By: Jo Shapiro, MD, chief, Division of Otolaryngology, and director, Center for Professionalism and Peer Support, Brigham and Women’s Hospital, and associate professor of otology and laryngology, Harvard Medical School
The study by Dyrbye and colleagues in the March issue reinforces the finding that burnout is more prevalent among physicians than among their peers in the U.S. population. It’s another sobering reminder of what I view as a crisis in medicine. This and other research reports by Shanafelt and colleagues point out just how pervasive and widespread the crisis is. We all want high quality, safe, compassionate patient care, but we have generally neglected the emotional and physical well-being of those who provide such care. I believe that if we are going to find our way out of this emotional impairment crisis, we need to look at what the particular stressors are and do something to mitigate them.
There are some particularly challenging times in a physician’s career, and one of those is being involved in adverse events. I have personally witnessed the devastating consequences to colleagues when things go wrong in caring for a patient, including feelings of shame, incompetence, fear, anger, sadness, and isolation. This isn’t to minimize the most important consequence—to the patient and his or her family—but we cannot ignore the significant effects of such events on the clinician. By not helping each other deal with this emotional fallout, we leave our colleagues in a state of isolation and pain that can lead to all of the negative consequences cataloged in Shanafelt’s work. It’s for this very reason that, at my hospital, we have a Center for Professionalism and Peer Support. Our Center supports clinician resilience and well-being through initiatives such as peer support after adverse events. Providing physicians with an opportunity to share this difficult experience with a colleague who understands and has struggled with similar issues is one way we are trying to mitigate the potentially devastating toll of adverse events. We also provide disclosure coaching, defendant support, and workshops in mindfulness-based practice. There is so much that is wonderful about practicing medicine. I am honored and privileged to care for my patients and their families. It’s crucial that our profession gives that same compassion and care to each other as well.