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teaching:z-physician-wellness [on April 12, 2020]
teaching:z-physician-wellness [on January 25, 2024] (current)
psychdb [Burnout]
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 ====== Physician Wellness ====== ====== Physician Wellness ======
 +{{INLINETOC}}
 ===== Primer ===== ===== Primer =====
-As medicine grows more complex, new stresses and demands are placed on healthcare providers. Only recently has the literature begun to investigate the role of burn out, compassion fatigue, and moral distress on healthcare providers. These phenomena do not just affect physicians, but also nurses, social workers, and other providers.+**Physician wellness** is often unaddressed in day-to-day practice. ​As medicine grows more complex, new stresses and demands are placed on healthcare providers. Only recently has the literature begun to investigate the role of burn out, compassion fatigue, and moral distress on healthcare providers. These phenomena do not just affect physicians, but also nurses, social workers, and other providers.
  
 ===== Burnout ===== ===== Burnout =====
-**Burnout** is an emotional and behavioural impairment from chronic exposure to high levels of occupational stress.[([[https://www.ncbi.nlm.nih.gov/pmc/articles/​PMC2175073/​|Kumar,​ S(2007). Burnout in psychiatrists. World Psychiatry, 6(3), 186.]])] In its totality, it is a syndrome of emotional exhaustion (tiredness, somatic symptoms, decreased emotional resources, and a feeling that one has nothing left to give to others), depersonalization (developing negative, cynical attitudes and impersonal feelings towards their clients, treating them as objects) and lack of feelings of personal accomplishment (feelings of incompetence,​ inefficiency and inadequacy). Burnout can also be seen as a "​contagious syndrome"​ in a social context, and especially when working along colleagues who are disillusioned and verbally complain of burn out.[([[https:​//www.ncbi.nlm.nih.gov/​pubmed/​16033595|Bakker, A. B., Le Blanc, P. M., & Schaufeli, W. B. (2005). Burnout contagion among intensive care nurses. Journal ​of advanced nursing, 51(3), 276-287.]])]+<alert type="​info"​ icon="​fa fa-book fa-lg fa-fw">​ 
 +See also: **[[https://​onlinelibrary.wiley.com/doi/10.1111/irj.12418|Fleming, W. J. (2023). Employee well‐being outcomes from individual‐level mental health interventions:​ Cross‐sectional evidence from the United KingdomIndustrial Relations ​Journal.]]** 
 +</​alert>​
  
 +**Burnout** is an emotional and behavioural impairment from chronic exposure to high levels of occupational stress.[([[https://​www.ncbi.nlm.nih.gov/​pmc/​articles/​PMC2175073/​|Kumar,​ S. (2007). Burnout in psychiatrists. World Psychiatry, 6(3), 186.]])] In its totality, it is a syndrome of emotional exhaustion (tiredness, somatic symptoms, decreased emotional resources, and a feeling that one has nothing left to give to others), depersonalization (developing negative, cynical attitudes and impersonal feelings towards their clients, treating them as objects) and lack of feelings of personal accomplishment (feelings of incompetence,​ inefficiency and inadequacy). Burnout can also be seen as a "​contagious syndrome"​ in a social context, and especially when working along colleagues who are disillusioned and verbally complain of burn out.[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​16033595|Bakker,​ A. B., Le Blanc, P. M., & Schaufeli, W. B. (2005). Burnout contagion among intensive care nurses. Journal of advanced nursing, 51(3), 276-287.]])] The most common cause of physician burnout is excessive administrative workload.[([[https://​pubmed.ncbi.nlm.nih.gov/​31520624/​|Yates,​ S. W. (2020). Physician stress and burnout. The American journal of medicine, 133(2), 160-164.]])]
 +
 +==== Mindfulness ====
 +  * Mindfulness-based stress reduction courses reduce physician burnout and improve mental well-being for a broad range of healthcare providers.[([[https://​pubmed.ncbi.nlm.nih.gov/​22849035/​|Goodman,​ M. J., & Schorling, J. B. (2012). A mindfulness course decreases burnout and improves well-being among healthcare providers. International journal of psychiatry in medicine, 43(2), 119–128.
