Thursday 11 July 2013

Important - but Usually Burried - Stressors for Physicians

     "Our (physicians' peer support group) meetings for the first year were formal, with careful selection of comments and an intellectual approach to emotional and psychological problems. ...
     After almost 2 years of discussing patients, we gradually began to focus directly on each member's feelings, reactions, & interpersonal dynamics, whether generated by a patient or by family or personal events. It became apparent that our problems with patients had roots in our personalities & experiences extending beyond the immediate practice setting. ... The turning point was a deeply personal presentation of a terminally ill patient that evoked the presenter's own fear of death. Feelings have gradually replaced intellectualization as we find the issues critical to our professional performance to be related more to our own marital discords, fears of death, failures to live up to our own goals as parents & persons, and feelings of incompetence or uncertain self-esteem. In essence, to reduce stress and do our clinical work well, we find that we must deal with our own unfinished business with parents and childhood raised by the day-to-day work of patient care.
     As the group has evolved, we have come to link our personal emotional health & growth with our professional performance & growth. ... the physician-patient relationship & the personhood of the physician (are) at the crux of a physician's work. With this approach, the personal issues of working (isolation & competitiveness, judgment, errors, wealth & personal value, limit setting, & relating to partners) and the existential human issues of practice (suffering, loss, & death) become the focus of group work."
  
     Eubank DF, Zeckhausen W, Sobelson GA. Converting the stress of medical practice to personal and professional growth: 5 years of experience with a psychodynamic support and supervision group. J Am Board Fam Pract 1991; 4(3): 151-8.

Nate Dogg   www.dpreview.com

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