help for mental health, it still exists. And the fear of being subjected to that stigma is very real.”

He believes there is a long-term need for wellness coaching among clinicians. He gives his own experience as an example. In the emergency department, he often sees the effects of stress on his colleagues and on himself. When hospital beds were most scarce at the height of the omicron wave, for example, he found himself coming up short in the care he could provide for a patient.

“I called 39 hospitals in New England to find a bed for one patient, and I could not find one. That’s not the kind of medicine I ever wanted or envisioned practicing. When you can’t get the patient the care they need and deserve, you feel a decreased sense of personal accomplishment, but even more than that, you could experience moral distress,” he said. “And that’s a lot to carry.”

Physicians and medical students throughout the U.S. can receive free, confidential emotional support via the Physician Support Line, which is staffed by a volunteer network of psychiatrists. Call 1-888-409-0141, 8:00 a.m. to 1:00 a.m. ET, seven days a week.

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