Radiologist Well-Being Program

As a long-term stress reaction characterized by depersonalization, emotional exhaustion, a feeling of decreased personal achievement and a lack of empathy for patients, burnout exacts a distressingly high toll. With almost half of radiologists reporting burnout in the 2019 Medscape Radiology Lifestyle Report, it is abundantly clear we must work together to help combat this; this is our struggle.
The American College of Radiology cares about your well-being and has developed the ACR Radiologist Well-Being Program to help. This program provides you with tools and resources to assess your level of wellness and identify ways to improve your well-being over time.  All ACR members, including residents/fellows and medical students, receive free access to the following:

Using the Well-Being Index (WBI) and Toolkit

This screening tool allows you to better understand your overall well-being and identify areas of risk compared to your peers across the country. This is 100% anonymous—your information will not be shared with anyone, including the ACR.

  1. Access the WBI  now or download the mobile app from the iTunes store (for iPhone)  or from Google Play (for Android) .
  2. Click on “Register Here” and enter the appropriate invitation code:
    • Radiologists and radiation oncologists: ACRPHYSICIAN
    • Medical physicists: ACRMEDPHYS
    • Residents and fellows: ACRRFS
    • Medical students: ACRMEDSTUDENT
  3. Register and complete the 9-question survey. If you have an existing account, WBI can merge accounts, ensuring you retain any previous scores. After verifying your password, check the box to “Make this my primary organization” in order to see the radiology-specific resources curated by the ACR.
  4. View your results and how your level of well-being compares to others in your demographic group. The comparative groups include more than 7,000 physicians, 1,700 residents and fellows, and 2,000 medical students. The resource categories provided are based on your score.
  5. Track your well-being over time by returning to the WBI and repeating your self-assessment. Resources are available any time, and the survey can be completed monthly.

Have a resource or feedback you would like to share? Contact the Well-Being team at copllstaff@acr.org.

ACR Well-Being Curriculum Resources

Curriculum Objectives

The ACR is providing radiologists with tools to promote wellness and combat burnout. Physician-directed interventions such as restoring work-life integration, mindfulness, cognitive behavioral therapy, seeking mental health services, improving one’s self confidence and communication skills can be helpful[1]. Organization-directed interventions must include open communication and transparency from leadership, workflow autonomy, mentorship opportunities, adequate PACS and EMR support, promotion of a healthy and collegial work environment, a regular measurement of wellness, creation of a wellness committee, and endorsement of wellness and burnout resources[1]. Two years ago, the Accreditation Council for Graduate Medical Education (ACGME) introduced updated common program requirements for all accredited residencies and fellowships in recognition of the need to further promote resident and faculty member well-being and patient safety[2].

However, both physicians and organizations/institutions may need guidance in assembling the tools to promote wellness; to this end, the Well-Being Toolkit (i.e., the radiology-specific resources within the WBI) and the Well-Being Curriculum (below) have been carefully curated by ACR Well-Being committees under the leadership of Lori Deitte, MD, chair of the ACR Commission on Publications and Lifelong Learning and Claire Bender, MD, FACR, chair of the ACR Commission on Human Resources. The compiled resources are shining examples of our talented community working together toward a common goal: being well together.

1. Chetlen AL, Chan TL, Ballard DH, et al. Addressing burnout in radiologists. Academic Radiology. 2019;26(4):526-533.

2. Accreditation Council for Graduate Medical Education. Common Program Requirements. Available at https://www.acgme.org/What-We-Do/Accreditation/Common-Program-Requirements . Accessed December 1, 2018.

