Physician resilience: cause or symptom?

Do you ever wonder
what compels someone to walk away from their current life
to leave all they worked for — jobs, spouses, kids — behind?

The community around them are caught off guard
of how unhappy or unfulfilled or
the silent suffering
that made their life so hard.

We say it is shocking and act so surprised.
But that seems a pretense.
It’s no secret that compassion fatigue and physician burnout
are both on a steady rise.

For us in the medical community,
this can be an opportunity to reevaluate
To allow us to open the windows of hearts and souls
so our healers do not suffocate.

Medicine is an art, not a fast food service.
Stop telling us that’s how we should do it.

They are more than a number, so
please respect each patient.
This is a contributing factor to the rates
of rising disillusionment.

Being a physician
is an honor and a privilege
but it takes its toll
on a physician’s mind, body, soul.

How long can we ignore
the complex emotions that are not shared but stored—
the difficult cases, the trauma, the days of sleep deprivation,
the long hours, cumbersome electronic medical records,
the disconnect between ideal and real-world medicine
the pressure to be perfect
the physician dehumanization?

Over time that suppression
translates to cynicism and fatigue.
But because we’re doctors,
there is no time be weak.

When we were residents, we didn’t have a voice
But as board-certified attendings, we have a choice
Keep our heads down and let things happen
Or speak up and take positive action.
I urge all of us in the medical community to do the latter
our physician decline is no laughing matter.



Why does this matter?

Recently, there has been a lot of discussion on physician wellness, resilience, the focus on burnout prevention, self-care and the like. Certainly, those are great points. Physician wellness matters. Read more on things to know about physician work life balance.

However, putting wellness and resiliency in the same category is misleading. Calling it a resiliency issue makes it a personal problem, a deficit that needs correction. Read more on why physician burnout should not be linked to resilience.

Having gone through the rigorous training of medical school and residency, the choice of “resilience” seems incorrect. If a person made it through all of that — decades of hard work, sacrifice, sleep deprivation — he is certainly resilient. Maybe it’s just semantics, but word choice is important as is the message that it conveys.

Many people outside the medical profession may not be aware that the rates of physician suicide are staggering and the highest of any profession. In the U.S., there about 400 suicides per year, which is more than one completed suicide per day.

This is shocking and unsettling on so many levels.

Why is this happening?

What would lead someone who has dedicated multiple decades of their life to serve others to just end it all?

The canary in the coal mine

This expression originated from the days when miners would take canaries into the coal mines to detect the conditions of the mine. If dangerous gases were present, the canary would become symptomatic, ill or pass away, and the miners would understand that to be a reflection of the toxic conditions of the mine. They did not call the canary weak, blame it on a delicate constitution or a lack of resilience on the part of the canary.

Let’s bring this back to physician burnout and resilience. Are we minimizing the real issues? Isn’t it about time that we as a medical community take a giant step back and consider why these so called deficits — these resiliency issues — are occurring in the first place?

Is it really an individual physician issue?

Read more about the culture of wellness and resilience in medicine.

Could it be a symptom of a much larger issue, a systems problem?

Maybe it is time to assess the health care mines, the conditions to which physicians are routinely exposed during their training and careers.

How many more canaries will take it to make some positive changes to the culture of medicine?

Nadia Sabri is a pediatrician and founder, the Mindful MD Mom.

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