Abstract
BACKGROUND: physician burnout is a public health crisis. While one-on-one professional coaching reduces physician burnout, its costs may limit widespread use. Small group professional coaching could offer a more scalable solution, but its effects on attending physician burnout remain unknown. OBJECTIVE: To determine the effects of small group and one-on-one professional coaching to decrease physician burnout and improve work life, work engagement, self-efficacy, and social support. DESIGN: A randomized, three-arm, waitlist-controlled trial from March 2, 2023 to April 13, 2024. PARTICIPANTS: 79 Internal Medicine faculty attending physicians. INTERVENTIONS: Six, one-hour, virtual one-on-one or small group professional coaching sessions rooted in positive psychological theory within 4 months. MAIN MEASURES: The primary outcome was overall burnout, measured by the Maslach Burnout Inventory (MBI). Secondary outcomes included MBI subscale measures, Areas of Worklife (workload, control, rewards, community, fairness, and values), work engagement (vigor, dedication, absorption), self-efficacy and social support, evaluated by validated measures. Outcomes were also evaluated 6 months post-intervention. KEY RESULTS: Small group and one-on-one coaching intervention participants experienced a 29.6% and 13.4% absolute reduction in the rate of burnout respectively, compared with an 11.1% increase among control physicians (difference-in-differences, -40.7% [95% CI, -71.3%, -10.1%], P = 0.01 and -25.0% [95% CI, -53%, 3%], P = 0.09, respectively). There was no significant difference in burnout reduction between small group vs one-on-one interventions (-15.9% [95% CI, -41.7%, 9.9%], P = 0.22). After 6 months, burnout remained stable in the small group intervention and continued to decrease in the one-on-one group, both without further intervention. CONCLUSIONS: In this randomized clinical trial, small group professional coaching decreased physician burnout though no statistically significant effect was detected in the one-on-one coaching arm. Small group coaching may offer a less costly and nationally scalable approach to address the physician burnout crisis. Replication of these methods are warranted in a larger, multi-centered randomized trial.
