Physicians and Stress - Highlights and preventions

Elias Sarru, M.D,M.S, AAFP Primary Care Physician: Saudi Aramco Medical Center; Kingdom of Saudi Arabia 

“Physicians are subject to stress and frustration”; it is a global problem. Physicians’ frustration and dissatisfaction are not with the core concepts of the discipline, or solely with complaints about low reimbursement, or even with hassles related to managed care. They stem from the economic system and its encroachment on the patient-doctor relationship. Additionally, several job related stresses increase the challenges to continue enjoying medicine from the first time we put on a lab coat.

In 1999, family physicians conducted 35 million visits, more than any other specialty (1), and in 2000 family practice had more residency programs than any other specialty (2). Family physicians, as well as other specialty physicians, are subjected to daily stresses and frustrations, as they try to overcome job related issues and an ever changing health care system. (3,4,5,6).

Physicians initially work hard to pay their medical school fees. Afterwards, they have to manage the increasing cost of medical practice. They have to maintain a hard work schedule to afford the rather expensive life style they have created as compensation for family members for their continued absences. Finally, family physicians are burdened  by the responsibility of supporting their children in having a less burdened professional career. Our profession might be considered neither among the best jobs, nor the most stressful jobs of the 21st century. However, our job has lots of demands; it deals with health and life standards. It’s a job that helps people and entails several stressful impacts.

Sources of Stress and Frustration in our Profession:

1 -     The constant changing nature of managed care as well as the growing governmental and insurance companies intrusion into the practice of our profession. (4)

2 -     Constant expectation to limit cost and provision of affordable rather than ideal services. This is more noticed with work on salaried basis. (4,5)

3 -     Continuous expectation to update medical knowledge, and provide high quality care. (4)

4 -     Progressive increase in practice costs and keeping up with professional demands. (6)

5 -     Patients and society continue to be strongly ambivalent about physicians: patients expect us to be always available and ready to listen to their concerns regardless of our state of mind, mood, or physical satiety. (4,5)

6 -     “We are always expected to be infallible in diagnosis and treatment”. Moreover, we are required to be models of virtuous behavior in our communities. (4,5)