1. Appreciative Inquiry

  • Appreciative Inquiry Commons — A collection of information and resources from Appreciative Inquiry practitioners all over the world.
  • Appreciative Inquiry: Fostering Positive Culture — An online learning module that allows physicians to earn CME as part of the STEPS Forward program, a practice improvement initiative created by the AMA. This module is part of the Professional Well-Being section of the STEPS Forward program; its objectives are to:
    • Evaluate current strengths, assets and values of the practice, department or organization;
    • Construct a “discovery team” to elicit positive stories and themes from the organization;
    • Incorporate appreciative inquiry into daily work and existing performance improvement initiatives.
  • Using Appreciative Inquiry as a Framework to Enhance the Patient Experience — A case study which depicts the journey of a non-profit hospital in an under-served community and its attempts to turn around suffering patient experience. The article shows how the hospital turned to the theories of Appreciative Inquiry and the power of a strengths-based approach to create a framework to support the patient experience initiatives.
  • Appreciative Inquiry in Medical Education — The AI approach can be used for the development and enhancement of the potential of both individuals and organizations. This guide from the Association for Medical Education in Europe describes the core principles of Appreciative Inquiry and their practical application in medical education.
  • What is Appreciative Inquiry? — The Center for Appreciative Practice, established in 2007 by UVA's Schools of Medicine and Nursing, its Medical Center and University Physicians Group, offers an overview of Appreciative Inquiry and its principles. Learn more.
  • Unleashing a Positive Revolution in Medicine — Appreciative Inquiry, a highly participatory approach to developing human and organizational systems, can accelerate positive change and provide the influence necessary to revolutionize medicine and create the positive future we desire.
  • Feeding the Good Wolf: Appreciative Inquiry in Graduate Medical Education (page 5) — Appreciative inquiry is an organizational change process that derives its power from the positive imagination of a community. Academic medicine currently struggles under a deficit model, bound by a seemingly unsolvable lack of time, money, respect, and purpose. Learn how the University of Virginia is improving its graduate medical education programs using Appreciative Inquiry.
  • Using Appreciative Inquiry to Inform Program Evaluation in Graduate Medical Education* — See how the authors implemented a novel application of Appreciative Inquiry and its four phases (Inquire, Imagine, Innovate, and Implement) in its pediatric pulmonology fellowship program evaluation process and demonstrate how it led to meaningful improvements.

2. Team Building

3. Ensuring Quality Patient Care

  • Patient-Centered Radiology — Patient-centered care is a model in which health care providers respect patients’ values and preferences, address their emotional and social needs, and involve them and their families in decision making. This may yield substantial benefits in the form of improved quality and patient safety, reduced costs, higher-value care, improved patient outcomes, and greater patient and provider satisfaction.
  • Patient-Centered Radiology Strategies: How Radiologists Can Demonstrate Value By Putting Patients First — Times are changing as radiology practices and hospital radiology departments are implementing patient-centered strategies intended to improve patient care and, in turn, support an increased level of patient satisfaction. This article outlines a number of actions radiologists have taken in the name of better care, better satisfaction and better reimbursement.
  • The SHARE Approach: Essential Steps of Shared Decision-making — The SHARE Approach outlines five steps health care professionals can take to ensure that they are effectively implementing shared decisionmaking with patients during clinical encounters, and offers sample conversation starters for meaningful discussions with patients.

4. Feedback

5. Dealing with Errors

  • Association of Perceived Medical Errors with Resident Distress and Empathy: a Prospective Longitudinal Study — Self-perceived medical errors are common among internal medicine residents and are associated with substantial subsequent personal distress. Personal distress and decreased empathy are also associated with increased odds of future self-perceived errors, suggesting that perceived errors and distress may be related in a reciprocal cycle.
  • The Heart of Darkness: the Impact of Perceived Mistakes on Physicians* — The perception of having made a mistake creates significant emotional distress for practicing physicians. The severity of this distress may be influenced by factors such as prior beliefs and perfectionism. The extent to which physicians share this distress with colleagues may be influenced by the degree of competitiveness engendered by medical training.
  • Medical Error: the Second Victim. The Doctor Who Makes the Mistake Needs Help Too — Physicians will always make mistakes. The decisive factor will be how we handle them. This articles offers suggestions for how to respond to and have a dialogue about medical errors.
  • Coping with Medical Mistakes and Errors in Judgment *— Evidence exists that errors are common in clinical practice and that physicians often deal with them in dysfunctional ways, yet there is no general acknowledgment of the inevitability of errors or of the need for practitioners to be trained in their management. This article focuses on the affective aspects of physician errors and presents a strategy for coping with them.
  • Understanding and Responding to Adverse Events* — Careful investigation and systems analysis can identify the factors that set the stage for a medical error. The author argues that the process of understanding adverse events leads to improvements in care and reductions in errors and that insensitive and inadequate handling of an incident can result in additional harm to patients and families. He outlines practical strategies to minimize the trauma resulting from adverse events.
  • Malpractice Risk According to Physician Specialty — In this analysis of malpractice data, the authors report the proportion of physicians who had malpractice claims in a year, the proportion of claims leading to an indemnity payment, and the size of indemnity payments, and estimate the cumulative risk of ever being sued among physicians in high- and low-risk specialties.
  • Coping with a Medical Malpractice Suit — This article discusses how and why physicians react to an accusation of malpractice and the range of strategies that they can use to diminish the emotional disequilibrium that accompanies this experience. 

