As clinicians, our work is focused on achieving patients’ health. A chapter on clinician wellness may feel extraneous, narcissistic even. Why is maintaining our well-being important? First, there is evidence that clinician well-being affects patient care.1 Physicians and other healthcare professionals who are experiencing burnout are more likely to report making medical errors,2 and less likely to be perceived as compassionate and caring by patients and families.3 Second, clinicians who are burned out are more likely to leave the practice of medicine or reduce the hours that they devote to medicine; similar results have been found for nurses.4,5 This loss of clinicians is costly for society. For physicians alone, in the United States we spend $15 billion per year to train residents to become practicing physicians.6 Finally, as community leaders promoting well-being it feels hypocritical to urge our patients to make difficult changes to promote their well-being, if we are unwilling to make the same changes.
In addition, contrary to the historical view of physicians in particular as sacrificing themselves and their families for the sake of patients, in our view we can better promote values of wellness and caring for patients and their families if we manifest the same values toward ourselves and our colleagues. As clinicians ourselves, we recognize that physicians, nurses, and other professionals working in the medical field form a community of individuals that is worthy of care. We care about the physicians, nurses, and other clinicians with whom we work and want to promote their well-being, just as we promote the well-being of patients.
In this chapter, we start by describing the concept of wellness, and how emotions play a part in maintaining, developing, or at times, destroying wellness. We will focus on the special challenges that healthcare providers face that may either detract from or support their well-being. We then describe emotional intelligence and other skills that clinicians need to develop to ensure they can manage the challenges inherent to clinical work.
Two introductory remarks. First, while much of the research focuses on physicians, this chapter includes all professionals who work in clinical settings. Physicians face some challenges that may be unique; however, nurses and other healthcare professionals work in the same clinical environment. For the purposes of this chapter, we will talk about clinician wellness. We acknowledge that as physicians ourselves, we are able to speak from our experiences more truly when writing about the physician experience.
Second, wellness has been traditionally defined by what is not present: distress or disease. Burnout is one such phenomenon of unwellness. Other studies assess stress as well as clinical depression and unhealthy coping behaviors such as substance use. More recently, there has been a movement to define wellness in terms of positive qualities: having meaning in life, strong social connections, and integrating work with the rest of life.5 There ...