Although there has been tremendous progress in our understanding of disease and in
interventions to restore health, many physicians have lost sight of their personal
well-being. Physicians now confront the stresses of increasing government regulations,
malpractice suits, the business aspects of medicine, increased clinical demands, less
time with patients, a rapidly expanding knowledge base, rising student debt, and how
to balance their personal and professional lives. Although many physicians acknowledge
the existence of these stresses, it is difficult to fully understand their effect
on health. After all, “Illness doesn’t belong to us. It belongs to them, the patients.
Doctors need to be taught to be ill. We need permission to be ill and to acknowledge
that we are not superhuman” (
2
).To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Galen. Of Protecting the Health, book V.in: In: Sleep Thieves: An Eye-Opening Exploration into the Science and Mysteries of Sleep. The Free Press, New York1996: 205
- Illness doesn’t belong to us.J R Soc Med. 1997; 90: 491-495
- The problem of quality of life in medicine.Jama. 1997; 278: 47-50
- Communication with terminal cancer patients in palliative care.Support Care Cancer. 2001; 9: 420-427
- Development and testing of a visit-specific patient satisfaction questionnaire.J Clin Oncol. 1999; 17: 1931-1938
- Substituting proxy ratings for patient ratings in cancer clinical trials.Qual Life Res. 2000; 9: 219-231
- The validity of proxy-generated scores as measures of patient health status.Med Care. 1991; 20: 115-124
- Burnout and self-reported patient care in an internal medicine residency program.Ann Intern Med. 2002; 136: 358-367
- Variation of mood and empathy during internship.Jama. 2002; 287: 3143-3146
- Doctors’ perceptions of the links between stress and lowered clinical care.Soc Sci Med. 1997; 44: 1017-1022
- Burnout and psychiatric disorder among cancer clinicians.Br J Cancer. 1995; 71: 1263-1269
- Burnout and career-choice regret among family practice physicians in early practice.Fam Pract Res J. 1994; 14: 213-222
- Burnout and its correlates in emergency physicians.Acad Emerg Med. 1996; 3: 1156-1164
- A stress management workshop improves residents’ coping skills.Arch Intern Med. 1991; 151: 2273-2277
- Psychiatric morbidity and burnout in the medical profession.Psychother Psychosom. 2000; 69: 329-334
- Burnout among American surgeons.Surgery. 2001; 130: 696-705
- Work-related stress and depression among physicians pursuing postgraduate training in emergency medicine.Ann Emerg Med. 1991; 20: 992-996
- Work-related stress and depression among practicing emergency physicians.Ann Emerg Med. 1994; 23: 1068-1071
- Burnout, depression, life and job satisfaction among Canadian emergency physicians.J Emerg Med. 1994; 12: 559-565
- Burnout in chairs of obstetrics and gynecology.Am J Obstet Gynecol. 2002; 186: 601-612
- The occurrence and distribution of burnout among infectious diseases physicians.J Infect Dis. 1992; 165: 224-228
- Stress and burnout in oncology.Oncology (Huntingt). 2000; 14 (,1636–1637): 1621-1634
- Burnout in the internist–intensivist.Intensive Care Med. 1996; 22: 625-630
- Maslach Burnout Inventory Manual.3rd ed. Consulting Psychologists Press, Palo Alto, CA1996
- Validity of the Maslach Burnout Inventory for family practice physicians.J Clin Psychol. 1986; 42: 488-492
- Burnout syndrome in the practice of oncology.J Clin Oncol. 1991; 9: 1916-1920
- Physician burnout.Med Care. 1994; 32: 745-754
- Burnout, self- and supervisor-rated job performance, and absenteeism among nurses.J Behav Med. 1995; 18: 581-599
- Practice satisfaction, occupational stress, and attrition of emergency physicians. Wellness Task Force, Illinois College of Emergency Physicians.Acad Emerg Med. 1995; 2: 556-563
- Emotional distress in junior house officers.Br Med J (Clin Res Ed). 1987; 295: 533-536
- Antecedents and consequences of work-home interference among medical residents.Soc Sci Med. 1999; 48: 1135-1148
- The well-being of physician relationships.West J Med. 2001; 174: 30-33
- The ravelled sleeve of care. Managing the stresses of residency training.Jama. 1989; 261: 889-893
- Calibrating the physician. Personal awareness and effective patient care. Working Group on Promoting Physician Personal Awareness, American Academy on Physician and Patient.Jama. 1997; 278: 502-509
- How satisfying is the practice of internal medicine? A national survey.Ann Intern Med. 1991; 114: 1-5
- Satisfactions, dissatisfactions, and causes of stress in medical practice.Jama. 1979; 241: 1483-1486
- House staff well-being.West J Med. 1988; 148: 97-101
- Emotional impairment in internal medicine house staff. Results of a national survey.Jama. 1986; 255: 1155-1158
- A prospective study of internal medicine residents’ emotions and attitudes throughout their training.Acad Med. 1991; 66: 111-114
- Prevalence of depression and distress in a large sample of Canadian residents, interns, and fellows.Am J Psychiatry. 1987; 144: 1561-1566
- Stress in medical residency.Ann Intern Med. 2002; 136: 384-390
- Results from CMA’s huge 1998 physician survey point to a dispirited profession.Cmaj. 1998; 159: 52-58
- The psychology of postponement in the medical marriage.Jama. 1989; 261: 2378-2381
- Job satisfaction in general practice.Soc Sci Med [Med Psychol Med Sociol]. 1980; 14A: 495-499
- Physician burnout.HMO Pract. 1994; 8: 58-63