6. Conflict Resolution

  • Teaching Conflict Resolution in Medicine: Lessons From Business, Diplomacy, and Theatre — The authors developed teaching tools emphasizing team dynamics and employing lessons from diplomacy and improvisational theatre to underscore nonverbal cues that improve communication during conflict. This resource includes instructions for teaching conflict management and conflict resolution styles, small-group negotiations, case-based clinical scenarios, personal reflection, and facilitated debrief. Find additional resources here »
  • Crucial Conversations and Conflict Resolution Interprofessional Simulation — A simulation/role-play activity for interprofessional learners to acquire knowledge about crucial conversations and conflict resolution and to demonstrate their skills with interprofessional team members. It was developed for learners on an interprofessional family medicine clerkship as an educational adjunct to be used during protected curricular time.
  • Conflict Management: A Primer for Doctors in Training — This paper describes the nature of conflict in the health care system and identifies the difference between conflict and disagreement. Using a conflict resolution model, strategies for dealing with conflict as it arises are explored and tips are provided on how to effectively manage conflict to a satisfactory resolution for all parties.
  • Conflict Management and Resolution — Understanding the nature and source of conflict is a vital aspect of leadership. Causes of conflict include the miscomprehension of communication, emotional issues, personal history, and values. When the difference is understood and the resultant behavior properly addressed, most conflict can be settled in a way that provides needed change in an organization and interrelationships.
  • Fighting Fair to Resolve Conflict — In most relationships, conflict is inevitable and it can cause some discomfort. If handled appropriately, conflict can strengthen relationships and improve our understanding of each other. When handled poorly, conflict can cause broken friendships, ended relationships, and long-simmering feuds.
  • Conflict Resolution — This site has been established through the joint efforts of the Office of Human Resource Development and Office of Quality Improvement at UW-Madison as a resource to enhance the skills of faculty, staff, and students as they seek to manage conflicts that occur in the campus community and build a positive campus climate.
  • Conflict Resolution Kit  — The Conflict Resolution Network has put together a toolkit of 12 skills - you can reach in and take out what fits for any occasion.
  • Conflict Resolution: Using the "Interest-Based Relational" Approach — The Interest-Based Relational approach to conflict resolution is based on the idea that your role as a manager is not simply to resolve conflict but to ensure that team members feel respected and understood, and that you appreciate their differences.

7. Mentorship

  • Transitioning from Radiology Training to Academic Faculty: The Importance of Mentorship* — Discover the importance of introspection and mentorship to successfully transition from radiology residency to academic faculty. Key points include alignment of goals with those of the institution, formation of a mentorship program, and periodic reassessment of career goals.
  • Mentorship of Junior Faculty Members in Academic Radiology — In this article, the authors define mentorship and discuss the challenges faced by junior faculty members in academic radiology, the value of mentorship in helping junior faculty members overcome these challenges, stages of mentorship, strategies to implement mentorship, and threats to successful sustained mentorship in radiology.
  • Formal Mentorship in a Surgical Residency Training Program: a Prospective Interventional Study — The purpose of this study is to determine the effects of a formal mentorship program (FMP) on the well-being of Otolaryngology-Head and Neck surgery resident (OHNSR) physicians. It is the first study to show that FMP can potentially alleviate high levels of stress and burnout within a surgical residency program and achieve higher levels of personal satisfaction as well as overall quality of life.
  • Impact of Organizational Leadership on Physician Burnout and Satisfaction* — A study which evaluates the impact of organizational leadership on the professional satisfaction and burnout of individual physicians working for a large health care organization. It shows that leadership qualities of physician supervisors appear to impact the well-being and satisfaction of individual physicians working in health care organizations.
  • Mentoring Clinical Trainees: A Need for High Touch* — Today, trainees face high levels of burnout, depression, anger, emotional exhaustion, sadness, anxiety, and uncertainty around performance. Career mentoring, a partnership focused on growth and development of the trainee, is rare in today’s postgraduate training environment. However, there is evidence that mentoring is beneficial: those with mentors make more informed career decisions, are more productive, experience less burnout, and have an improved sense of well being than do those without mentors.
  • Career Fit and Burnout Among Academic Faculty* — Hypothesizing that physicians who spend more of their time in the aspect of work they found most meaningful would have a lower risk of burnout, the authors suggest that efforts to optimize career fit may promote physician satisfaction and help to reduce attrition among academic faculty physicians.
  • Mentoring Across Differences — In this study of effective mentoring, the Mentoring Across Differences sessions are workshops designed to develop and nurture skills, tools, self-awareness, and mindful practice in mentors and mentees. The workshops encourage participants to gain confidence in navigating differences across a variety of domains.

