Welcome to the Clinician Wellbeing Program at UC Davis. Our vision is to create a better quality of life for all clinicians at UC Davis by changing our culture and implementing supportive cultural, efficiency and individual wellbeing interventions for all medical and clinical staff. We believe that effective patient care requires clinician wellbeing, that physician wellbeing in particular is related to the wellbeing of all members of the healthcare team and that clinician wellbeing is a quality marker and a shared responsibility. We look forward to your involvement with our program, whether you work at UC Davis, or elsewhere. There are lots of opportunities – as collaborators in research or teaching, as funders or donors, as policy developers and as faculty and students. So please explore our website and programs, and we look forward to hearing from you.

But what about our mental health?

But what about our mental health? I have recently reviewed this. (Yellowlees 2020)

“How do physicians compare with the general population here? Not so well unfortunately. Most medical students start at medical school aged 22-24 years, and we know that at this time they are more resilient and less depressed than equivalent graduate students in other disciplines. So we start out well having often overcome a number of childhood adverse events and proved our resiliency by jumping the very high hoops associated with medical school entry. However within a few years this changes and numerous studies have documented increasing levels of burnout and depression during medical school and residency. It is now widely accepted that 10-15 years post entry to medical school, the average physician has twice the level of burnout of the average professional non-physician. And we know this is primarily caused by systemic and organizational issues. In terms of their general mental health physicians have all the same mental health problems as community controls except in relation to three areas. The good news is that physicians tend to have a smaller prevalence of schizophrenia than the community, because this is usually symptomatic prior to the age physicians enter medical school, although their rates of bipolar disorder are similar. On the other hand both male and female physicians exhibit the same, and higher, rates of completed suicide than the community, where males typically suicide more commonly than females. For female physicians this is twice the rate of community controls, with male physicians suiciding at 1.4 times the rate. Rates of suicide are related to depression, often caused by chronic exposure to trauma on a daily basis, and here female physicians in particular exceed community rates. Finally, while physician rates of alcohol abuse disorder match those of the community, physicians abuse prescribed drugs, such as narcotics and benzodiazepines, more commonly than community controls, and non-prescribed drugs, such as methamphetamine, heroin and cocaine, significantly less.”

It is clear we have a long way to go to improve access to care for all our clinicians, to prevent burnout especially through organizational change, to improve the culture of medicine and healthcare, to work more efficiently especially with technologies, and to improve our capacity to be resilient in the face of continuous stress in our workplaces. But we will get there.

Reference: Yellowlees P. Physician Well-being: Cases and Solutions. 2020. American Psychiatric Association Publishing Inc, Washington DC.