Physicians writing on KevinMD about burnout, moral injury, depression, and suicide in medicine: what causes burnout and whether the word fits, resilience training and why physicians distrust it, who leaves and why, the fear of seeking help and the licensing questions behind it, what physicians say actually helps, and, on the patient side, psychiatry, access to care, and the arguments over diagnosis and treatment. Three maintained records draw on this archive: Physician burnout: what physicians say, in their own words, Physician suicide: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.
The stress and hardship of the ongoing pandemic caused an increase in the number of adults, teens, and children who have sought mental health care recently. More than 23 million American adults received mental health care last year and the American Academy of Pediatrics, the Children’s Hospital Association, and the American Academy of Child and Adolescent Psychiatry warned of a mental health crisis among children and adolescents.
Of course, the need …
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Is it time to find a new mental health provider?
As the latest pandemic wave seems to be easing, I am again thinking about traveling. I love to travel on vacation. A staycation can be nice, especially if there’s a lot to do around the home, whether that’s working on my home (decluttering and organizing anyone?) or just getting all the little things done that I usually don’t make time for. A break from working, but still at home.
Those homestay …
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How physicians can restore themselves on vacation
After working a 10-hour Monday, I came home and wanted to collapse on the couch. It was a typical day of dealing with more needs and demands than what was humanly possible to meet. Specifically, I was chewing on what happened at the end of the day regarding a patient’s unrealistic demands juxtaposed up against a medical system that cannot meet the physical and psychological demands of the latest wave …
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Managing expectations in the face of COVID-19
“Do you plan to cut down on your hours?”
This was what my primary care doctor asked me after she found me complaining about multiple somatic symptoms.
As a psychiatrist, I always took pride in how I prioritized my family’s needs and found a work-life balance. I had decided to work part-time as soon as I graduated from my training. I belong to a dual physician household. Going part-time was the best …
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When primary care helps a psychiatrist
You may be feeling hopeless. That wouldn’t be shocking, under the current circumstances. Reading the headlines, one can’t help but remember the beginning of the pandemic, when we were reading about “flattening the curve” and overrun, understaffed hospitals.
Additionally, the dark days of winter can be a difficult time for many, even under the best of circumstances. Losses from the year become highlighted, family dynamics are under strain, and we may …
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Finding a pathway to hope: reflections from a psychiatrist
I was a third-year medical student in 1999 when the landmark report titled “To Err is Human” was released by the Institute of Medicine (IOM), unveiling the uncomfortable truth about the fallibility of physicians and our medical system. I remember it vividly.
The publication’s scandalous revelation that nearly 100,000 preventable deaths occurred in hospitals each year shocked me. I recall feeling simultaneously offended and defensive at the implication …
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Who will heal the physician?
Early into my military career and as an oral and maxillofacial surgery resident, I started to acknowledge the fact that, during periods of sleep deprivation that were initially inherent to my military training hours and then surgery call requirements, I found myself thinking dark thoughts that I had never experienced before. I scheduled an appointment with a Psychiatrist and was diagnosed with depression. Scratch that. I was diagnosed with “high …
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I risked my career to save my life
The problem
Even in the midst of a global pandemic, mental health in medicine is rarely discussed. And yet, the circumstances of our profession create the perfect milieu for darkness. The long work hours. The regularity of tragedy and loss. The nights, weekends, and holidays you miss with those you love. The constant pressure to be perfect — to be professional, to be composed, to be vigilant, to not make any …
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Reflections on physician mental health and tips for sustaining it
Living in the U.S., chances are you get some regular mail that you never signed up for — a magazine, a journal, a sales flier. As medical professionals, we also get these free journals related to our field. We don’t always have the time to fact-check a publication. And with names that appear to be legitimate, we might take information at face value. This is especially true if we are …
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Misinformation in transgender health care is harming patient care
High functioning depression (or HFD) is the mental health diagnosis given to an individual who exhibits symptoms of high-level depression but manages to maintain overall functionality in life. An HFD person will often engage in activities that would be considered “normal” and healthy for a typical person, maintaining a job and even social relationships (though they may not appear as close and involved as typically expected). However, they might find …
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Recognizing high functioning depression
New Haven, West Virginia, is a small town nestled in Appalachia and located approximately eight miles from the juncture of the Ohio and Kanawha rivers. Newspaper articles from the 1950s and ’60s suggest that the town’s demographic makeup and surrounding area as nearly 97 percent Caucasian.
In 1926, as commissioned by West Virginia, a psychiatric facility was opened and named The Lakin Hospital for the Colored Insane. In the tradition of …
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Mildred Mitchell-Bateman, MD: an icon in psychiatry
Frustration.
If you’ve treated patients with PTSD, I’m guessing that both you and your patients have experienced frustration at numerous points along the treatment course. And it’s understandable – up until this point, the efficacy of PTSD treatments has been notoriously poor. The best options aimed to diminish the severity of symptoms with a combination of therapy and daily medications.
However, the …
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What doctors need to know about psychedelic medicine
The first time I heard the phrase “shoulding all over yourself,” I laughed. As a gastroenterologist, I have a particular affinity for poop jokes. It might not be obvious when you read the phrase, but say it out loud, and you will hear it. I think the phrase also caught me off guard. I didn’t understand the significance of the word should. It just seemed like an ordinary word in …
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Stop “shoulding” all over yourself
I come calling from the frontlines of COVID.
My colleagues and I are exhausted. Defeated. And on the brink of collapse.
I have been a health care worker for 15 years. I have never seen things so bad in so many ways.
At the height of COVID, I was working 12-hour overnight shifts and weekend day shifts, in addition to my full-time job of helping manage a life support system called extracorporeal membrane …
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Support desperate health care workers now, before your life counts on them
Shame.
It’s what keeps physicians silent. It’s what keeps physicians from getting the help they need.
I’ve been a successful doctor for many years, but I’ve lived with the shame of having an eating disorder. It was my secret that hardly anyone in my life knew about.
No more. My shame is gone, and I’m ready to tell you my story.
When I was in eating disorder recovery, my …
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The silent burden of shame
If we are honest with ourselves, many of us are often bored with our lives. It’s not our fault. We followed the blueprint that society laid out for us. We worked hard to get to this stage of our personal and professional lives. Most of us have achieved more than we could have dreamed of when we were younger. We are in the elite profession of medicine. We have the …
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Using positive psychology to cultivate attention to things that matter
For the most highly educated and specialized professional on the health care totem pole, physicians put up with a ridiculous amount of nonsense in the workplace.
You are pressured to see high volumes of patients in a rapid-fire fashion (15 minutes per visit) even when it interferes with the quality of care.
You are expected to complete mundane and excessive administrative tasks and generally are not directly compensated for this time.
You are …
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Why do physicians stay in toxic work environments?
One of the most extensive studies to look at trauma in the U.S., the ACE study (Adverse Childhood Events), showed that more than 60 percent of adults surveyed had experienced one traumatic event during childhood, including enduring physical, emotional, or sexual abuse — 25 percent of women had experienced sexual abuse. This shows how prevalent abuse is in childhood and how most of us carry trauma. It does not escape …
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Who will heal the wounded healers?
I began pondering this topic after I witnessed a health care professional post on Facebook her hospital system’s expectation that she return to work five days into COVID, still ill and actively symptomatic. She needed more recuperative time but struggled to give herself permission to take it. Unfortunately, this scenario is all too common in the health care community. How did we get here?
Demoting the importance of my own health …
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“Me too” instead of “me last”: Have you filled your self-care bucket today?
