We collected 108 surveys. contains descriptive statistics for the entire sample.
Survey Respondent Characteristics
Over half of respondents had been involved in a serious adverse patient event (53%) or had experienced a personal stressor or indicator of distress (57%) in the past year; three-quarters (79%) had experienced at least one of these two. Among personal stressors or indicators of distress, serious illness among family members had affected more than a third (36%), while death in the family (13%), serious personal physical illness (11%), and other personal crises (12%) were somewhat less common, but not rare. These results are displayed in .
In the past year, have you experienced any of the following?
Willingness to Seek Support
The vast majority of responders (94%) indicated that they would anticipate wanting support for one or more of the listed stressful situations. Legal situations were the most commonly cited reason for which support would be desired (72%). Involvement in medical errors (67%) and adverse patient events (63%), substance abuse (67%), physical illness (62%), interpersonal conflict at work (50%), and mental health illness (50%) would also motivate a majority of people. Less common reasons for seeking support are described in .
Please indicate whether you would or would not seek support for the following difficulties.
Barriers to Seeking Support
Nearly all respondents (89%) perceived that lack of time would present a barrier to seeking support. A majority also indicated that concerns about lack of confidentiality (68%), negative impact on career (68%), documentation on their records (63%), the stigma of mental health care (62%), uncertainty about whom to see (61%), difficulty accessing services (52%) and unwanted interventions (50%) would prevent them from seeking care. contains an exhaustive list of barriers.
Please indicate whether you agree or disagree that the following factors would be a barrier.
Sources of Support
contains the results for the questions regarding the likelihood of seeking support from various people and/or services. Physician colleagues – faculty (70%), residents (61%), program directors (56%), and chief residents (51%) – were the most commonly identified potential sources of support. A smaller, but substantial minority (35%) chose departmental chairmen as a potential source of support. Institutional organizations such as Physician Health Services (40%), Employee Assistance Program (29%), and Graduate Medical Education (15%) drew the fewest physicians. Indeed, 32%, 38%, and 30% of respondents had never heard of these services, respectively, while only a minority (21%, 19%, and 30%) knew how to contact them. We did not ask about the role of family members, friends, or spouses in physician support in our survey, but 20 respondents wrote them in under “other,” either as a potential or a previously utilized resource.
Please state the likelihood that you would or would not seek support from each of the following when faced with stressful situations.
Trainee and Attending Differences
Trainees were significantly more likely than attendings to report that they would seek support for legal situations (82% v. 50%, p<0.01). The majority of both trainees and attendings cited lack of time as a barrier, although the trainees cited this more frequently (93% v. 79%, p=0.05). Three times as many trainees as attendings would be hindered by cost (38% v. 13%, p=0.01).
Predictably, residents were significantly more likely than attendings to seek support from other residents (53–82% v. 10–13%, p<0.01); however, there were no significant differences in the use of faculty, including chairmen and/or program directors, between trainees and attendings. Perhaps due to their increased willingness to pay, attendings were significantly more likely to seek support from mental health professionals (64% v. 41%, p=0.04). There were no significant differences between trainees and attendings in their experience with stress over the past year.
Emergency Medicine physicians were significantly less likely to seek support for involvement in a medical error (EM 48%, Surgery 62%, Anesthesia 77%, p=0.02). Likewise, anesthesiologists were significantly more likely to seek support for involvement in adverse events (Anesthesia 78%, Surgery 51%, EM 52%, p=0.02). Surgeons were less likely to seek support for an interpersonal conflict in the workplace (Surgery 28%, Anesthesia 62%, EM 61%, p<0.01).
There were higher levels of concern regarding a lack of confidentiality in seeking support (Surgery 70%, Anesthesiology 77%, EM 48%, p=0.0461) among surgeons and anesthesiologists. Similarly, anesthesiologists had more prevalent fears of legal consequences (Surgery 35%, Anesthesia 60%, EM 26%, p=0.01).
Differences Based Upon Prior Experiences
Those who had reported any type of stressor in the past year were more likely to seek support from colleagues (faculty 75% v. 48%, p=0.02; chief residents 57% v. 30%, p=0.03), perhaps because they already had. Similarly, experience may have informed responses for those who reported a specifically personal stressor or indicator of distress within the past 12 months. These respondents were less likely to fear legal consequences (33% v. 58%, p=0.02).