Great Read: What Doctors Feel (How emotions affect the practice of Medicine) by Dr. Danielle Ofri

Several years ago, a colleague was cleaning out his bookshelf and gave me copies of Dr. Danielle Ofri's books Singular Intimacies:  Becoming a Doctor at Bellevue and Medicine in Translation:  Journeys with My Patients.  The first took me back to my early years of training and practice and reminded me of the many beautiful (and stressful) experiences of the time.  The second was a more inspirational read, focused as it is on patient resiliency and courage.  Both reminded me of the power physicians have to tell powerful, educational, and emotional stories that can influence others to stretch, grow, and learn.

Dr. Ofri is an internist at Bellevue Hospital and an associate professor at New York University School of Medicine.  Her latest book, What Doctors Feel (How Emotions Affect the Practice of Medicine) was a great long weekend read...full of vivid storytelling that captures the not so obvious emotional journey of physicians as they care for their patients (and, to a degree, each other and themselves).

We never really know what a physician is thinking or feeling as they care for their patients....if they have just been yelled at by a hostile colleague, experienced a frustrating patient death or complication, are worried about their marriage or kids, are mind-numbingly tired (or depressed), or...yet, that world can have a profound impact on the quality of the care they deliver.

Dr. Ofri does a great job illustrating the complexities of this inner world of physicians and peppers her narrative with reference to what evidence exists in this unexplored corner of physician health.

Grateful to Dr. Ofri for making a weekend on call much more interesting (a real page turner in between cases); she reminds us of the powerful role the humanities play in enhancing our resilience, insight, and motivation.

How can surgeons promote learner/patient safety threefold?

A reader sent me an article that I really enjoyed over the weekend.  Not only was it focused on Surgeons, a group of colleagues I have tremendous respect for, it also focused on an eloquent and simple strategy to promote learner and patient safety.

The intervention was simple.  From the paper:

"A randomized clinical trial in which medical students (n=55) were randomized to an “encouraged” (E, n=28) or “discouraged” (D, n=27) group. Participants underwent personality tests to assess decision-making styles, and were then trained on basic tasks (“burn” then “cut”) on a laparoscopic surgery simulator. After randomization students assisted at a simulated laparoscopic salpingectomy. The senior surgeon used either an “encourage” (E) or a “discourage” (D) script (e.g.: E: “Your opinion is important.” D: “Do what I say. Save questions for next time.”). Otherwise, the surgery was conducted identically. Subsequently a surgical mistake was made by the senior surgeon who instructed students to cut without burning. Students were considered to have spoken up if they questioned the instruction and did not cut."

The outcome?  Equally simple but of a profound impact:

"The students in the encouraged group were significantly more likely to speak up (23/28, 82% vs. 8/27, 30%, P<0.001). "

This is exciting - a supervising surgeon can increase - almost threefold - the motivation and ability of a learner to speak up in a crucial moment by doing nothing more than a singular encouraging statement.

Well-MED: The Newest International Physician Health Gathering of Minds

Efharis Panagopoulou, PhD (Aristotle University Medical School, Greece) and Anthony Montgomery, PhD (University of Macedonia, Greece) recently launched the "First International Meeting on Wellbeing and Performance in Clinical Practice" in Alexandroupolis, Greece.

There have been similar conferences elsewhere in Europe (in fact, very soon will be the International Conference on Physician Health in London, England), Australia, New Zealand, the United States and Canada and there is much need and interest in more opportunities for scholarly work and connectivity in the field of health professional health.

This event attracted an all-star list of keynote speakers and invited experts on physician health including Canada's own experts Dr. Jean Wallace, Dr. Pierre Gagne, Dr. Todd Hill and Dr. Joan Horton.

The theme of the event was "Doctors think.  Doctors feel.  Doctors do." and attracted participants from 31 countries involved in medicine, nursing, psychology, ethics, sociology and economics.

The conference has published abstracts from its amazing agenda for broad dissemination - a very useful and practical outcome.  For those interested in the field, the abstracts are worth the read.  You can follow them on Facebook as well.

Hopefully, there will be a 2nd conference - congratulations to all!