Goldman L, Myers M, and Dickstein, L (Eds). (2000) The Handbook of Physician Health: The Essential Guide to Understanding the Health Care Needs of Physicians. American Medical Association Press.
Covers self-care/prevention, stress & burnout syndromes, relationships, depression/anxiety, substance use, physical illness & disability, and includes a chapter on residents/students needs as well as administrative responses to troubled physicians including a resource list.
Robert J Wicks. (2006) Overcoming Secondary Stress in Medical and Nursing Practice: A Guide to Professional Resilience and Personal Well-Being. New York: Oxford University Press.
Discusses the dangers of compassion fatigue/burnout and vicarious post-traumatic stress disorder in health care settings. Introduces a newly-developed "Medical-Nursing Professional Secondary Stress Self-Awareness Questionnaire" that can be self-administered and reflected upon in private or a small group setting. Includes a unique section on strengthening one's inner life through the use of three core spiritual wisdom approaches drawn from a world religion perspective and provides a description of four types of "voices" one needs to have in one's circle of friends to ensure that balance, perspective, growth, and challenge are fostered in one's personal and professional life. Describes how health professionals can formulate a personally-designed self-care protocol for themselves. Includes an extensive bibliography.
Quill, TE, Williamson, P. Healthy Approaches to Physician Stress. Arch Int Med 1990; 150: 1857-1861.
Qualitiative study of techniques used by practicing physicians to successfully cope. Divides strategies into five categories with specific examples of each.
McCray, LW et al. Resident Physician Burnout: Is There Hope? Fam Med Oct 2008; 40(9): 626-632.
Systematic review of the literature 1966-2007 with a classification of the quality of the research to identify evidence-based interventions to decrease burnout. LeBron McBride J. Making Family Practice Doable in Everyday Life. Fam Prac Man April 2003; 41-44.
Short, practical article with 10 tips for incorporating meaning, greater self awareness, and basic self care.
Levey, RE. Sources of Stress for Residents and Recommendations for Programs to Assist Them. Acad Med 2001; 76 (2): 142-150.
Reviews sources of stress and then outlines the components of a residency assistance program for helping those who may need it.
Addison, RB, Reisenberg, LA, Rosenbaum, P. Psychosocial Support Services for Family Medicine Resident Physicians. Fam Med 2004; 36 (2): 108-112.
Survey of all US FM residency programs of what support services they provide. Gives a good overview of what's out there.
Stress Management Resources
This page teaches 65 skills that help you change your environment to reduce stress, relax when you’re under pressure, and cope when there’s nothing you can do about the situation.
The Compassion Fatigue Test
Job related stress with self-test with emphasis on provider related stress.
Learning to address Impairment and Fatigue to Enhance patient safety. The LIFE Curriculum is designed to help residency program directors prevent, identify, and manage fatigue and impairment in their residents and fellows. Although intended as a tool for graduate medical education, the curriculum has themes that are pertinent for medical students, practicing physicians, and others in the health professions. This case-based curriculum, derived from a literature review and needs assessments by North Carolina program directors, includes seven vignettes of typical situations to demonstrate impaired performance and inappropriate behavior. Because all the vignettes involve providing clear, timely feedback, an eighth case addresses the facilitation of instructive feedback.
Remembering the Heart of Medicine: Institute for the Study of Health and Illness at Commonweal
SAFER: Sleep Alertness and Fatigue Education in Residency
SAFER, or Sleep, Alertness and Fatigue Education in Residency, is a 37-minute narrated video presentation that provides an introduction to the science of sleep and the effects of sleep deprivation.
Schwartz Center for Compassionate Healthcare
Nationwide nonprofit organization dedicated to strengthening the relationship between patients and their clinical caregivers. The organization was founded by Ken Schwartz, who died of lung cancer at age 40, to promote compassion as he felt it essential to quality healthcare. Institutions can establish through the organization, Schwartz Rounds, which are multidisciplinary discussion groups focusing on difficult emotional and social issues that arise in patient care to improve patient-caregiver relationships. Their website includes evidence that caregivers that participate report feeling less alone in their work, have more energy for their work with patients, and report improved communication.
Physician Health and Wellness. Report of the Council on Ethical and Judicial Affairs, American Medical Association, 2003.
Spickard, A. Gabbe, S & Christensen, J. Mid-Career Burnout in Generalist and Specialist Physicians. JAMA, 2002; 288 (12): 1447-1450.
This article outlines symptoms of burnout, discusses factors which contribute but also (half the article) strategies to prevent in a very concise article.
Thomas, N. Resident Burnout. JAMA, 2004; 292 (23): 2880-2889.
Includes a review of the literature from 1983-2004 focusing mainly on prevalence and contributing factors and ends with a short section on prevention.
Green, M. What (if Anything) Is Wrong with Residency Overwork? Ann Intern Med, 1995; 123 (7): 512-517.
Reviews the rationale for decreasing work hours from multiple perspectives. Includes a list of 94 references.
Colford, JM, McPhee, SJ. The Ravelled Sleeve of Care: Managing the Stresses of Residency Training. JAMA, 1989; 261 (6): 889-893.
Review of stresses of residency, effects, and strategies to reduce on multiple levels.