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STRESSED OUT
Approaching wellness, understanding the
challenges and finding solutions to the
crisis in physician wellbeing
By Jon Courand, MD
A 43-year-old Family Practitioner dreads the beginning of the
workweek and feels little empathy for the next patient asking for
pain medications. A 36-year-old Emergency Medicine physician and
mother of two yells at a nurse for a minor oversight and later finds
herself crying “for no reason”. A 55-year-old Internist fighting the
electronic health record at 8 p.m. to complete his daily notes counts
the days until retirement. Do any of these sound familiar? All of
them? That would not be a surprise given the current statistics. Cur-
rently over one half of all physicians meet at least one criterion for
burnout and fully one third are clinically depressed. Burnout is best
defined as a constellation of three features: emotional exhaustion,
depersonalization, and diminished sense of personal accomplish-
ment. More alarming is the rate of physician suicide equivalent to
two full medical school classes, or close to 400 individuals per year. Resident Work Life Subcommittee and my involvement in physician
14 San Antonio Medicine • April 2017
In some recent studies, the occurrence of suicidal ideation in the
past year was as high as 10 percent in medical students and 16 per-
cent in surgeons following a medical error. These issues are systemic
in medicine, manifesting as early as in the first few months of med-
ical school and continuing through residency training and practice;
concerning given the fact that enrollees to medical school are more
empathetic and well adjusted than their age matched peers pursing
other professional occupations.
As a physician practicing in one of the high risk groups, Critical
Care, I have personally experienced the effects of anxiety and
burnout, and have been fortunate enough to gain greater insight
into these issues as the Chair of the Institutional GME Wellness and
wellness at the national level.