Journal Club: March 2013

If  Every Fifth Physician Is Affected by Burnout, What About the Other Four? Resilience Strategies of Experienced Physicians

Zwack, Julika PhD; Schweitzer, Jochen PhD

Physician Resilience: What It Means, Why It Matters, and How to Promote It

Epstein, Ronald M. MD; Krasner, Michael S. MD

About Physician Well-being and Distress

Burnout affects nearly half of all physicians, and no specialty or career stage is immune. Factors associated with burnout are incompletely understood, but loss of meaning in work and loss of workplace control appear to play important roles. Even less well understood are the factors associated with positive work experiences, including engagement, thriving, and resilience. Research on these factors is necessary if effective future interventions are to be developed.

Article Summary

Zwack and Schweitzer conducted a qualitative study to explore strategies physicians use to effectively cope with stress and promote resiliency. The authors found three broad themes summarizing these approaches: job-related sources of gratification, resiliency-supporting practices and routines, and useful attitudes. These results are reassuringly consistent with prior literature. Gratification provided meaning to the work of the participating physicians. The practices and routines these physicians reported reflected attention to self-care and relationships, along with mindfulness. Finally, the useful attitudes reported in this study echoed these approaches, focusing on self-awareness, realism, and appreciation.

In an accompanying commentary, Epstein and Krasner expand on these results. In particular, they emphasize the role of community in promoting well-being. Their proposals remind us that attending to these issues is a shared responsibility of individual physicians, their institutions and organizations, and the medical profession as a whole.


  1. How do you react to the list of strategies to promote resilience reported in this study?
  2. Do you think effective strategies will differ across specialties?
  3. How well would these strategies generalize to other medical professionals?
  4. What would you add to this list of effective well-being strategies?
  5. What are the necessary next steps to further research on physician well-being?

Further Reading

Beckman HB, Wendland M, Mooney C, et al. The impact of a program in mindful communication on primary care physicians. Acad Med. 2010;87:815-819.

Leape LL, Shore MF, Dienstag JL, et al. Perspective: A culture of respect, Part 2: Creating a culture of respect. Acad Med. 2012;87:853-858.

Shanafelt TD, Sloan JA, and Habermann TM. The well-being of physicians. Am J Med. 2003;114:513-519.

Shanafelt TD, West CP, Poland GA, et al. Principles to promote physician satisfaction and work-life balance. Minn Med. 2008;91:41-43.

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One Comment

  1. Kemi Tomobi
    July 10, 2013 at 9:33 PM

    I agree with Epstein and Krasner, and have seen their work outside of this setting. There needs to be more lectures and discussions on these topics, and hope they will do more to promote physician and physician-in-training resilience.


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