"Invert the Pyramid, Let Internists Design the Job as Pilots Do a Cockpit": The Views of General Internal Medicine Physicians on Enhancing Well-Being Through Human Factors Engineering.

Abstract

Objectives: Understanding the protective factors of general internists' well-being helps maintain a resilient health care system. As human factors engineering (HFE) offers promising solutions to the challenges physicians face, it is essential to explore how internists understand the field.

Methods: A cross-sectional survey focusing on the well-being of general internal medicine physicians was mailed out to a random sample of 1,463 internal medicine physicians using the American Medical Association national database. This study focused on the HFE aspects of the survey.

Results: A total of 655 general internists responded to our survey (44.8% response rate). Out of 632 respondents, more than half (59.5%) believed that HFE has a role in enhancing their well-being as an internist, and roughly one-third (36.1%) were unsure. A qualitative analysis performed for the 176 open-ended responses revealed 15 unique categories, with most internists referencing their benefits for improving leadership quality, developing shared mental models among teams, and optimizing current processes.

Conclusions: Our findings indicate that most internists recognize the potential of HFE to positively impact their well-being, though a substantial portion remain uncertain about its applications and benefits. This highlights a need to conduct systems analyses to identify barriers and facilitators of internists' tasks to design tailored, systemic interventions, such as support from leadership in adaptation, support during patient rounds, and improvements to the EMR system. These systemic improvements in combination with spreading HFE knowledge have the potential to enhance internist well-being.