Physician Discomfort : Some Reasons Why They are Discomforted

If anyone thinks that physicians have some quality of training or experience that prevents them from experiencing or reacting to emotional discomfort, that person is frankly mistaken. The importance of considering physician discomfort is that such a reaction to an incident or condition may lead to the affected physician's temporary impairment of the intellectual function and clinical reasoning. The subsequent behavior and actions may not be appropriate for proper medical care.

The origin of the discomfort may be from many causes. It can range from something as simple as poor scheduling of patients with the physician having to feel rushed to unexpected patient demands or sexually suggestive patient behavior or even dealing with patient’s discussion about what they saw on direct-to-consumer TV advertising. Such acts as being required to perform unfamiliar examinations may discomfort physicians. For a physician to do evaluations, such as disability exams, writing excuses for school, work or jury duty or writing for disabled parking permits are also discomforting since these are actions where there are patient pressures along with legal consequences for the physician which cannot be ignored.

Physician discomfort can involve dealing with families after the patient’s death or in dealing with medical standards that suggest termination of life-support but which is in conflict with the family’s demands to continue therapy or that the physician may feel personally responsible for a patient’s death by signing an order for termination. As mentioned in prior postings, physicians may feel discomfort in being involved in medical management of medical colleagues, other physicians or even nurses or other “very important persons”. Even responsibilities such as attention to the minor health matters of family members may progress to situations where further self-medical management may be discomforting to the physician.

And there are more. There is no doubt that the overarching fear of being involved in litigation with financial and other consequences or loss of license to practice associated with some alleged unprofessional behavior is common to most physicians. This leads to the well-known practice of “defensive medicine” in an attempt to prevent these occurrences and to ease the professional discomfort. Such medical practice can lead to treatment delays, medically unnecessary additional consultations, increased costs and unnecessary risks to the patients.

I hope to write additional posts about physician discomfort and present some references to other writings dealing with this topic. ..Maurice.