8. Inclusion and Diversity

9. Communication

10. Harassment and Bullying

  • In America, Becoming a Doctor Can Prove Fatal — There's no question that bullying is endemic in medical education. One study revealed that about half of residents and fellows in the U.S. reported being bullied, most often by their attending physicians. Canadian researchers found that 78% of residents surveyed reported being bullied and harassed in their training, often by attendings or program directors.
  • 75% Of Workers Are Affected By Bullying -- Here's What To Do About It — Workplace bullies can be hard to detect because they work within the rules of the organization. That means that the solutions lie within the organizational structure.
  • How Neglect Fosters Workplace Toxicity — We need to ensure that people feel safe and empowered to share their concerns and create a workplace culture where no one feels they are laboring in obscurity.
  • Taking a Stand Against Bullying — While seasoned clinical professionals may tell you that bullying has always been present at patient care facilities, some experts believe it’s on the rise, likely because of health policy changes putting massive financial pressures on the healthcare system.
  • What We Know, What We Do Not Know, and What We Should and Could Have Known About Workplace Bullying: An Overview of the Literature and Agenda for Future Research — In order to develop robust and effective interventions for bullying there is consequently a need for further research on the nature, risk groups antecedents, and consequences of bullying through the use of advanced and sound methodological designs and a well-developed theoretical framework.
  • Workplace Bullying Institute — The Workplace Bullying Institute is dedicated to the eradication of workplace bullying and offers help for individuals, research, books, public education, training for professionals-unions-employers, legislative advocacy, and consulting solutions for organizations.
  • Workplace Culture & Bullying — Workplace culture impacts all aspects of a business, from day-to-day functioning to the organization's bottom line. In his book, From Bully to Bull's Eye, Andrew Faas describes three types of workplace cultures: dictatorial, disjointed, and stable.

11. Humor at Work

  • Leading with Humor — According to research, every chuckle brings with it a host of business benefits. Laughter relieves stress and boredom, boosts engagement and well-being, and spurs not only creativity and collaboration but also analytic precision and productivity.

12. Self-care

13. Resilience

  • The Emotional Wellness of Radiology Trainees* — Most radiology residents reported high levels of personal achievement but routine symptoms of emotional exhaustion and depersonalization. Finances may be an underappreciated influence on resident burnout, and subjective feelings of financial scarcity could outweigh the impact of objective indebtedness.
  • Burnout in Radiology* — This article reviews causes, preventive measures, and possible solutions for physician (radiologist) burnout.
  • Addressing Burnout in Radiologists* — A health and wellness task force presents a review of the prevalence, causes, and impact of burnout among radiology faculty and trainees, and a discussion on strategies for overcoming burnout and promoting overall health and well-being among radiologists.
  • A Curriculum to Foster Resident Resilience — This curriculum serves as an introduction for medical trainees and educators to the concept of resilience and teaches skills to help cultivate resilience and promote wellness. 
  • Building Resilience for Wellness: A Faculty Development Resource — In order for faculty to role-model behaviors of wellness, they need to understand what this means and how to incorporate it into their lives.
  • Resident Wellness: An Intervention to Decrease Burnout and Increase Resiliency and Happiness — It is feasible to implement a low-cost, peer-led wellness curriculum to educate residents and foster an environment during residency training where mindfulness, optimism, gratitude, and social connectedness are the norm.

14. Grand Rounds and Journal Clubs

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ACR Bulletin: Road to Wellness



In this special issue of the Bulletin, hear personal stories of burnout and resilience.

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JACR: Road Map to Foster Wellness

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The 2018 radiology Intersociety Committee reviewed workplace burnout and identified approaches for fostering engagement, wellness, and job satisfaction.

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