Would you ever consider a routine day at the office as how many people are going to abuse you?
As a psychiatrist who works primarily in an acute care setting, I look after patients that enter the emergency room with complex mental health and social difficulties. I have been doing this work for close to a decade now. I often get asked why I choose to continue the work, and the simple answer is that I do see the value of looking after some of society’s most vulnerable individuals. Yet, there are moments that degrade every ounce of you because of the encounters with abuse. Whether this abuse lies in the form of racial abuse, verbal abuse, or even physical abuse, I have found that we do not talk about it enough.
In the evolving landscape of health care, doctors are often esteemed as healers. However, there lies a disturbing reality: Many doctors are subject to various forms of abuse within the health care system. This abuse, which can be physical, emotional, psychological, and verbal, is a growing concern and has far-reaching consequences not only for the doctors but for the entire health care system.
I have a distinct memory from medical training over a decade ago. I would assess my patients in patient rooms. As time has lapsed, I now am forced to see patients in hallways as they wait hours, and sometimes days, to get into a room. The excessive wait times, archaic hospital policies, and lack of pillows on hospital beds create a cauldron where patients feel the need to lash out at the doctor who is part of the cog of a breaking system. The same environment that stimulates abusive behavior towards physicians is the environment that is causing many physicians to leave the field and work in a different way. What does this mean for the profession?
The effects of abuse on doctors can be deeply traumatizing. As a physician who has experienced various forms of abuse, there are many times when the impact has affected my ability to keep empathy real and not develop negative transference to abusive patients.
The escalating abuse experienced by physicians in today’s health care world provides, at times, the final straw to reconsider the profession. As many doctors leave the profession or reduce their hours due to burnout or mental health issues, health care systems are left with fewer providers to care for an ever-growing patient population. This creates a vicious cycle in which patient care deteriorates, leading to more frustration and abuse directed at remaining health care providers.
I have yet to come up with solutions for how we as a profession combat abuse. In reflecting on the institutions I work in, creating awareness of the issue is often the first step in eliciting behavioral change. I feel that the health care systems we work in must create safe and supportive environments for us. I think the creation and implementation of anti-abuse policies is a great first step in addressing this huge issue facing our field.
Medical training should also play a role in preparing future doctors for the emotional challenges of the profession. The future generation of physicians learning how to handle difficult patient interactions and be in tune with self-care is of utmost importance. Furthermore, mentorship programs can help guide new doctors through the pressures of the profession, reducing the likelihood of abuse.
Finally, public awareness campaigns can help shift the narrative around doctors” work. Patients and their families must be educated about the pressures doctors face and encouraged to communicate respectfully and cooperatively. Promoting mutual respect between health care providers and patients can go a long way in reducing abuse.
As physicians, medicine is a place we call home because of the passion to look after humankind. When faced with abuse, the construct of why I became a clinician unravels. The abuse doctors experience in health care today is a complex issue that affects not only the individuals involved but the broader health care system as well. Verbal, physical, and institutional abuse can lead to burnout, mental health issues, and a decline in the quality of care provided to patients. By recognizing the toll abuse takes on doctors and taking proactive steps to mitigate it, we can ensure a healthier, more effective health care system for everyone involved.
Devina Maya Wadhwa is a psychiatrist.
