Individual-Focused Interventions for Physician Burnout: A Meta-Analysis of Mindfulness, Coaching, and Peer Support

Abstract

Background and Objectives: Physician burnout, commonly described as emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA), remains common. We assessed whether structured, individual-focused programs improve Maslach Burnout Inventory (MBI) subscale scores among physicians. Materials and Methods: Registration, Open Science Framework, doi: 10.17605/OSF.IO/UAZ6B (unfunded). PubMed (MEDLINE) was searched from 1 January 2009 to 9 December 2023 (last searched 9 December 2023) to conduct a meta-analysis. Eligible English language studies evaluated a physician-focused intervention intended to reduce burnout and reported MBI outcomes; eligible designs were randomized trials, crossover trials, prospective cohort studies, or single-group pre–post studies. Risk of bias was rated using the original Cochrane Risk of Bias by two reviewers with consensus resolution. For quantitative synthesis, we pooled mean differences (MD) using fixed-effect inverse-variance meta-analysis with 95% confidence intervals (CI); heterogeneity was summarized with I2, and funnel plots were inspected qualitatively. Results: Of 2769 records, 17 studies met criteria for qualitative analysis, and 6 studies (n = 585 physicians; 273 intervention, 312 control) were pooled. Interventions included mindfulness curricula, professional coaching, or structured peer discussion groups. Compared with controls, interventions were associated with lower EE (MD −5.56; 95% CI, −6.68 to −4.44; I2 = 42%), lower DP (MD −2.11; 95% CI, −2.64 to −1.58), and higher PA (MD 2.01; 95% CI, 1.41 to 2.60). Funnel plots suggested asymmetry for EE. Evidence was limited by few trials, frequent high or unclear risk of bias in at least one domain, and variable intervention formats, and one pooled study used a single-group pre–post design. Conclusions: Structured individual-focused programs were associated with small but statistically significant changes in MBI subscale scores in physicians, but confidence in magnitude and generalizability are limited by study quality and a small evidence base. These programs may be useful adjuncts to organizational approaches to burnout.