Go-it-alone approach can bring fallout for physicians’ wellness

Sara Berg, MS , Senior News Writer

Patients often express frustration because they feel physicians are not present in medical care. However, physicians and health professionals are frustrated because they feel they are not allowed to be present. Physician, educator and author Abraham Verghese, MD, attributes this to the many interruptions and intrusions on a physician’s time with their patients.

As a keynote speaker at the American Conference on Physician Health 2017, Dr. Verghese’s subject is “healing the healer.” The talk will draw on themes from his second book, The Tennis Partner: A Story of Friendship and Loss, which Dr. Verghese describes a story about the phenomenon of addiction and wellness in physicians.

Taking place Oct. 12–13 in San Francisco, the conference is hosted by the Stanford University School of Medicine in collaboration with the AMA and the Mayo Clinic. The event aims to bring together physicians, researchers and others from across the country to help create an organizational foundation to achieve joy in medicine.

“We often think that in return for caring for individuals and being exposed to the kind of carnage that most people don’t witness, that we’re somehow insulated from this or we’re even immune from some of the rules that apply to the rest of the world,” Dr. Verghese told AMA Wire®. “That sort of thinking is often the genesis of addiction.”

Dr. Verghese is a professor and senior associate chair for the Theory and Practice of Medicine at Stanford University School of Medicine. He also runs Presence, a medical center at Stanford University, which has the subtitle, “Art and Science of Human Connection.” The best-selling author’s website says Dr. Verghese has earned an international reputation because of his “focus on healing in an era where technology often overwhelms the human side of medicine.”

“I’ve always had a long interest in the human experience of medicine, not just the human experience of patients, but also the human experience of physicians,” he said.

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Physician burnout and stress can lead to substance-use disorders, Dr. Verghese argues. “Addiction is a disease of secrecy and loneliness” is an old AA aphorism.  Physicians carry professional secrets and cannot often share what they see and feel. When looking at the Alcoholics Anonymous model, he argued that one reason it can be a lifesaver is because it helps people with substance-use disorders share their innermost thoughts with peers who understand their experience and can share in a journey toward recovery.

“You give up your secrets, and it forces you to give up your loneliness,” he said.

Dr. Verghese says that when he began his training doctors weren’t encouraged to talk about what they saw or experienced. That model can discourage physicians from deep reflection on what they are seeing and experiencing in practice, he said.

“Not only do we have secrets, but we’re also somewhat isolated,” said Dr. Verghese. “Not even your spouse necessarily can make the journey with you. You’re making it alone, for the most part.”

“That is when people become unwell. That is the setting when people can fall into practices of self-medication and other things that can get you in trouble,” he added.

Dr. Verghese recommends physicians not deny their "patient-hood" when they are ill or stressed. While it can be easy—when taking care of someone else—for physicians to ask how their marriage is, how much they are drinking or probe whatever else is going on, physicians are not good at taking that thoughtful approach with themselves or their colleagues, he said.

“The new generation that is coming through is much more adept at taking care of their physical selves and being more conscious of their sleep and the hours they spend, but not entirely,” Dr. Verghese said. “These are problems that never quite go away.”

Dr. Verghese hopes his keynote and the other speakers at the ACPH will reaffirm physicians’ faith in their calling and the reason they are here.

“Sometimes we can lose track of that, the passion, the calling, what was called ‘the ministry of healing’ and there’s great joy in gathering together and renewing our vows,” he said. “It’s a crucial aspect of medicine that’s so different than many other walks of life.”