What Makes a Physician Well?: Development of the Physician Wellness Inventory Jodie Eckleberry-Hunt, Ph.D., A.B.P.P. Heather Kirkpatrick, Ph.D., A.B.P.P. Kanako Taku, Ph.D. Ronald Hunt, M.D., F.A.A.F.P. Rashmi Vasappa, D.O. Jaime Essian, D.O. Free Powerpoint Templates

How Do We Define Physician Wellness? Lack of burnout? Mental health? Physical health? Social health? Is physician wellness different from wellness in other populations? Bottom line: It is not clearly defined in the literature

Study Goals Develop an evidence-based definition of physician wellness Develop a validated measure

Hypotheses 1: Measures of physician wellness will be associated with burnout as measured by the Maslach Burnout Inventory (MBI). 2: Measures of physician wellness will be positively correlated with resilience as measured by the Resilience Scale. 3: Physician wellness will be positively correlated with certain demographic variables (i.e., social support and marital status).

Methodology 3 health systems in Michigan 32 programs 839 survey packets Residents, Fellows, Attendings Survey packets included: Physician Wellness Inventory Maslach Burnout Inventory The Resilience Scale-14 Demographics

Data Analysis 1) Principal Component Analysis with Varimax Rotation Removed items 2) Second Principal Component Analysis with Varimax Rotation 3) Correlational analyses among MBI scales, RS scales and PWI scales 4) Multiple regression analyses to examine the impact of demographic variables and perceived social support

Results Table 2. PWI Factor Analysis Component Factor 1: Emotional Distress 1 2 3 4 W17_During the past month, I have often been bothered by feeling down, depressed, or hopeless .791   -.268 W23_Over the last two week, I have often been bothered by feeling nervous, anxious, or on edge .766 W8_During the past month, I have often been bothered by little interest or pleasure in doing things. .687 W30_I am able to stop dwelling on problems. -.653 W15_I have a difficult time accepting my own mistakes or shortcomings. .606

Results Table 2. PWI Factor Analysis Component Factor 2: Career Purpose 1 2 3 4 W33_Working with patients brings me satisfaction.   .759 W31_My work brings joy to my life. .709 W11_I feel a spiritual purpose or connection in my life's work. .673 W3_I can put my personal values into my action in my work. .615 W16_I get my energy from being around other people. .338

Results Table 2. PWI Factor Analysis Component Factor 3: Health Behaviors 1 2 3 4 W10_I do not get enough exercise   -.752 W7_Others would say that I have a balanced diet most days. .732 W25_I look ahead to prevent things from going off course. .400 .393 W9_I regularly get enough sleep. -.255 .530

Results Table 2. PWI Factor Analysis Component Factor 4: Cognitive Flexibility 1 2 3 4 W18_I often see more than one side to an issue.   .715 W20_I am open to new ideas and ways of doing things. .645 W32_I spend time reflecting on things I can improve about myself and life. .280 .282 .562

Results Table 3. Correlations among subscales of Maslach Burnout Inventory, Physician Wellness Inventory, and Resilience Scale Note. ** p < .01, * p < .05. Note. Burnout Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA), Physician Wellness Inventory Emotional Distress (ED), Career Purpose (CP), Health Behaviors (HB), and Cognitive Flexibility (CF).   EE DP PA ED CP HB CF Burnout DP .583** Burnout PA -.221** -.261** Emotional Distress .607** .386** -.285** Career Purpose -.359** -.342** .477** -.266** Health Behaviors -.355** -.227** 0.111 -.327** .258** Cognitive Flexibility -0.108 -0.116 .283** -.149* .309** 0.112 Resiliency Total Score -.229** -.210** .416** -.423** .244** .289** .192**

Results Emotional Distress F(1, 264) = 9.38, p < .01. For men, having children was not associated with ED. However, women with children reported significantly less emotional distress than women without children Career Purpose F (1, 268) = 7.01, p < .01 Women with children had higher levels of career purpose than women without children. This finding was not present among men.

Results Cognitive Flexibility F(1, 270) = 6.47, p < .05 Women with children displayed higher levels of cognitive flexibility as compared to women without children. For men, having children was unrelated to cognitive flexibility.

Conclusions Physician Wellness may be defined as: Low Emotional Distress Career Purpose Health Behavior Cognitive Flexibility

Next Steps We need more data. Questions Remain: What combinations of the scales make a physician well? Is interpersonal wellness the fifth scale? Are children protective?