A new Kaiser Permanente physician peer support program designed to reduce burnout helped improve doctors’ well-being and had a positive impact on the culture of the participating medical departments, Kaiser Permanente researchers found.

The study, published November 1 in the scientific journal PLOS ONE, analyzed the benefits of the Kaiser Permanente Northern California Peer Outreach Support Team (POST) program in departments at 2 Kaiser Permanente hospitals in Northern California that implemented the program between June 2019 and May 2022.

Peer support helps physicians feel more human

“Peer support allows the recognition of and remedy to the moral injury that physicians experience when they feel they can’t be fully themselves, adhere to their own values, or do enough for a patient due to constraints within health care,” said first author Molly L. Tolins, MD, a Kaiser Permanente East Bay emergency medicine physician, and POST’s founder and regional director. It helps foster a culture that allows us as physicians to return to our full humanity.”

The study found the survey respondents overall rated the program very favorably. Among those who had a peer support interaction, the majority reported that the support was helpful, improved their well-being, and made them more comfortable talking about their work-related emotions. In addition, nearly 85% of the survey respondents said they would recommend the program to another department.

“There are also societal expectations for physicians — we are supposed to be perfect and tough. With this program, we are baking in the idea that it is OK for physicians to feel vulnerable and get such crucial support.”

— Jamal Rana, MD

The POST program is now active in 10 Kaiser Permanente hospitals in Northern California, and 3 more hospitals intend to launch it over the next few months. POST was designed to complement other types of support programs for physicians, nurses, and other hospital staff.

“It’s important that rather than having outside clinicians provide support, we are getting support from our colleagues who understand the environment we work in and who experience the same challenges,” said senior author Dana Sax, MD, a Division of Research (DOR) adjunct investigator and a Kaiser Permanente East Bay emergency medicine physician who works at one of the hospitals where the program was started.

Counteracting culture of suppressed emotions

The peer program is designed to counteract a culture of medicine that values suppressing emotions.

“Through medical training, many times inadvertent messaging can be that feeling vulnerable or showing emotions is somehow a personal failure,” said study co-author Jamal Rana, MD, PhD, a DOR adjunct investigator, a cardiologist, and assistant physician chief for Medical Specialties and Wellness Operations at the Oakland Medical Center, who helped implement the POST program. “There are also societal expectations for physicians — we are supposed to be perfect and tough. With this program, we are baking in the idea that it is OK for physicians to feel vulnerable and get such crucial support.”

Another distinct aspect of the POST program is third-party referrals — a process that allows physicians to refer other physicians.

“Studies show that physicians in particular are much less likely and much more reticent to reach out for support of any kind, including peer support,” said Dr. Tolins. “By creating a third-party referral system, we’re asking people to look out for each other, fostering a culture of mutual support.”

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