How I Feel Affects My Decisions & Patient Care

     "Historically, the prevailing view in medicine is that clinical decisions should be objective and free from contextual affective issues: one could not be objective and rational if emotion entered the reasoning process. Indeed, many of us would consider it a professional virtue to be able to rise above the emotional pull of clinical situations, to deliver cool, clear, analytical judgments. However, despite what we might believe, our feelings (affect) intrude into almost every decision that we make. Our daily interactions with others are influenced by conscious or unconscious social transference phenomena which are affectively polarised in ways that range from subtle to substantial. Similarly, specific clinical situations provoke lesser or greater degrees of affective valence. In fact, our first response to anything is an affective one that governs the future direction of our relations — we tend to trust our first impressions and stick with them. To then understand the role that affective state has in clinical decision making seems important. 

     The best evidence might be degraded when it is unconsciously passed through an affective filter."
       Croskerry P, Abbass AA, Wu AW. How doctors feel: affective issues in patients' safety. Lancet 2008; 372(9645): 1205-6. 


     "Within mindfulness, the busy physician may find a practical place to begin. Through the cultivation of mindfulness, the busy physician can find clues to the self and to the other, as well as to the aspects of inter-being that not only set the intention of the medical encounter but also provide boundless information and the basis for right action."
       Physician, Know Thyself, Michael Krasner, Shambhala Sun, September 2007.

 

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