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A Call to Restore Your Calling

Self-care of the Emergency Physician in the Face of Life-Changing Stress—Part 1 of 6

Mull, Colette C., MD*; Thompson, Amy D., MD*; Selbst, Steven M., MD*; Miller, Elissa G., MD; Rappaport, David I., MD; Gartner, J. Carlton Jr, MD; Bowman, Wesley R., PhD§

Section Editor(s): Mull, Colette C. MD; Feature Editor

doi: 10.1097/PEC.0000000000001807
Physician Wellness/Burnout

Few practicing emergency physicians will avoid life-changing stressors such as a medical error, personal illness, malpractice litigation, or death of a patient. Many will be unprepared for the toll they will take on their lives. Some may ultimately experience burnout, post-traumatic stress disorder, and suicidal ideation. Medical education, continuing education, and maintenance of certification programs do not teach physicians to recognize helplessness, moral distress, or maladaptive coping mechanisms in themselves. Academic physicians receive little instruction on how to teach trainees and medical students the art of thriving through life-changing stressors in their career paths. Most importantly, handling a life-changing stressor is that much more overwhelming today, as physicians struggle to meet the daily challenge of providing the best patient care in a business-modeled health care environment where profit-driven performance measures (eg, productivity tracking, patient reviews) can conflict with the quality of medical care they wish to provide.

Using personal vignettes and with a focus on the emergency department setting, this 6-article series examines the impact life-changing stressors have on physicians, trainees, and medical students. The authors identify internal constraints that inhibit healthy coping and tools for individuals, training programs, and health care organizations to consider adopting, as they seek to increase physician satisfaction and retention. The reader will learn to recognize physician distress and acquire strategies for self-care and peer support. The series will highlight the concept that professional fulfillment requires ongoing attention and is a work in progress.

From the *Division of Emergency Medicine,

Division of Palliative Care, and

Division of General Pediatrics, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Sidney Kimmel Medical College, Thomas Jefferson University; and

§Employee Assistance Program, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.

Disclosure: The authors declare no conflict of interest.

Reprints: Colette C. Mull, MD, Division of Emergency Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Sidney Kimmel Medical College, Thomas Jefferson University, 1600 Rockland Rd, Wilmington, DE 19803 (e-mail:

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