Creating a culture of wellness: conversations, curriculum, concrete resources, and control.

Burnout and depression across the career life cycle of healthcare providers are increasing at alarming rates. We need to devote our resources and efforts to bolster the next generation of healthcare providers who have the capacity for resiliency and well-being--the antidote to burnout and depression. A handful of organizations have implemented general wellness programs to combat burnout but there are surprisingly few documented, well-researched interventions to build resiliency. Wellness provides an alternative framework to approach the epidemic rates of burnout and depersonalization within the healthcare profession. In this article we describe our rationale for developing a culture of wellness among primary care physicians along with the specific activities and initiatives for creating a culture of wellness throughout medical educational training. Examples of the four core components of a residency wellness program-concrete resources, positive conversations, curriculum, and control-are described with regard to our Family Medicine Residency. A brief description of early efforts to empirically examine the impact of the wellness initiative across systemwide residency programs (Family Medicine and other programs) is described.