Authors: Jennifer Reese, MD (1) and Martin Huecker, MD (2)
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Brief Excerpts:
…By blaming the system for our problems, are we instilling learned helplessness and even depression in healthcare professionals? …from Seligman: “Learning that trauma is uncontrollable may produce more stress”… “Learning and believing that one is helpless and hopeless is the central psychological cause of depression”. We must stop telling healthcare workers that they are powerless, doomed in the current system.
The system can remove barriers (clear the path) and help prevent burnout, but this approach is unlikely to cultivate wellness. Thriving happens on an individual level. Our hypothesis: System changes can prevent burnout, but individuals must achieve wellness. System changes occur at a “glacial pace,” while individual change can occur today. When doctors assume control, they exert a “self-perpetuating prophecy of self-efficacy”. Individuals can modify behavior with striking efficiency, while system changes are inherently inefficient and not applicable to “stressors and unique needs of different healthcare professionals”.
This does not attempt to negate the valid argument that physicians are already resilient… Grinning and bearing a difficult surgical rotation, powering through eight weeks of studying for the USMLE Step 1, missing your friend’s wedding due to demands of residency – these stubborn exertions of willpower may signal doggedness, but do they indicate mature resilience? Stress exposure without time and space for compensatory recovery does not allow for stress tolerance and growth. We should also consider that there is no apparent ceiling to resilience. A high school football player is extremely resilient, but becomes more physically fit in college, and if lucky enough to become a professional athlete, becomes even stronger. Psychologically we can all continue to build fortitude and become more content throughout our lives…
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Affiliation:
- University of Colorado School of Medicine, Department of Pediatrics
- University of Louisville, Department of Emergency Medicine