Finding, Keeping, and Revitalizing the Meaning in Family Medicine

Abstract

The culture of medicine is undergoing revolutionary change. Physicians are pulled in many directions involving the practice of medicine, the business of medicine, and the technology of medicine. Financial incentives and career promotions may be dependent upon such things as patient satisfaction scores, as well as adherence to guidelines for admissions and diagnostic testing. Of course, these metrics are monitored closely by hospitals, insurance companies, and the federal government. The resultant seemingly endless paperwork, deadlines, and multiple demands may result in a sense of time famine for physicians. Unfortunately, these expectations and demands can subsequently diminish the passion for medicine. Moreover, physicians are at high risk for significant physical and emotional exhaustion, often leading to a sense of demoralization. Physicians can ultimately lose sight of their reasons for choosing the field of medicine. Indeed, they can lose the inspiration and "meaning" derived from work in medicine all together. How, then, does one buffer oneself against such perils, and maintain the original passion and meaning in a chosen career of service to others? This article will describe one program's approach to promoting resilience and maintaining meaning during the residency training years through the establishment of a Meaning in Family Medicine Group. The conceptual background, approach to curriculum development, goals and objectives, resident feedback, and suggestions about how to carry this curriculum beyond the residency training years will be discussed.

Where does resiliency fit into the residency training experience: a framework for understanding the relationship between wellness, burnout, and resiliency during residency training

“…2 Many programs focus on preventing burnout through stress reduction and work-life balance, rather than exploring hardship as an opportunity for learning. Some residency training programs have implemented initiatives to enhance resident resilience, 43 - 45 but at times the terminology can be confusing as the terms resilience and wellness are often used interchangeably…”

“…2 Many programs focus on preventing burnout through stress reduction and work-life balance, rather than exploring hardship as an opportunity for learning. Some residency training programs have implemented initiatives to enhance resident resilience, [43][44][45] but at times the terminology can be confusing as the terms resilience and wellness are often used interchangeably This proposed framework (Figure 1) can be used by residency programs to promote educators and residents' understanding of the unique role of resilience within residency, and the importance of differentiating between wellness and resilience initiatives.…”

Well-being in trainee and faculty physicians

“…A critical concept is that responses suggest that well-being is more impacted by workplace satisfaction than the workplace environment. Although other studies have also noted the important concept of ‘meaning’ in wellbeing [ 14 , 15 ] our study is important in that it describes and differentiates the domains of workplace satisfaction and workplace environment.…”

Faculty burnout in a large department of pediatrics

“…[11] "Research shows that approximately 15% to 20% of physicians will have mental health problems at some point in their careers". [12] There are many factors that have been linked to faculty burnout including patient load, [13] electronic health care records, [3] administrative responsibilities, [14] long hours, [15] and the critical decisions they must make on a daily basis. [16] The present study was designed to assess levels of burnout and sources of stress in clinical, educational, and research faculty (physicians and doctoral research faculty) working in a Department of Pediatrics at a large Children's Hospital setting.…”