How physicians draw satisfaction and overcome barriers in their practices: It sustains me

PATIENT EDUCATION AND COUNSELING

卷:100

Article

Branch, William T., Jr.¹  Weil, Amy B.²  Gilligan, MaryAnn C.³  Litzelman, Debra K.⁴  Hafler, Janet P.⁵  Plews-Ogan, Margaret⁶  Rider, Elizabeth A.⁷  Osterberg, Lars G.⁸  Dunne, Dana⁵  Derse, Arthur R.⁹  Pittman, J. Richard¹  Frankel, Richard M.^4,10 

[1] Emory Univ, Sch Med, Atlanta, GA USA

[2] Univ N Carolina, Sch Med, Chapel Hill, NC USA

[3] Med Coll Wisconsin, Milwaukee, WI 53226 USA

[4] Indiana Univ Sch Med, Indianapolis, IN 46202 USA

[5] Yale Univ, Sch Med, New Haven, CT USA

[6] Univ Virginia, Sch Med, Charlottesville, VA 22908 USA

[7] Harvard Med Sch, Boston Childrens Hosp, Inst Professionalism & Eth Practice, Boston, MA USA

[8] Stanford Univ, Sch Med, Palo Alto, CA 94304 USA

[9] Med Coll Wisconsin, Inst Hlth & Soc, Milwaukee, WI 53226 USA

[10] Cleveland Clin, Educ Inst, Cleveland, OH 44106 USA

关键词: Faculty development;    Professional identity formation;    Medical humanism;    Physician satisfaction;    Medical education;    Physician burnout;    Mindfulness;   

DOI  :  10.1016/j.pec.2017.06.004

来源: Elsevier

【 摘 要 】

Objective: Major reorganizations of medical practice today challenge physicians' ability to deliver compassionate care. We sought to understand how physicians who completed an intensive faculty development program in medical humanism sustain their humanistic practices. Methods: Program completers from 8 U.S. medical schools wrote reflections in answer to two open-ended questions addressing their personal motivations and the barriers that impeded their humanistic practice and teaching. Reflections were qualitatively analyzed using the constant comparative method. Results: Sixty-eight physicians (74% response rate) submitted reflections. Motivating factors included: 1) identification with humanistic values; 2) providing care that they or their family would want; 3) connecting to patients; 4) passing on values through role modelling; 5) being in the moment. Inhibiting factors included: 1) time, 2) stress, 3) culture, and 4) episodic burnout. Conclusions: Determination to live by one's values, embedded within a strong professional identity, allowed study participants to alleviate, but not resolve, the barriers. Collaborative action to address organizational impediments was endorsed but found to be lacking. Practice implications: Fostering fully mature professional development among physicians will require new skills and opportunities that reinforce time-honored values while simultaneously partnering with others to nurture, sustain and improve patient care by addressing system issues. (C) 2017 Elsevier B.V. All rights reserved.

【 授权许可】

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