title: Utility of a brief screening tool to identify physicians in distress.
abstract: BACKGROUND
  Despite a high prevalence of distress, few physicians seek help. Earlier identification of physicians in distress has been hampered by the lack of a brief screening instrument to assess the common forms of distress.
  
  
  OBJECTIVE
  To evaluate the ability of the seven-item Physician Well-Being Index (PWBI) to i) stratify physician well-being in several important dimensions (mental quality of life [QOL], fatigue, suicidal ideation); and ii) identify physicians whose degree of distress may negatively impact their practice (career satisfaction, intent to leave current position, medical errors).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  National sample of 6,994 U.S. physicians.
  
  
  METHODS
  PWBI, Mental QOL, fatigue, suicidal ideation, career satisfaction,and clinical practice measures.
  
  
  RESULTS
  Physicians with low mental QOL, high fatigue, or recent (< 12 months) suicidal ideation were more likely to endorse each of the seven PWBI items and a greater number of total items (all P < 0 .001). Assuming a prevalence of 19 %, the PWBI could reduce the post-test probability of a physician having low mental QOL to < 1 % or raise it to > 75 %. The likelihood ratio for low mental QOL among physicians with PWBI scores ≥ 4 was 3.85 in comparison to 0.33 for those with scores < 4. At a threshold score of >4, the PWBI's specificity for identifying physicians with low mental QOL, high fatigue, or recent suicidal ideation were 85.8 %. PWBI score also stratified physicians' career satisfaction, reported intent to leave current practice, and self-reported medical errors.
  
  
  CONCLUSIONS
  The seven-item PWBI appears to be a useful screening index to identify physicians with distress in a variety of dimensions and whose degree of distress may negatively impact their practice.
authors.affiliation: Department of Medicine, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. dyrbye.liselotte@mayo.edu
authors.forename: Liselotte N
authors.initials: LN
authors.lastname: Dyrbye
authors.forename: Daniel
authors.initials: D
authors.lastname: Satele
authors.forename: Jeff
authors.initials: J
authors.lastname: Sloan
authors.forename: Tait D
authors.initials: TD
authors.lastname: Shanafelt
mesh_terms: D002055:Burnout, Professional / Q000175:diagnosis; D003430:Cross-Sectional Studies; D059026:Diagnostic Self Evaluation; D005221:Fatigue / Q000175:diagnosis; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010815:Physician Impairment / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D013315:Stress, Psychological / Q000175:diagnosis*; D059020:Suicidal Ideation; D014481:United States; D014940:Work Schedule Tolerance