• Physician Distress Goes Beyond Burnout: A Call to Action

    By Lynda Seminara
    Selected By: Prem S. Subramanian, MD, PhD

    Journal Highlights

    Canadian Journal of Ophthalmology
    2020;55(3S1):7-16

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    Physician wellness has become a trending topic. Reports from Canada, the United States, and elsewhere have shown soaring rates of burnout, de­pression, and suicidal ideation among physicians. However, “burnout” is an inadequate umbrella term that fails to capture the complex and nuanced circumstances that physicians deal with daily. In a call-to-action report, Wong describes the personal struggles, systemic dynamics, and moral suffering that physicians endure while striving to provide high-quality care with empathy and thoughtful stewardship. Greater emphasis on training in empathy, communication, and self-care is needed to improve physician well-being, as is the development of healthier work environments.

    Physician distress is influenced by personal, interpersonal, and systemic factors. For instance, the heavy focus on fact-based evidence and clinical diagnostics for decision-making has taken precedence over “soft” skills such as communication, collaboration, and advocacy.

    Long work hours, the need to per­form mundane or irrelevant tasks, and reduced interaction with patients also contribute to physician dissatisfaction. Moreover, lack of consistent support and recognition for efforts can lead to distress, perceived loss of autonomy, and greater cognitive dissonance.

    Pressures from the current health care system to do more, ever faster and with fewer resources, can lead to frustration and obsession. The system’s intense focus on cost reduction has interfered with physicians’ traditional approach to making treatment decisions for patients. Economic rationality “de­prives physicians of the moral experi­ence of doctoring—to restore health and alleviate human suffering,” said Wong, which is what “sustains, energizes, and engages them.”

    To combat the myriad factors causing burnout and distress for physicians, Wong emphasized the need for specific skills to be learned and put into prac­tice. “By looking deeply into physician distress, we can commence the pro­cess of transforming medicine into a healthy system that acknowledges not only the condition, personhood, and struggle of the sick, but also those of physicians,” said Wong. “By healing the healers and the health care system, we can return medicine back to its original fundamental core—a deeply interpersonal, relational practice that resonates with both physicians and patients about the joys and pains of living and dying, our common human­ity, the purpose and meaning of life, and, ultimately, the true nature of our existence.”

    The original article can be found here.