- Physicians’ characteristics influence patients’ adherence to medical treatment.Health Psychol. 1993; 12: 93-102
- Is the professional satisfaction of general internists associated with patient satisfaction?.J Gen Intern Med. 2000; 15: 122-128
- Physician and patient satisfaction as factors related to the organization of internal medicine group practices.Med Care. 1985; 23: 1171-1178
- The job satisfaction and retention of physicians in organized settings.Med Care Rev. 1984; 41: 139-179
- Satisfaction, commitment, and psychological well-being among HMO physicians.West J Med. 2001; 174: 13-18
- The work lives of women physicians results from the physician work life study. The SGIM Career Satisfaction Study Group.J Gen Intern Med. 2000; 15: 372-380
- Mental health, job satisfaction, and job stress among general practitioners.Bmj. 1989; 298: 366-370
- HMO physicians’ use of referrals.Soc Sci Med. 1999; 48: 547-557
- Predicting and preventing physician burnout.Am J Med. 2001; 111: 170-175
- Correlates of burnout among family practice residents.J Med Educ. 1988; 63: 682-691
- The inner life of physicians and care of the seriously ill.Jama. 2001; 286: 3007-3014
- The heart of darkness.J Gen Intern Med. 1992; 7: 424-431
- Views of Practicing Physicians and the Public on Medical Errors.New England Journal of Medicine. 2002; 347: 1933-1940
- The physician’s reaction to a malpractice suit.Obstet Gynecol. 1988; 71: 138-141
- Coping with a medical malpractice suit.West J Med. 2001; 174: 55-58
- Marital and parental satisfaction of married physicians with children.J Gen Intern Med. 1999; 14: 157-165
- Resident physicians in family practice.Fam Med. 1987; 19: 203-208
- A study of occupational stress and depression among emergency physicians.Ann Emerg Med. 1992; 21: 58-64
- Healthy approaches to physician stress.Arch Intern Med. 1990; 150: 1857-1861
- The care of the patient.JAMA. 1927; 88: 877-882
- Just being.West J Med. 2001; 174: 63-65
- Medicine and the Family. Basic Books, New York1995
- A qualitative study of physicians’ own wellness-promotion practices.West J Med. 2001; 174: 19-23
- The funds, friends, and faith of happy people.Am Psychol. 2000; 55: 56-67
- Differences in meanings of health.Fam Pract. 1996; 13: 511-516
- Promoting wellbeing among doctors.Bmj. 2001; 322: 252-253
- Quality of Life and Pharmacoeconomics in Clinical Trials. Lippincott-Raven, New York1996
Am Psychol. 2000;55:1–169
- Religious commitment, Yuppie values, and well-being in post-collegiate life.Review of Religious Research. 1991; 32: 244-251
- Medical Marriages. Plenum Medical Book Co, New York, NY1994
- Individual development in a bio-cultural perspective.Am Psychol. 2000; 55: 24-33
Recapturing the Spirit of Medicine. West J Med. 2001;174
- The American Freshman–Twenty year trends. Los Angeles: Higher Education Research Institute, Graduate School of Education, University of California, Los Angeles1987
- The American Freshman: National norms for fall 1998. Higher Education Research Institute, University of California, Los Angeles, Los Angeles1998
- A checklist for making good choices in trying - or tranquil - times.West J Med. 2001; 174: 41-43
- Doctoring to Heal.West J Med. 2001; 174: 66-69
- Estimates of costs of primary care physician turnover.Am J Manag Care. 1999; 5: 1431-1438
- Understanding physicians’ intentions to withdraw from practice.Health Care Manage Rev. 2001; 26: 7-19
Revisions to selected Medical Staff Standards. Physician Health. Available at http://www.jacwo.org
- Managed care, time pressure, and physician job satisfaction.J Gen Intern Med. 2000; 15: 441-450
- Market-level health maintenance organization activity and physician autonomy and satisfaction.Am J Manag Care. 1997; 3: 1357-1366
- Dimensions and correlates of physician work satisfaction in a midwestern city.Med Care. 1998; 36: 610-617
- Career satisfaction of US women physicians.Arch Intern Med. 1999; 159: 1417-1426
- Physicians’ view of their work environment and organisation.Psychother Psychosom. 1997; 66: 155-162
- Managed care, professional autonomy, and income.J Gen Intern Med. 2001; 16: 675-684
- Physicians and organizations.J Fam Pract. 1995; 41: 27-32
- Changes in career satisfaction among primary care and specialist physicians, 1997–2001.JAMA. 2003; 289: 442-449
- Leading to well-being.West J Med. 2001; 174: 34-36
- The influence of health care organizations on well-being.West J Med. 2001; 174: 43-47
- Mid-career burnout in generalist and specialist physicians.Jama. 2002; 288: 1447-1450
- Perceptions of housestaff stress and dysfunction within the academic medical center.Psychiatr Q. 1989; 60: 283-296
- New requirements for resident duty hours.Jama. 2002; 288: 1112-1114
ACGME. Report of the ACGME Work Group on Resident Duty Hours. Available at: www.acgme.org. Accessed 2002
- Restructuring residency training in obstetrics and gynecology.Am J Obstet Gynecol. 1999; 180: 516-518
Stress and impairment during residency training: strategies for reduction, identification, and management. Resident Services Committee, Association of Program Directors in Internal Medicine. Ann Intern Med 1988;109:154–161
- Medical residents’ emotional well-being.Jama. 2002; 288: 1846-1847
- Resident Burnout.Ann Intern Med. 2002; 137 (; discussion 698–700): 698-700
- Who is sicker.Ann Intern Med. 2002; 136: 391-393
Article info
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
