Recapturing the soul of medicine: Physicians need to reclaim meaning in their working lives

Abstract

In the past 10 years, the culture of medicine in California has changed radically. A study of 454 clinicians by the Sacramento Medical Society indicated that most had felt the effects of these changes deeply.1 Forty percent of those interviewed were clinically depressed. Most reported that they had thought about leaving the profession at least once in the past 12 months. Even more surprising, many would not want their children to go into medicine nor would they choose medicine as a career again. This is not a California phenomenon. An unprecedented number of physicians nationwide, many of them young, are dropping out or seeking early retirement. Something unusual is happening among physicians, and those who care about physician well-being may need to broaden their concern from the care of impaired physicians to the care of all physicians. The future of our profession may be at stake. There is reason to believe that our professionalism—our traditional professional stance, our attitudes, self-expectations, and indeed our training—has made us particularly vulnerable to the kind of stress we currently experience. Year after year in medical schools across the country, the first-year class enters filled with a sense of privilege and excitement about becoming doctors. Four years later, this excitement has given way to cynicism and numbness. By graduation, students seem to have learned what they have come to do but forgotten why they have come. In these times, we need to reconsider the principles by which we traditionally educate physicians. We will need to reexamine our educational goals, objectives, and strategies, to help students to stand up to the stresses of contemporary medical practice.