 +]])]
 ===== Compassion Fatigue ===== ===== Compassion Fatigue =====
 **Compassion fatigue** is generally described as caregiver exhaustion as a result of cumulative and progressive absorption of a patient’s pain and suffering.[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​26322644|van Mol, M. M., Kompanje, E. J., Benoit, D. D., Bakker, J., & Nijkamp, M. D. (2015). The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: a systematic review. PloS one, 10(8), e0136955.]])] This frequently results in emotional and physical exhaustion from providing patient care.  It is associated with a gradual desensitization to patient stories, increased clinical errors, poorer quality of care, and vicarious trauma.[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​16569133|Adams,​ R. E., Boscarino, J. A., & Figley, C. R. (2006). Compassion fatigue and psychological distress among social workers: a validation study. American Journal of orthopsychiatry,​ 76(1), 103.]])] **Compassion fatigue** is generally described as caregiver exhaustion as a result of cumulative and progressive absorption of a patient’s pain and suffering.[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​26322644|van Mol, M. M., Kompanje, E. J., Benoit, D. D., Bakker, J., & Nijkamp, M. D. (2015). The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: a systematic review. PloS one, 10(8), e0136955.]])] This frequently results in emotional and physical exhaustion from providing patient care.  It is associated with a gradual desensitization to patient stories, increased clinical errors, poorer quality of care, and vicarious trauma.[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​16569133|Adams,​ R. E., Boscarino, J. A., & Figley, C. R. (2006). Compassion fatigue and psychological distress among social workers: a validation study. American Journal of orthopsychiatry,​ 76(1), 103.]])]
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   * [[https://​www.nytimes.com/​2019/​08/​15/​well/​live/​moral-distress-in-neurosurgery.html|NYT:​ Moral Distress in Neurosurgery]]   * [[https://​www.nytimes.com/​2019/​08/​15/​well/​live/​moral-distress-in-neurosurgery.html|NYT:​ Moral Distress in Neurosurgery]]
 +
 +===== Physician Suicide =====
 +<alert type="​info"​ icon="​fa fa-book fa-lg fa-fw">​See also: **[[https://​pubmed.ncbi.nlm.nih.gov/​31430184/​|Myers,​ M. F., & Freeland, A. (2019). The mentally ill physician: Issues in assessment, treatment and advocacy. The Canadian Journal of Psychiatry, 64(12), 823-837.]]**</​alert>​
 +
 +Between 300 to 400 physicians die by suicide each year in the United States. Physician suicide rates in Canada are unclear and not well studied. Male physicians have rates that are slightly higher than non-physician men, while female physician rates are 3 to 4 times higher than non-physician women. The majority of physicians who die by suicide are living with a mental disorder. Between 10 to 15% of physicians who die by suicide are thought to have received no treatment at all.[([[https://​pubmed.ncbi.nlm.nih.gov/​31430184/​|Myers,​ M. F., & Freeland, A. (2019). The mentally ill physician: Issues in assessment, treatment and advocacy. The Canadian Journal of Psychiatry, 64(12), 823-837.]])]
 +
 +  * [[https://​pubmed.ncbi.nlm.nih.gov/​31061076/​|Albuquerque,​ Joy, and Sarah Tulk. "​Physician suicide."​ CMAJ 191, no. 18 (2019): E505-E505]]
 +
 ===== Resources ===== ===== Resources =====
 +<WRAP group>
 +<WRAP half column>
 +==== Professional ====
   * [[https://​www.cmpa-acpm.ca/​en/​advice-publications/​physician-wellness|CMPA:​ Physician Wellness]]   * [[https://​www.cmpa-acpm.ca/​en/​advice-publications/​physician-wellness|CMPA:​ Physician Wellness]]
 +  * [[https://​pubmed.ncbi.nlm.nih.gov/​31430184/​|Myers,​ M. F., & Freeland, A. (2019). The mentally ill physician: Issues in assessment, treatment and advocacy. The Canadian Journal of Psychiatry, 64(12), 823-837.]]
 +</​WRAP>​
 +<WRAP half column>
 +==== Articles ====
 +  * [[https://​in-housestaff.org/​resident-wellness-is-a-lie-part-1-1319|In-House:​ Resident Wellness is a Lie]]
 +</​WRAP>​
 +</​WRAP>​
 +
 {{tag>​med-ed}} {{tag>​med-ed}}