Cases and Solutions
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Fictional, but thorough and realistic, case studies are at the heart of Physician Well-Being. One per chapter, they allow readers to get inside the minds of physicians and understand their lives and stressors, from long hours and staff shortages to onerous administrative demands.
For although physicians tend to live, on average, 2 years longer than nonphysicians in the general population, when it comes to mental health, the situation is more dire: 10–15 years after entering medical school, the average physician has twice the level of burnout of the average professional nonphysician. Suicide rates among physicians are 1.4 and 2 times higher than in the general population for men and women, respectively. Abuse of prescribed drugs is also higher than in community control subjects.
Physician Well-Being argues that the major reasons for physician distress are organizational and systemic and focuses on solutions that work, maintaining that changes in the culture and process of medicine aren’t just possible, they’re essential—not only for improving the well-being of health care providers but also for patient care and safety.
The volume’s opening chapter examines the current culture of medicine and the unintended drawbacks of professionalism. Subsequent chapters delve into
- Scenarios in a large health system and multidisciplinary clinic, focusing on solutions that work in current typical health care environments
- Solutions needed to improve the onboarding of physicians in the early years of their career, starting in pre-med programs
- Finding meaning in medicine and navigating the challenges of medical marriages, focusing on solutions that range from alternative medical and nonclinical careers to the use of technology to work remotely and more efficiently
Each chapter includes concise literature reviews that highlight the most salient points, as well as a detailed list of references for readers interested in further exploration. The insights in the book will be useful not only to physicians and medical students but to anyone with an interest in the culture of health care.
Bolstered by knowledge gleaned from the author’s own 30-year career as a psychiatrist, during which he has treated hundreds of physicians as patients, Physician Well-Being offers real-world solutions that serve to make health care systems more effective as the population ages and medical practice becomes ever more complicated.
- Chapter 1. “Our Dedicated Dad”
- Chapter 2. Health Care Is a Team Sport
- Chapter 3. A Unified Mission
- Chapter 4. Trust, Mentoring, and Innovation
- Chapter 5. Pre-Med: Vulnerability and Trauma
- Chapter 6. Medical School: Implicit Biases and a Well-Being Curriculum
- Chapter 7. Residency: A Narcotic Addict’s New Career
- Chapter 8. Cognitive Dissonance and Defining Meaning in Medicine
- Chapter 9. Medical Marriages: Caring for Each Other
- Chapter 10. The Joy and Meaning of Medicine
About the Authors
Peter Yellowlees, MBBS, M.D., is Chief Wellness Officer at UC Davis Health and Professor of Psychiatry and Vice Chair for Faculty Development in the Department of Psychiatry at the University of California–Davis in Sacramento, California.
Dr. Peter Yellowlees, the Chief Wellness Officer of UC Davis Health System and a trained psychiatrist, has prepared an engaging and comprehensive guide to the issues and solutions involved with physician wellness. This is a wonderful follow up to his first book, with each chapter using individual cases to engage the reader and illustrate how deeply these issues affect physicians, their families, and their whole lives, giving urgency to the need for solutions. Physicians and health care leaders will gain an understanding and direction on how to implement changes individually and in their system. These two books are the first I have encountered to truly address the multifaceted issues in physician wellness and can jointly be used as textbooks in the field.—Anju Hurria M.D., MPH, Associate Clinical Professor, Director of Medical School and Faculty Wellness Program, UC Irvine Department of Psychiatry
Peter Yellowlees’s new title Physician Well-Being: Cases and Solutions successfully captures the scourge that affects the modern-day doctor, who is seemingly pulled in every which direction to perform. In his compelling case studies, Yellowlees captures the innumerable stressors facing the health profession. The poignant anecdotes he relates, no doubt derived from a career full of exposure, serve as a platform to spark discussion on the challenges faced by the everyday doctor. The book is a valuable tool to promote discourse among policymakers, hospital and health system administrations, and the new growing cadre of leaders tasked with promoting clinician well-being. Perhaps most importantly, his commentaries are infused with optimism, informed by present-day solutions suggesting a pathway forward that is paved by hopeful solutions to overcome the obstacles facing our profession.—Jonathan Ripp, M.D., MPH, Senior Associate Dean for Well-Being and Resilience Icahn School of Medicine at Mount Sinai, Chief Wellness Officer Mount Sinai Health System
In Physician Well-Being, Peter Yellowlees builds on his seminal work on physician suicide with another brilliant series of illustrative narratives that lay out the root causes, and solutions, of the crisis in physician burnout, depression, and suicide. This is a true tour de force and is by far the most comprehensive and readable work I have seen on this subject. Everything from underlying personality factors in physicians to medical marriages, financial literacy, and systemic factors such as implicit bias, loss of autonomy, and electronic medical records is covered and interweaves seamlessly to lay out what’s happening in contemporary medicine in the United States. This book brings a beacon of hope to those medical students, residents, and attending physicians working in an ailing system of care and has never been more needed than right now.—Steven Wengel, M.D., Professor of Psychiatry, Assistant Vice Chancellor for Campus Wellness, University of Nebraska Medical Center
This book takes a novel approach to presenting and reviewing material related to physician wellbeing. Excerpts and stories exemplify important wellness topics and concluding remarks in each chapter encourage deep and thoughtful discussions. For the reader who seeks to understand the important nuances of physician health and wellbeing, this publication is a treasure trove of salient topics.—Karen Miotto, M.D.
