Resilience.
A quality extensively discussed in the context of the massive stressors under which medical practitioners labor today. From the demands of electronic record-keeping and productivity goals that limit time with patients, to aging patient populations with complex comorbidities and understaffing challenges; the list goes on.
In a paper published in the journal Academic Medicine, Ronald M. Epstein and Michael S. Krasner define the term. “Resilience,” they write, “is the capacity to respond to stress in a healthy way such that goals are achieved at minimal psychological and physical cost; resilient individuals ‘bounce back’ after challenges while also growing stronger.”
In the context of medicine, they add, “Resilience is a key to enhancing quality of care, quality of caring, and sustainability of the health care workforce.”
“A Sick Feeling”
While Epstein and Krasner note that “community and institutional factors” contribute to physician resilience or the lack of it, their emphasis is on equipping individual practitioners to be able to “bounce back.” And this individualistic emphasis, reflected in other studies, leaves many physicians feeling conflicted, including Lauren Roth, MD.
In a 2022 post on MedPage Today’s Kevin MD community, she discusses legislation in Congress to help promote physicians’ mental and emotional well-being.
“Although my very first thought was, ‘oh, thank God … they are finally listening,’” she writes, “that was quickly replaced with a sick feeling in my gut. Why? Because I realized that, like almost every other “resource” available to promote mental well-being in health care workers, the word resilience would inevitably show up. I looked at the official wording of the law and sure enough, it’s there: ‘Identify strategies to promote resiliency.’”
Sustainable Resilience
In our recent article, we address Dr. Roth’s concern in a particularly nuanced way. While the r-word is used, it’s qualified as “sustainable resilience,” meaning individual resilience sustained by a wide range of interpersonal and systemic factors. What we’re calling for, in fact, is a proactive, holistic approach that creates a work culture of well-being. Such a culture buoys physicians rather than leaving them on their own to bounce back.
The ecosystem of the medical workplace has levels that run from the individual to his or her closest colleagues, to their work unit, then all the way up through the organization, including multiple people, policies and procedures. To establish this kind of proactive approach to well-being, we need to ask this question: How can concern for the well-being of practitioners become an essential element in our thinking and practice at each and every level in the ecosystem?”
