The prevalence and impact of physician stress

Connected coverage — selected articles on trends, challenges and controversies in the changing world of medicine.

Posted March 25, 2013

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For all the focus put on improving physician performance and quality of care, one area of concern often is overlooked — the everyday stress and strain of the health care workday.

American Medical News has reported on how the seemingly ever-growing demands on physicians are affecting them negatively and often are having an impact on the quality of care patients receive. Although studies find that stress-related mistakes aren’t many, they do happen, and they represent what many health care experts believe is a persistent — but they hope fixable — issue in the fight for better care.

Warning sounded on demoralized health care work force

A report from the National Patient Safety Foundation’s Lucien Leape Institute finds that many medical environments are growing more taxing for those who work in them, creating a greater risk for those treated in them. The organization said increasing occupational injury rates, more verbal and physical assaults among colleagues, and a drive to deliver more care in less time is setting back the effort to increase quality of care. The institute has some suggestions on how to reverse this trend, including creating an environment that values civility and transparency.

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Primary care time squeeze explains errors in diagnosis

Diagnosis errors that result in patients returning to the doctor or checking into the hospital are relatively few, but when they happen, it’s often related to physicians being caught in a time crunch, according to a study in JAMA Internal Medicine, formerly Archives of Internal Medicine. The study’s lead author said that’s because so many of the mistakes are related to the bread-and-butter of the office visit — how patients and physicians communicate, and how doctors conduct exams and take histories.

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Using mindfulness to soothe physician stress

With nearly half of doctors reporting symptoms of burnout, a movement known as “mindfulness in medicine” has sprung up to help physicians find productive ways to relieve the pressure. A goal of mindfulness training is to help doctors stay connected with their patients and practice deliberately on a moment-to-moment basis, rather than get caught up in thinking about all the days’ stresses to come. At least a dozen U.S. medical schools offer courses in mindfulness techniques, and courses for practicing physicians are popping up nationwide. At least one study has found mindfulness to be an effective stress-reducing strategy.

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Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

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American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

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Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

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Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

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Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

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How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

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Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

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Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

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