Resiliency Programs Not Very Resilient

I am no statistician but I still think this article called Resiliency Program Reduces Burnout Symptoms in FM Residents looks a little fishy. Doesn’t the title seem to look positive to you? Here is the basics to the study:

  • Thirty-two family medicine residents at two residency programs in Toledo, Ohio, were recruited to participate; 19 were assigned to an intervention group and 13 to a control group. Most were international medical graduates.
  • Residents in the intervention group engaged in interactive sessions that covered topics such as time management, mindfulness and coping skills. Each session included a handout and a didactic presentation by a health care professional, followed by practicing a skill such as breathing awareness, meditation or guided imagery. Residents participated in eight hours of training during their first year, and between four and six hours of advanced training in their second and third years.
  • Residents in the control group watched videos from a program called the LIFE curriculum,(sites.duke.edu) which consisted of learning modules designed to evaluate fatigue, stress, depression, substance abuse and disruptive behavior.
  • Of the residents originally recruited, 18 from the intervention group and 10 from the control group completed the study.

So, most were IMGs, which could have cultural differences. That could be a very confounding variable. Also, four of the 32 residents dropped out. That may be a problem too. Okay, then there is this:

  • Compared with controls, residents in the intervention group showed a trend toward lower burnout and secondary traumatic stress scores, although this finding was not statistically significant.

What? NOT STATISTICALLY SIGNIFICANT? I feel like Walter Sobchak when he says, “Am I the only one around here who gives a shit about the rules?” So how in the hell does the article say this:

Results of a small trial(journals.sagepub.com) published online July 5 in The International Journal of Psychiatry in Medicine indicate that a program focused on cultivating personal awareness, building social connections and coping skills, and maintaining work-life balance can provide both short- and long-term benefits for family medicine residents.

They go on to say:

  • The resiliency program appeared to be effective in keeping burnout rates from rising over the longer term (WTF?)
  • “The take-home message is that resiliency or well-being programs should be included in curriculum throughout the three years, and well-being should be treated as a competency similar to the other competencies, including medical knowledge,” Brennan said.

Here we go again. I expect this to be put into all residency programs soon without any real evidence proving its worth. Just another thing to add to the agenda to make the programs look good.

Hey, I am for fixing this crap but maybe they are concentrating on the wrong thing. How about removing the source of the problem? How about giving these FP residents hope that there is a light at the end of the tunnel by promoting DPC? Nope.

This crap never ceases to amaze me.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  5 comments for “Resiliency Programs Not Very Resilient

  1. arthur gindin MD
    August 7, 2019 at 9:44 pm

    “not significantly different” means THE STUDY IS OF NO VALUE.

  2. Natalie Newman, MD
    August 5, 2019 at 10:30 pm

    I’m totally suspicious. Why not a mix of residents or a specific group? Why mostly IMG’s in a hodge podge of residents? Why only two programs, why not 30? How do they draw a conclusion when the “data” is statistically insignificant? I’m no genius when it comes to studies/research/date, etc., but this is garbage. It makes no sense. It is as if they wanted to arrive at a conclusion and just created a model to get there. And it was sloppy. Doesn’t anyone care about quality anymore?

  3. Rick
    August 4, 2019 at 11:55 am

    Sounds like a conclusion in search of data.
    I tend to rate psychology “studies” sheer BS anyway.
    Good call Doug.
    And yes, this is SO bureaucratic anyway. Just like the government. Don’t dare look for the real problem and solve it.. Just cover it over with fluffy poop. That makes people “feel good.” Like Mr. Rogers.

  4. Steve O'
    August 4, 2019 at 8:47 am

    Technocracy demands that propaganda be published with standard deviations, in order to induce gullibility on the part of the reader. That seems to describe most of the medical literature.
    The myth of technocracy is built upon the pretense that all things imaginable can be measured with infinite accuracy and precision. The fact that an absurd question has no answer, is heresy to the technocrat.
    This being said, the most glaring finding is that, of the 19 recruited subjects and 13 controls, 4 dropped out – and these were “controls.” The “dropout rate” for controls is about 30%, in a study where the difference in participation between “controls” and nonparticipants should be nil. Why drop out of a study, unless your dropping out changes something in your experience?
    It is incredibly easy to confound such studies, deliberately or unwittingly, by incentivizing the “subject” role versus the “control” role. If the “subjects” get a nice lunch and an hour of quiet meditation while the control slaves are covering their patients, that is confounding. If the “go-go” top-flight competitive group in the residency gets into the “subject” class, and the “controls” remain invisible toiling serfs, that is also a confounding factor.
    But something is right there, and certainly significant. Why drop out of “nothing?”

  5. Thomas David Guastavino
    August 4, 2019 at 6:43 am

    “The beatings will continue until moral improves”….but at least you will learn how to cope with the beatings.

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