This book explores the important topic of mental health and related problems among physicians, including trainees. The all-too-common human response of "suffering in silence" and refusing to seek help for professional and personal issues has ramifications for physicians who work in safety-sensitive positions, where clear-headed judgment and proper action can save lives. Problems covered include burnout, disruptive and unprofessional behaviors, impaired performance, traumatic stress, addiction, depression and other mood disorders, and suicide.
The authors of this work include psychologists, psychiatrists, and other physicians who diagnose and treat a range of patients with stress-related syndromes. Among their patients are physicians who benefit greatly from education, support, coaching, and treatment.
The book's content is organized into three parts with interconnecting themes. Part I focuses on symptoms and how physicians' problems manifest at the workplace. Part II discusses the disorders underlying the manifesting symptoms. Part III focuses on interventions at both the individual and organizational levels. The major themes investigated throughout the book are developmental aspects; mental health and wellbeing as a continuum; and the multifactorial contributions of individual, interpersonal, organizational, and cultural elements to physician health.
This book is intended for anyone who works with, provides support to, or professionally treats distressed physicians. It is also intended for healthcare leaders and organizations that are motivated to improve the experience of providing care and to change the culture of silence, such that seeking help and counsel become normal activities while minimizing stigma. By writing this book, the authors aim to outline effective pathways to well-being and a healthy work-life balance among physicians, so that they may provide optimal and safe care to their patients.
Kirk J. Brower, M.D.
is professor in the Department of Psychiatry at the University of Michigan (U-M) and executive director of U-M Addiction Treatment Services. Board-certified in both addiction medicine and addiction psychiatry, he serves as the training director of the ACGME-accredited UM Addiction Psychiatry Fellowship Program. As psychiatric consultant for the Michigan Medicine Office of Clinical Affairs, as well as a certified Medical Review Officer, he evaluates and makes recommendations for physicians whose impaired or disruptive behaviors potentially threaten the work environment and the safety of patients. He also is a qualified provider for, and treats physicians enrolled in, the State of Michigan Health Professionals Recovery Program. Dr. Brower is a Fellow of the American Society of Addiction Medicine and a Distinguished Life Fellow of the American Psychiatric Association. His research focuses on improving treatment outcomes for patients with substance use disorders. He has served on the Editorial Board of Alcoholism: Clinical and Experimental Research
and authored or co-authored over 120 peer-reviewed journal articles.
Michelle B. Riba,
M.D., M.S. is clinical professor and Associate Director of the University of Michigan Comprehensive Depression Center, and Director of the PsychOncology Program at the University of Michigan Comprehensive Cancer Center. Currently, she is Secretary for Scientific Publications for the World Psychiatry Association. Dr. Riba's clinical and research interests include primary care psychiatry, depression and cardiovascular disease, psychoncology, and the role of screening for distress in patients with medical illness. She has served on the editorial board of Psychiatric Services and Cancer News on the Net, Current Psychiatry and has served on the editorial advisory board of the American Psychiatric Press, Inc. She is a reviewer for Psycho-Oncology; Academic Psychiatry; Psychiatric Services; Journal of Psychiatric Practice; and Psychosomatic Medicine; Breast Cancer Research and Treatment. She has co-edited 15 editions of The American Psychiatric Press Review of Psychiatry series. She has co-edited Psychopharmacology and Psychotherapy: A Collaborative Approach; Primary Care Psychiatry; and The Doctor-Patient Relationship in Pharmacotherapy: Improving Treatment Effectiveness and has edited or co-written another 15 books.
Part I - Presenting Issues.- 1. Physician Burnout and Wellness.- 2. Work-Associated Trauma.- 3. Disruptive and Unprofessional Behaviors.- 4. Suicidal Behaviors in Physicians.- 5. Physician Impairment and Safety To Practice.- Part II - Underlying Clinical Problems.- 6. Physician Mental Health - Depression and Anxiety.- 7. Manic and Hypomanic States.- 8. Substance Use and Addictive Behaviors Among Physicians.- 9. Cognitive Changes.- 10. Personality Traits.- Part III - Interventions.- 11. Self-Care, Resilience, and Work-Life Balance.- 12. Physician Health Programs: The U.S. Model.- 13. Organizational Level Interventions to Promote Physician Health and Well-Being: From Taking Care of Physicians to Giving Care to Patients.