A Scoping Review on the Concept of Physician Caring

Abstract

Background Physicians’ interest in the health and well-being of their patients is a tenet of medical practice. Physicians’ ability to act upon this interest by caring for and about their patients is central to high-quality clinical medicine and may affect burnout. To date, a strong theoretical and empirical understanding of physician caring does not exist. To establish a practical, evidence-based approach to improve health care delivery and potentially address physician burnout, we sought to identify and synthesize existing conceptual models, frameworks, and definitions of physician caring. Methods We performed a scoping review on physician caring. In November 2019 and September 2020, we searched PubMed MEDLINE, Embase, PsycINFO, CINAHL, and CENTRAL Register of Controlled Trials to identify conceptual models, frameworks, and definitions of physician caring. Eligible articles involved discussion or study of care or caring among medical practitioners. We created a content summary and performed thematic analysis of extracted data. Results Of 11,776 articles, we reviewed the full text of 297 articles; 61 articles met inclusion criteria. Commonly identified concepts referenced Peabody’s “secret of care” and the ethics of care. In bioethics, caring is described as a virtue. Contradictions exist among concepts of caring, such as whether caring is an attitude, emotion, or behavior, and the role of relationship development. Thematic analysis of all concepts and definitions identified six aspects of physician caring: (1) relational aspects, (2) technical aspects, (3) physician attitudes and characteristics, (4) agency, (5) reciprocity, and (6) physician self-care. Discussion Caring is instrumental to clinical medicine. However, scientific understanding of what constitutes caring from physicians is limited by contradictions across concepts. A unifying concept of physician caring does not yet exist. This review proposes six aspects of physician caring which can be used to develop evidence-based approaches to improve health care delivery and potentially mitigate physician burnout. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-021-07382-4.

You Cannot Function in “Overwhelm”: Helping Primary Care Navigate the Slow End of the Pandemic

“…Healing the broken trust in patient–doctor relationships can be addressed by enabling clinicians to spend more time with their patients. Indeed, the ability to care and the time to do so are important burnout mitigators (Burstein et al, 2022).…”

Benefits and barriers to implementing precision preventive care: results of a national physician survey

“…Respondents brought their own information and perceptions in these responses, as the survey did not inform them about the cost of PRS testing or about the Genetic Information Nondiscrimination Act of 2008, which prohibits discrimination on the basis of genetic information in employment and health insurance, but not in life or disability insurance. 45 The majority (73%) of respondents categorized insufficient time to explain PRS to patients as at least somewhat of a barrier; however, given concerns about PCP burnout, 46,47 it is striking that this was the least often selected potential barrier. Barrier response patterns varied among the 3 latent classes of PCP identified from the data.…”