Promoting Well-being of Physicians: Lessons from the Past and the Present

Well-being of Physicians

In the fast-paced world of medicine, where doctors and future medical professionals strive to heal and provide care, let’s take a moment to reflect on the timeless wisdom of Dr. Weiss, who, in 1983, penned an essay titled “WELL-BEING: A Medical Student Perspective.” Dr. Weiss offered profound insights into the well-being of physicians, insights that remain as relevant today as they were nearly four decades ago.

The Unprecedented Challenge of COVID-19

COVID-19 thrust the medical profession into an unprecedented challenge. Physicians found themselves on the front lines, facing not only a novel and highly contagious virus but also the emotional toll of witnessing the suffering and loss of countless patients. The demands were overwhelming, with long hours, resource shortages, and constant uncertainty becoming the new norm.

The Toll on Physician Well-Being

As physicians worked tirelessly to save lives, their own well-being often took a back seat. The pressures of the pandemic exacerbated existing issues related to burnout, stress, and mental health. The emotional burden of delivering difficult news, making life-and-death decisions, and witnessing the human toll of the virus has left lasting scars on many healthcare professionals.

The Importance of Self-Care

In the face of such challenges, Dr. Weiss’s insights on well-being become more relevant than ever. Read the essay below:

WELL-BEING: A Medical Student Perspective

Eric Weiss, MIV, UCSF

CISR Dolegate,11/1/83

As students of science and of humanity we have become accustomed to paradoxes and incongruities, however, earlier this year the tragic suicide of one of my classmates prompted me to examine one of medicine’s more bewildering paradoxes: that we as physicians, and physicians to be, who are expected and honored by society to be the deliverers of hope, of love, and of health to those in need, should have an incidence of un-happiness, of dissatisfaction, and of disease far above that of the general population. Consider these statistics: the incidence of suicide among physicians is 3 to 4 times and the incidence of narcotics addiction is 30 to 100 times that of the general public, and although there is no good data to confirm it, we sport a notorious reputation as poor lovers or marital partners.

Theories attempting to explain these numbers are abundant. It is argued that the very characteristics which propelled us to medical school, such as high aspirations, compulsiveness, and a willingness to delay gratification, may predispose us to future emotional difficulties. Many of us arrive at medical school prepared to work hard and to forego personal and financial freedoms without any true understanding of our chosen profession, thus setting ourselves up for disillusionment as we confront fallen demigods, incurable patients, and the ever increasing emotional, moral, medical-legal, and fiscal stresses of medicine and its training.

I present this scenario not to suggest that such a progression is inevitable or that we should abandon the many wonderful and unique attributes of medicine and, God forbid, apply to law school, but rather to suggest that a problem exists and that the first steps toward a solution are awareness and recognition. Much of the interest in this area has focused upon those physicians already in trouble, the “impaired physician” whose personal problems interfere with the quality of his or her medical care, education, or family life. But more recently attempts are being made at prevention, stressing physician (and medical student) “well-being” through articles, group discussion, and conferences (see the end of this essay for information regarding the upcoming CMSR sponsored symposium on Medical Student Well-Being). Well-being has been defined by Freud as “the ability to live, work, and love successfully”, it might also be described as fulfilment through the development of all aspects of one’s self.

Many of the things which we can do to promote well-being may seem to be just common sense, yet it behooves us to identify them as given the many demands for our time there is a dangerous tendency to put our own needs low on our list of priorities. Any one of us might generate such a list of activities and attitudes. The following list is modified from the fine work of two men who have shown considerable interest in this area, John-henry Pfifferling, PhD, director of the Center for the Well-Being of Health Professionals in Durham, North Carolina, and Bernard Virshup, MD, author of the book Coping in Medical School:

“Activities and Attitudes that Promote Well-Being”:

  • regular exercise
  • regular conversations with someone with whom you can share personal needs
  • involvement in a personally productive project outside of medical school (to fuel self-esteem and the need for individuation and creativity)
  • confidence in professional ability 
  • willingness to take some risks
  • good time management
  • a realistic commitment to one’s role as a professional

Although our needs as individuals will differ, we all recognize the feelings when such needs are not met: anxiety, anger, depression, and feelings of inadequacy. The prevalence of such feelings amongst our classmates merits some thought. It can be argued that such emotions are healthier responses than the denial of conflicts which will inevitably arise during our training, and this suggests to me a valuable truism: any conflict or crisis presents both a danger to self as well as a unique opportunity for learning and personal growth. Armed with this philosophy we need only master the ability to transcend and move forward from our crisis rather than to be thwarted and stumble backward into anxiety and depression, and as such the issue of physician well-being carries with it enormous potential for our own personal development and revitalization as we continue with our training and onward into our futures.

I am pleased to close this essay with the announcement of a symposium entitled “Medical Student Well-Being: A Preventive Approach to Physician Impairment”, which is being sponsored by the California Medical Association’s (CMA) student arm, the Committee of Medical Student Representatives (CMSR), as part of the CMA’s upcoming interim meeting. The symposium will be open to all interested parties, free of charge, commencing at 8:30 am on Saturday, February 11,1983, at the Disneyland Hotel in Anaheim, California. Dr. Pfifferling and Dr. Virshup, mentioned above, will be present to share their thoughts on this subject, and I hope you will take advantage of this opportunity to join us in examining how, with an attitude of charity and gentleness towards ourselves and our peers, we may enjoy a lifetime of sharing our hope, our love and our health with our patients.

In reflection on Dr. Weiss’s timeless words, it’s evident that the principles of well-being remain as relevant as ever, especially in the context of a global health crisis like COVID-19. As we honor the sacrifices and dedication of healthcare professionals, we must also recognize the importance of supporting their well-being. By doing so, we ensure their continued ability to provide care and preserve the essence of what drew them to medicine in the first place: the desire to heal and make a difference in the lives of others. In this ever-evolving landscape of medicine, Dr. Weiss’s insights continue to serve as a guiding light, reminding us of the enduring importance of physician well-being.

Read Also: Concierge Medicine: What Is It and Why Do I Need It?

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Eric Weiss, MD, Ocotber, 2023