A tour de force! Dr. Yellowlees, duplicating his inimitable style of fictional stories and commentary (so masterfully employed in “Physician Suicide: Cases and Commentaries”) has taken a contextual and incisive look at the lives of today’s doctors and what is ailing them. He argues – passionately and convincingly - for a systemic overhaul of American healthcare to achieve the joy and meaning of medicine. His offerings are cutting-edge and visionary – embracing advanced technology and working remotely, examining climate change and reducing physicians’ carbon footprint, employing hybrid models of in-person and on-line clinical work, revisiting mentoring and promoting connection of diverse health professionals, to name a few. This book will enlighten a wide audience – medical corporate leaders, technocrats and thought leaders, medical school deans and chairs, heads of medical associations, physician health program and state medical board officials, clinicians who treat physicians and their families, and last, but not least, physicians themselves.—Michael F. Myers, M.D. Professor of Clinical Psychiatry. SUNY Downstate Health Sciences University, Brooklyn, NY and author (with Glen O Gabbard) The Physician as Patient: A Clinical Handbook for Mental Health Professionals.
Dr. Yellowlees has come through once again. His skill in storytelling serves to illustrate concrete solutions to the current crisis of physician wellness and burnout. A Great resource for physicians, Health System leaders and anyone else who wishes to gain a better understanding on the topic of physician wellness.—Rajiv Misquitta, M.D., FACP, Past President, Sierra Sacramento Valley Medical Society (SSVMS), Chair, Joy of Medicine committee (SSVMS)
Following the same successful framework used in Physician Suicide: Cases and Commentaries, Dr. Yellowlees once again writes a must read for all physicians in practice, medical students, residents and fellows. In addition, all spouses, significant others, family members and administrators that work closely with physicians should read this book. Physician well-being has been the major focus of health systems over the years and has especially come under our radar following the National Academy of Medicine’s publication in 2017 on the same topic. Physician Well-Being goes upstream and closely examines the root causes that lead to burnout. I applaud that Dr. Yellowlees addresses the continuum and identifies those pivotal points along the trajectory from pre-med, medical school, residency, to practice. The case examples are captivating, real, and compelling and are sure to trigger many of the ‘lived experiences’ that the reader has personally had. The commentaries are thought provoking, provide evidence-based research, and provide pragmatic solutions and resources to address and mitigate the issues at hand. Dr. Yellowlees addresses topics that are often difficult for physicians to discuss, e.g. stigma of mental illness, burnout, failure, addiction, suicidality. It was refreshing that Dr. Yellowlees included a discussion on how implicit and explicit biases, stereotypes, and imposter syndrome impact and influence burnout... something that we often do not see other authors address yet are very real and experienced by many physicians. After reading the book, one quote stands out, “ physician burnout, depression and addiction [are] no longer just a physician wellness issue, it has become a national policy issue.” I now find myself motivated and compelled to become a ‘hybrid practitioner’ and take more of a leadership role in this important issue. I hope this book influences the reader as much as it has influenced me.—David A. Acosta, M.D., Chief Diversity and Inclusion Officer, Association of American Medical Colleges
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