Why Do So Few Physicians Use Employee Assistance Programs?
In a 2012 survey of physicians at one large academic hospital, only 29% named the employee assistance program (EAP) as a source of support they would turn to, compared with 88% who named physician colleagues. The study’s authors concluded that, despite stressful experiences and a desire for support, established services are underused. This article covers what that research found, what it cannot tell us, and what to ask before you use an EAP.
What the study found
The study, “Physicians’ needs in coping with emotional stressors: the case for peer support,” by Yue-Yung Hu, Mary Fix, Nathanael Hevelone and colleagues, surveyed a convenience sample of 108 resident and attending physicians in surgery, emergency medicine and anesthesiology at a tertiary care academic hospital. (Hu et al., 2012)
- 79% had experienced a serious adverse patient event, a traumatic personal event, or both in the preceding year.
- Willingness to seek support varied by situation, from 72% for legal situations to 50% for mental illness and for interpersonal conflict at work.
- Physician colleagues were the most popular potential source of support (88%), ahead of mental health professionals (48%) and the EAP (29%).
- The barriers named were lack of time (89%), uncertainty or difficulty with access (69%), concerns about lack of confidentiality (68%), negative impact on career (68%) and stigma (62%).
- Based on the results, the hospital added a one-on-one peer physician support program.
What this does not tell us
- It is not a measure of whether EAPs work. The survey asked about willingness and barriers, not outcomes. I did not find a primary source this week that measures how well physician-focused EAPs work, so this article does not make that claim either way.
- It is a small sample from one hospital, from 2012. Programs and attitudes may have changed.
- It reports intentions, not actual usage rates.
Why the barriers matter
The barriers in the survey are mostly practical or about trust: time, access, confidentiality, career impact, stigma. The 2017 licensure research found nearly 40% of surveyed physicians would hesitate to seek help for a mental health condition because it could harm their medical license. (ScienceDaily, 2017) The U.S. Surgeon General’s 2022 advisory on health worker burnout includes removing punitive policies around seeking care among its recommended actions. (Office of the Surgeon General, 2022)
Questions to ask before you use an EAP
You can ask these of the EAP itself or your employer’s HR department:
- Who sees my information, and is anything reported back to my employer?
- How many sessions are included, and what happens after they are used?
- How quickly can I be seen, and are appointments available outside clinic hours?
- Are the counselors familiar with the pressures clinicians face?
- Is it available to my family members?
Alternatives and complements
Many clinicians prefer to start with a person they trust. Peer support is one option. The Physician Support Line connects US physicians and medical students with volunteer psychiatrists, free and anonymously. (Physician Support Line) Your own physician or a mental health professional of your choice is another route.
This article is education, not medical or mental-health advice.
This article is education, not medical or mental-health advice. Talk with your own clinician about your situation.