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 holiday season was notorious for causing loneliness, sadness, anxiety, and a sense of loss even before adding the COVID-19 pandemic to the mix. The pandemic has only served to magnify many of these feelings, as gatherings with loved ones are postponed or canceled. The stress of getting everything done on time and navigating family dynamics can lead to struggles that can benefit from support and self-care. In 2021, support …
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Sustaining mental health during the holidays and starting strong in 2022
Smoking cigarettes is well known to cause heart disease, lung cancer, and premature death. In the face of these risks of death, quality of life issues that affect smokers are often overlooked. Although some quality of life issues such as cost, cravings, inconvenience, illness, and stigma are well known, some important effects are largely unknown to the public. For one, smoking is connected with a surprisingly large variety of pains.
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Tobacco is a painful addiction
Trying to match into residency or fellowship can be stressful. I’ve gone through the match once for residency, and I’m currently going through it a second time for fellowship, so I understand your plight if you are going through it too. There are many variables that are out of our control. As much as we may desire to match our desired specialty at our desired location, this uncertainty can lead …
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Healthy ways to reduce stress during match season
Over the last several years, there has been an increasing recognition that burnout is rising exponentially among health care workers – and there has been a positive shift in the public understanding of burnout and other mental health issues in general. Unfortunately, the policy response from governments, health care institutions, and policy-makers has been woefully inadequate.
Instead of addressing the root causes of burnout and mental distress among our health care …
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The trouble with resiliency: It’s time to get to the root causes of health care worker burnout
I remember receiving the email, “Eating Disorder Panel Q & A.” My physician colleague had become very experienced at caring for eating disorder patients. She understood the importance of this work and how misinformed much of the health care community was on the topic.
She took it upon herself to set up a medical didactic session for the health care providers in our practice to provide us with additional education. The …
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Think eating disorders don’t happen to Black people? Think again.
The word vulnerable is derived from the Latin, “vulnerare,” to wound. Vulnerable literally means “able to be wounded.” In common usage, we refer to being vulnerable when we’re feeling weak, fragile, and emotionally worn down. No wonder most of us want nothing to do with vulnerability. Beginning in childhood, we learn to protect ourselves from emotional attacks perpetrated by family members, peers, and teachers. What’s more, if our parents are …
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To be, or not to be, vulnerable in a relationship
When the term white supremacy culture is used, people get uncomfortable — they picture the skinhead as the prototypical racist. And while those people are dangerous, whether by their openly racist views being broadcast or in other subtle ways, they are largely recognizable.
White supremacy culture is inescapable in the United States. We have been saturated in it. Our country was founded on its tenants. The far more dangerous racist is …
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Racism in medicine much more than just overt
For decades, I was constantly told how brave I was and wore “brave” like a scarlet letter on my chest. Brave for choosing to raise my children alone. Brave for becoming a nurse practitioner. Brave for going public with my story of child sexual abuse and complex PTSD. Brave for being willing to stand on a stage and talk about my journey.
I was so convinced of my brave-ness that I …
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If you’re a nurse or an abuse survivor, you don’t have to be brave
A family medicine resident sings, “Self-Care Should Now Be Your Plan.”
Lyrics:
You’ve seen lots of deaths in the hospital.
Many patients you just couldn’t save.
You did everything you could have possibly done, but the winner was the grave.
People over you showed you no sympathy,
So you began to despair.
You just needed someone to show empathy
And some time to do self-care.
The wounds you have might be deep,
But a healer’s …
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Self-care should now be your plan
One patient down. Nine more to go.
My attending politely closed the door behind him and walked back to his computer to chart his patient. His pen crossed off a line from the list that he pulled from his pocket. His schedule was listed in 15-minute intervals.
As we got to the workroom, he sat down, and under his breath, I heard him sigh. It was barely ten o’clock in the morning. …
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We must help physicians at the brink of burnout, depression, and high stress
In Catholic elementary school, we sat at our school desks, and the nuns had us pray for the lost souls in purgatory every day.
If we prayed hard enough, we would pray them out of purgatory and lift them into heaven.
Before I clock in, I say my anti-assault prayers to the gods. I pray for safety. I pray for the next 12 hours to be uneventful.
I thought I would give ICU …
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A nurse’s prayer for safety
There are several major transitions in a person’s medical career. The first occurs when you leave behind undergraduate life for medical school. The first term as a medical student will test your resiliency and confirm whether you are prepared to make the necessary sacrifices to be a physician. The next transition occurs as you leave the academic portion of medical training and enter clinical rotations. This process culminates with the …
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Free association on lessons learned as a new attending psychiatrist
The COVID-19 pandemic escalated the mental health crisis in the U.S., with researchers estimating that 1 in 3 employees will develop a mental illness in the next 12 months. With the majority of Americans part of the U.S. workforce, the onus is increasingly on employers to offer solutions that address ongoing mental health concerns. With mental health providers scarce, a transformative plethora of new treatment options are available, including digital …
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Mental health and the balance between technology and the human touch
On August 30th, Uncle Xi Jinping stepped into many Chinese living rooms and asked hundreds of millions of his nieces and nephews to hand over their video game controllers. Three hours per week is all they get now. According to a press release from Xinhua state news, he promised to give them back on Friday, Saturday, and Sunday for an hour each evening.
Now to my ear, that sounds a bit …
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Addressing online addiction has become a moral imperative
Chronic pain is an epidemic, currently affecting over 100 million American adults – more than diabetes, heart disease, and cancer combined. This doesn’t include children, 1 in 3 of whom live with a chronic pain condition ranging from migraine to chronic stomachaches. Chronic pain disrupts life, impeding the ability to work, exercise, have sex, engage in hobbies, even go outside. It’s the number one cause of long-term disability in the …
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What you don’t know about pain will hurt you
If you find yourself reaching for a bottle or sighing with relief at a well-deserved glass of wine at the end of a stressful day, then you are not alone.
Far more people than you can imagine do the same thing, and many of them feel ashamed that they do.
Those same people are often baffled to learn that alcohol causes the very feeling that they are drinking to alleviate. Most busy …
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Stress: Is it time to expose the alcohol con?
I tend to size people up pretty quickly. Adult ADHD? I can diagnose it in about two minutes. Borderline personality disorder? About one minute. Bad actors on the Dr. Phil show? About 30 seconds (with the benefit of Dr. Phil’s preamble). I can’t help it. I attribute my habit of analyzing people to my training and practice in psychiatry. After a 40-year career in medicine, I can no longer delineate …
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My biggest blind spot is me
