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First Do No Self HarmUnderstanding and Promoting Physician Stress Resilience$
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Charles Figley, Peter Huggard, and Charlotte Rees

Print publication date: 2013

Print ISBN-13: 9780195383263

Published to Oxford Scholarship Online: January 2014

DOI: 10.1093/acprof:oso/9780195383263.001.0001

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Ethical Decisions

Ethical Decisions

Stress and Distress in Medicine

Chapter:
(p.281) 16 Ethical Decisions
Source:
First Do No Self Harm
Author(s):

Spike Jeffery

Carlin Nathan

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780195383263.003.0016

No profession takes so many years of training yet results in a practice with so much regulation. It is not surprising that doctors might expect that after 7 to 10 years of training they will be considered sufficiently expert to wield a large degree of professional autonomy yet are often surprised to find people limiting or disputing their right to make decisions based on their perceived expertise. Lawyers trolling for plaintiffs, Health Maintenance Organizations (HMOs) limiting payments on the basis of performance, state licensing rules requiring Continuing Medical Education (CME) courses, patients asking too many questions when only 15 minutes have been scheduled: each of these common situations and more can create restrictions on professional judgment and become potential sources of physician stress. And that is only a tiny representation of the problems doctors face daily. It is not surprising that a number of physicians end up with drug and alcohol problems, even without the additional factor of unusually easy access to these drugs, which their profession also enables. Many American physicians see themselves by and large as an overworked and underappreciated lot; and the fact that the public sees them as relatively rich and powerful only adds to the sense of isolation or dissonance that some physicians feel.

Keywords:   Physician Stress, Challenges to Practice, Physician Perceptions, Ethical Violence, Ethical Idealism, Humor, Resilience

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