Relationships among perceived psychological growth,resilience and burnout in physicians

The purpose of this study was to examine the relationships between perceived growth as a physician (i.e., positive psychological changes experienced as a result of the professional experience) and burnout after controlling for the effects of perceived family support, dispositional resilience, age, and marital status among physicians. Physicians (n = 289) rated perceived support from family and completed the short form of the Posttraumatic Growth Inventory, the Resilience Scale, and Maslach Burnout Inventory. Results of hierarchical regression analyses revealed that the addition of perceived growth significantly improved prediction of resilience and perceived family support for burnout, showing that higher growth, resilience, and family support all were associated with lower levels of burnout. Moreover, the effects of growth on depersonalization, a domain of burnout, were stronger for physicians who perceived a lower level of family support, whereas the effects of growth on personal accomplishment, another domain of burnout, were stronger for physicians who showed a lower level of dispositional resilience. Current results have clinical implications for understanding protective factors for burnout, that is, a sense of personal growth may be a key factor for physicians who may be less resilient or may not perceive strong family support.     

Pediatrician/Psychologist Collaboration: Opportunities for Clinical Child Psychologists

In the United States, pediatricians prescribe the majority of medications used to treat children with psychological disorders, such as ADHD. However, because pediatricians have limited background in psychology or psychiatry, opportunities exist for properly trained clinical child psychologists to assist pediatricians in assessing and treating youngsters with psychological disorders. Psychologists with additional training in psychopharmacology can make even greater contributions by helping pediatricians select and monitor appropriate medications. This paper reviews models of consultation that are especially relevant to psychologists who seek to expand their practice by consulting with pediatricians. Consultant-centered models seem most appropriate in private practice settings, but institutionally employed psychologists have opportunities to also utilize some system-centered approaches. Examples of methods in which pediatric clinical psychologists and child psychologists with psychopharmacology training can assist pediatricians in treating a child with ADHD are discussed.     

Does young adults’ preferred role in decision making about health,money, and career depend on their advisors’ leadership skills?

Few empirical data exist on how decision making about health differs from that in other crucial life domains with less threatening consequences. To shed light on this issue we conducted a study with 175 young adults (average age 19 years). We presented the participants with scenarios involving advisors who provided assistance in making decisions about health, money, and career. For each scenario, participants were asked to what extent they wanted the advisor to exhibit several leadership styles and competencies and what role (active, collaborative, or passive) they preferred to play when making decisions. Results show that decision making about health is distinct from that in the other domains in three ways. First, most of the participants preferred to delegate decision making about their health to their physician, whereas they were willing to collaborate or play an active role in decision making about their career or money. Second, the competencies and leadership style preferred for the physician differed substantially from those desired for advisors in the other two domains: Participants expected physicians to show more transformational leadership—the style that is most effective in a wide range of environments—than those who provide advice about financial investments or career. Finally, participants’ willingness to share medical decision making with their physician was tied to how strongly they preferred that the physician shows an effective leadership style. In contrast, motivation to participate in decision making in the other domains was not related to preferences regarding advisors’ leadership style or competencies. Our results have implications for medical practice as they suggest that physicians are expected to have superior leadership skills compared to those who provide assistance in other important areas of life.     

现代医师心理人格数学模型的建立及测评

目的探索现代医师职业心理人格特点及构建其数学模型。方法采用经典性格量表16PF测验职业医师与新医师两类群体,并应用Logistic回归模型以及判别分析等统计方法研究。结果新医师和职业医师心理人格存在不同的特点,并随着职业生涯发展其心理人格呈现一定变化趋势;结论现代医师心理人格数学模型基本能反映新入行者大致的职业心理倾向,准确判别率为82.8%,可作为医院选聘考核新医生的参考依据。     

The conscience debate: resources for rapprochement from the problem’s perceived source

This article critically evaluates the conception of conscience underlying the debate about the proper place and role of conscience in the clinical encounter. It suggests that recovering a conception of conscience rooted in the Catholic moral tradition could offer resources for moving the debate past an unproductive assertion of conflicting rights, namely, physicians’ rights to conscience versus patients’ rights to socially and legally sanctioned medical interventions. It proposes that conscience is a necessary component of the moral life in general and a necessary resource for maintaining a coherent sense of moral agency. It demonstrates that an earlier and intellectually richer conception of conscience, in contrast with common contemporary formulations, makes the judgments of conscience accountable to reason, open to critique, and protected from becoming a bastion for bigotry, idiosyncrasy, and personal bias.

Stress,achievement, marriage and social support: Effects on the psychological well-being of physicians entering midlife/mid-career

Abstract

The major aim of this study was to examine the relative contribution of stress, professional achievement, personality, quality of marriage and family life, social support satisfaction, work satisfaction, average hours worked and family responsibilities to the psychological well-being (life satisfaction and psychological symptoms) of medical practitioners entering mid-life/mid-career. Fifty-nine female and 57 male physicians completed interviews, questionnaires, and daily stress records. The results confirm the central role that stress plays in the well-being of physicians. Pearson correlations and hierarchical multiple regressions showed other major variables examined did not explain additional variance in psychological symptoms, but did in some instances (professional achievement, quality of marriage, social support satisfaction for work issues) contribute to life satisfaction. A path model indicating a direct and independent effect of professional achievement on life satisfaction and a specific causal sequence of stress, quality of marriage and social support satisfaction for work issues is suggested.     

Médicaments princeps vs. marché concurrentiel. De la motivation obligatoire,au contrôle des motifs médicaux ?

Physicians are free to prescribe the drugs they consider the best for their patients, and simultaneously required to seek healthcare’ cost-effectiveness — especially after patents expiry. While the physician choice of a given molecule is indisputable, French pharmacists gradually gained a large power to choose the brands on chemicals’ and biologics’ competitive markets. In May 2018, the highest judicial Court decided the physician must expressly motivate his exclusive choice of a given brand, and can not simply refuse the brand’ substitution by pharmacists. This unprecedented requirement is extrapolable to all substitutable drugs in France (registered generics and biosimilars). It raises the possible examination of medical choice motives — but in our opinion, it finishes, rather than it opens the arms race between prescribers and mandatory health insurers in France.     

试论病人的自主性与医主之间的关系

病人具有自主性,应该受到医生的尊重。由于病人的自主性受到一些条件的限制,因而医主仍具有继续存在的价值。但是,除在一些特定情况下外,病人的自主性应优先于医主,然而医生又不能放弃自己的责任。