The first analysis we will be reviewing is an overview of stress in medical practice, which allows the reader to get a general overview of stress. Stress can be defined as an undue, inappropriate or exaggerated response to a situation. Anxiety about a situation could be positive, but stress is always negative. The adverse psychological changes can actually decrease productivity. This stress in medical practice is simply due to the fact that medical service involves taking care of other people's’ lives and that mistakes or errors could be costly and irreversible. With this aspect of medicine being so highly valued, it is expected that the medical doctor himself must be in a perfect state of mind, without the morbid worries and anxieties. However, doctors are affected by same variables to impose stress, but also prone to stress because of their own work situations and societal expectations. The British Medical Association (BMA) published a treatise on stress in junior and senior doctors. The conclusions were that the effect of stress was similar in both groups and obstructed the doctors’ health and service delivery to patients. Other studies from the American Foundation for Suicide Prevention, show that on average death by suicide is 70% more likely among male physicians than any other professions and 250-400% higher among female doctors, caused by stress and depression. Social expectation, training, and a hostile job environment all factors that contribute to these terrifying statistics. Similar to other professions, there are societal expectations for a doctor. For example, doctors are supposed to be a comfortable person as they are financially well off and failure to meet this expectation can lead to eventual depression. The training for becoming a doctor itself is extremely strenuous, with just getting into the undergraduate and postgraduate levels requiring students to pass through the eye of a needle. A hostile job environment is also very common within the medical field, one that is created by administrative ineptitude and bureaucratic bottlenecks that make the job harder to get though. These issues caused early on in the medical journey can be materialized through individual behavior of increased alcohol consumption and smoking. However, these effects can also be seen through the mental toll that can lead to intense seclusion and individualism. This compromises the quality of care and can lead to impairment of health, grief and suffering.
The second research study we will be looking at is a report on how doctors have managed to deal with difficult patient encounters. Starting with some statistics, it becomes seemingly clear that the number of patients that are “difficult” is so high that even we, as patients, could be included in it! 15% of patient-physician encounters rated as difficult. This difficulty could be caused by patient characteristics like depression or anxiety disorders, somatic symptoms, and greater symptom severity. Physician characteristics that can affect how difficult they see patient interactions are their attitudes about care, fatigue, stress, and burnout. When patients are angry, defensive, frightened, resistant, physicians have to uncover source of difficulty for patient and pay attention to how emotions relate to the medical issues at hand. All of this must be done without getting drawn into a conflict. Patients can also be manipulative and play on guilt of others, threatening range, legal action, or suicide making it all the more difficult to distinguish between personality disorder and being manipulative. With patients like these, physicians must be aware of their own emotions and attempt to understand what the patient wants to get from their care. Two things that physicians must be prepared to deal with are the normal stages of grief and how to break bad news. In terms of grief, doctors must evaluate its cultural context and learn how to validate the patient’s experience with grief. When you are breaking bad news, it is imperative to know who will be present, allow adequate time, privacy, and review clinical situation. Though this is a very personal experience and doctors each have their own way with how they choose to do this, this study recommended disclosing the news directly, allowing adequate response time, discussing implications, having additional resources ready, summarizing discussions, and arranging for a follow-up. This is the final blog and truly gives us enough information to see why the relationship between a doctor and their patients and the relationship between a doctor and their own emotions are equally important in the medical field. Before choosing to become a doctor, people should be aware of the aforementioned and evaluate themselves based on how effectively they can execute these relationships. CHECK OUT THE STUDIES: www.ncbi.nlm.nih.gov/pmc/articles/PMC2408543/. www.aafp.org/fpm/2007/0600/p30.html .
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