Many physicians work in a demanding professional climate fraught with long hours, rapidly paced schedules and, most often, an overwhelming clinical responsibility. As a backdrop to these daily rigors, the onus of legal liability along with professional isolation, will, over the long haul, exponentially compound the emotional toll of a medical practice.
While these are powerful dynamics in the work-a-day world of the physician, they can also become corrosive forces in the private lives of physicians. Opportunities for social support, collegial relationships outside the workplace, participation in family life, recreation and self-care activities can take a costly backburner to the daily practice of medicine. The physician is consistently challenged to find a balance in daily living that will support and rejuvenate the ability to practice and practice well.
Training does not prepare physicians for the balanced management of a practice. Medical school does not focus upon the well-being the physician. Conversely, training more frequently reinforces the denial of personal needs in various ways. Early on the career path, the physician is expected to work to full capacity even when physically and emotionally spent. Additionally, often victims of the nonprofessional behavior of superiors themselves, younger physicians are soon initiated into the professional world of power and control.
Professional role models often expose the physician-in-training to their own emotional distress in the workplace. Emotionally-driven behavior and poor, even abusive interpersonal behaviors, are not uncommon ‘lessons’ for the student or resident. Superiors can model powerful and self-sabotaging workplace behavior that the younger physician internalizes. Students often learn early on that those in charge can behave in marginal or even abusive ways to those with ‘lesser rank’.
The training of a physician is lengthy and arduous. It takes place, throughout its course, within the rank and file of a rigid hierarchy. The need to please superiors in order to be successful is always front and center. Moreover, medical training is a difficult and costly investment. While the majority of physicians will begin practice in deep financial debt, the emotional investment of training is deep as well. Consequently, young physicians will endure much to succeed. Unfortunately, in a profession that demands so much over the long haul, and in the confines of a work day, many will struggle to cope with the emotional costs of practice while their training has often ill-prepared them to do so.
Gregory A. Kyles, M.A., LPC, CEAP, CAMF
Director, Anger Management Institute of Texas
Diplomate, President of Texas Chapter
American Association of Anger Management Providers