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Health professional wellness hierarchy.

Beyond Burnout: A Physician Wellness Hierarchy Designed to Prioritize Interventions at the Systems Level

Burnout has been implicated in higher physician turnover, reduced patient satisfaction, and worsened safety, but understanding the degree of burnout in a given physician or team does not direct leaders to solutions. The model proposed integrates a long list of variables that may ameliorate burnout into a prioritized, easy-to-understand hierarchy. Modified from Maslow’s hierarchy, the […]

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Building Trust in the Profession: What Can We Learn from Choosing Wisely?

  The Choosing Wisely campaign sought to prompt physician–patient conversations about unnecessary care. At its 2012 launch, physicians and patients felt uncomfortable about “denying” even unnecessary or potentially harmful care. Opponents of the Affordable Care Act raised fears of rationing and death panels. Physicians and patients had long mistrusted the motives of third parties, including […]

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Annals of Communication: ’Giving a Patient a Diagnosis‘ and Other Idioms in Development

Communication is at the heart of the medical enterprise. We doctors share our research and our interpretations of that research in words. We use words to learn about the concerns of our patients and record our impressions, our findings, and our plans; words to share with patients and families what we have discovered, how we […]

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Burn Bright II: Reflections on Solutions to Burnout (Part Two of a Two-Part Series)

  There have been many published studies describing the current epidemic of burnout among physicians, but there are far fewer with solutions to the problem. Different approaches have been tried, but few have shown a significant impact on burnout or improved wellness among physicians. Nevertheless, the few published studies of solutions present some promising strategies […]

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Assessment and Treatment of Physician Speechlessness

What does a doctor say when words don’t come? Such was my dilemma several years ago on an inpatient psychiatric service when I responded to an emergency alarm activated by staff in a patient’s room. A young female patient—call her Lisa—had just knotted some latex gloves around her neck, and her face was still plethoric […]

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Burn Bright I: Reflections on the Burnout Epidemic (Part One of a Two-Part Series)

I’m not alone in having experienced burnout and its consequences. One of the hardest working and most successful in my medical school class, I experienced early predictors of later struggles: I would get anxious whenever I had to go on away rotations, partly because of being far from my family, friends, and community support network […]

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