title: Promoting resident wellness: evaluation of a time-off policy to increase residents' utilization of health care services.
abstract: OBJECTIVE
  To evaluate awareness and utilization of a new institutional policy to grant residents time off to access personal and family health care.
  
  
  METHODS
  In 2012, two years after policy implementation, an electronic survey was sent to all 546 residents and fellows at a tertiary care academic medical center in the United States. Residents were asked questions regarding awareness of the time-off policy, use of the policy, health care status, reasons for policy use, and barriers to use.
  
  
  RESULTS
  A total of 490 (90%) residents responded. Eighty-nine percent of those surveyed were aware of the policy. Of those who were aware, 49.7% used the policy to access health care. Top reasons for policy use were for personal routine or preventive health care, dental care, and urgent health care needs. The most commonly reported barrier to policy use was concern about the impact the resident's absence would have on colleagues.
  
  
  CONCLUSIONS
  Implementation of policies to prospectively schedule residents' time off during business hours to address health care needs is an important means to promote resident wellness. Such policies remove one commonly cited barrier to residents' access to health care. However, residents still reported concerns about impact on peers and patients as the main reason they were reluctant to take the time off to address their health care needs. More work is needed on both wellness policy implementation practices and on refining the systems that will allow seamless and guiltless transitions of care.
authors.affiliation: A.S. Cedfeldt is education consultant, Division of Graduate Medical Education, and associate professor, Department of Medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon. E. Bower is associate professor, Department of Medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon. C. Flores is associate director, Division of Graduate Medical Education, School of Medicine, Oregon Health & Science University, Portland, Oregon. P. Brunett is associate dean, Division of Graduate Medical Education, and associate professor, Department of Emergency Medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon. D. Choi is professor, Department of Public Health and Preventive Medicine, Department of Ophthalmology, School of Medicine, and Department of Community Dentistry, School of Dentistry, Oregon Health & Science University, Portland, Oregon. D.E. Girard is senior consultant, Divisions of Graduate Medical Education and Continuing Medical Education, J.S. Reinschmidt Professor of Medical Education, and professor, Department of Medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon.
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Cedfeldt
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bower
authors.forename: Christine
authors.initials: C
authors.lastname: Flores
authors.forename: Patrick
authors.initials: P
authors.lastname: Brunett
authors.forename: Dongseok
authors.initials: D
authors.lastname: Choi
authors.forename: Donald E
authors.initials: DE
authors.lastname: Girard
mesh_terms: D002055:Burnout, Professional / Q000517:prevention & control*; D005260:Female; D006291:Health Policy; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010820:Physicians / Q000600:supply & distribution*; D012189:Retrospective Studies; D014481:United States; D000078329:Workforce