Effect of Physician Peer Coaching (PPC) on Burnout in Hospital-Based Physicians: A Pilot Randomized Controlled Trial

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IntroductionPhysician burnout (PB) is a significant and growing problem among hospital-based physicians.Coaching delivered by external professional coaches has previously been used to reduce burnout, but coaching delivered by trained physician peers has not been evaluated.This pilot randomized controlled trial examined whether physician peer coaching (PPC) is associated with lower burnout and a more favorable work environment for hospital-based physicians. MethodsWe conducted a pilot randomized controlled trial at Geisinger Health System, Wilkes-Barre, Pennsylvania, to assess whether PPC is associated with lower PB and more favorable work environment factors among hospital-based physicians (HBP).Fifty-one physicians were consented and randomized; 45 (23 intervention, 22 control) received the allocated condition and were included in the analysis (modified intention-to-treat).Twenty-three physicians in the intervention group (IG) received six peer-coaching sessions between June and December 2022 at three-to five-week intervals by a trained physician coach; the control group received no coaching until after the six-month assessment.Burnout was measured with the Maslach Burnout Inventory (MBI), and work environment with the Areas of Worklife Survey (AWS), at baseline, three, six, and nine months. ResultsIn the between-group difference-in-differences analysis at six months, coaching was associated with a significantly greater reduction in emotional exhaustion (EE) (primary outcome -6.51, 95% CI -12.70 to -0.31; p=0.04), and a greater improvement in workload congruence [0.57, 95% confidence interval (CI) 0.13-1.01;p=0.01] relative to control.No other between-group difference reached significance, including overall burnout (OB) [odds ratio (OR) 0.58, 95% CI 0.17-2.05;p=0.40].Exploratory within-group analyses: MBI repeated measures trends for IG (median scores at baseline, three, six, and nine months): EE (30, 25, 18, 17; p<.01); depersonalization (DP) (6, 5, 2.5, 3; p=0.01); personal accomplishment (PA) (37, 40, 41.5, 39; p=0.02);OB (60.9%, 52.2%, 40.9%, 33.3%; p=0.05); high EE (60.9%, 39.1%, 31.8%,23.8%; p=0.01); high DP (30.4%, 30.4%, 22.7%, 14.3 %; p=0.18).AWS repeated measures trends for IG (median scores at baseline, three, six, and nine months); workload (2.2, 2.4, 2.4, 2.9; p<0.01); control (3.0, 3.3, 3.4, 3.0; p=0.49); reward (3.0, 3.5, 3.5, 3.5; p<0.01); community (3.4,3.6, 3.7, 3.6; p=0.31); fairness (2.8, 3.0, 3.2, 3.0; p=0.21); values (3.5, 3.5, 3.9, 3.6; p=0.62).In the control group, OB did not significantly change (59.1% at baseline to 52.4% at 6 months; p=0.66; trend p=0.65), and no other burnout or work-environment measure showed a significant trend. Conclusions and relevanceThis pilot randomized controlled trial suggests that PPC may reduce EE and improve perceived workload among hospital-based physicians.Favorable within-group trends in DP, PA, OB, and reward were not confirmed by between-group comparison and should be considered exploratory.Within-group improvements persisted three months after coaching ended, but this observation is uncontrolled because the control group was offered coaching after six months.Confirmation in larger, adequately powered, multisite trials is needed.