Small group coaching reduces physician burnout more effectively than one-on-one method

New UCLA research finds that small group professional coaching can reduce physician burnout rates by up to 30%, suggesting that it is more effective than the traditional, and more expensive, one-on-one coaching method.

Nearly half of physicians in the US suffer from burnout, which is marked by emotional exhaustion, depersonalization and decreased personal accomplishment. These can lead to medical errors and other harmful consequences to the healthcare system and patient outcomes, said lead author Dr. Joshua Khalili, director of physician wellness in the UCLA Department of Medicine and assistant clinical professor of medicine at the David Geffen School of Medicine at UCLA.

Most current evidence related to professional coaching is related to individual coaching and its impact on reducing burnout. But individual coaching can be quite costly, which is a barrier to broad implementation."

Dr. Joshua Khalili, director of physician wellness, UCLA Department of Medicine and assistant clinical professor of medicine, David Geffen School of Medicine at UCLA

The study will be published in the peer-reviewed Journal of General Internal Medicine.

Physician burnout is estimated to cost the US healthcare system about $4.6 billion annually, mostly due to costs associated with physician turnover and fewer clinical hours. 

The researchers conducted a randomized, wait-list controlled trial with 79 UCLA attending internal medicine physicians for just over a year starting in March 2023. The intervention consisted of six one-hour coaching sessions, with one-third of the group receiving one-on-one coaching via Zoom while another third were coached in small groups consisting of three physicians and one coach. The final third acted as control group, receiving no coaching during the first few months of the trial, and subsequently received six, one-on-one coaching sessions.

The primary outcome the researchers measured was overall burnout. They also examined areas of work life such as workload, control rewards, community, fairness, and values; work engagement such as vigor, dedication, and absorption; self-efficacy, and social support. They measured each of these outcomes before and after the intervention and again six months afterward.

They found that small group intervention participants experienced a nearly 30% reduction in burnout rate. Participants in the one-on-one coaching experienced a 13.5% burnout rate reduction. By contrast, the control group experienced an 11% increase in burnout rates. Burnout remained stable among the small group participants and continued to fall in the one-on-one group six months after the initial intervention.

Coaching for the one-on-one sessions cost $1000 per participant, compared with $400 for the small group coaching sessions.

"This new, small-group model of professional coaching can make a significant impact in physician burnout and costs much less than the one-on-one model," Khalili said.

Study limitations include potential selection bias among participants who would most likely benefit from the intervention. The baseline overall burnout rate was higher in the small group coaching arm (70.4%) compared to the one-on-one group (40.0%); however, relative reductions in burnout were similar: 42% in the small group intervention compared to 34% the one-on-one group. In addition, the study was conducted at a large academic center whose physicians may not be comparable to those in other healthcare institutions.

The researchers are now providing coaching to physicians in the UCLA Department of Medicine and hope that this research encourages other health care institutions and organizations to implement professional coaching, Khalili said.

"By improving physicians' well-being, engagement, and sense of support, interventions like coaching can enhance the quality of care patients receive, making this a public health priority, not just a workplace issue," he said.

The study was co-authored by Dr. Karen Miotto, Dr. Tisha Wang, Dr. John Mafi, Elizabeth Kyababchyan, Jesse Sanford, Dr. David Elashoff, Jenny Brook, Yetunde Adebambo, Paige‑Ashley Smith, Emma Nguyen, and Dr. Sun Yoo.

The UCLA Department of Medicine funded the study.