Once a word that was synonymous with getting through tough times in medicine, it has become the 10-letter word of physician wellness. Naively, we grasped onto this word given the underlying concept of “being able to bounce back from adversity”. How could it be a bad thing?
Now we aren’t suggesting that resilience be outcast terminology from the hard work of being human, because quite frankly, resilience has been an underlying factor in the progression of the human race. What we are proposing is that when we discuss the causes of burnout, and how to prevent and manage this epidemic among physicians, we don’t use resiliency in this context. It implies that physicians need to figure out how to ride the waves to avoid burnout.
Dr. Nisha Mehta wrote an article, Physician Burnout: Why I Don't Stress Resilience, that we read on Kevin MD this past week. She made an extremely valid point that physicians are no less resilient than they have always been. What we have is systems and a medical culture that are becoming too much for the already resilient physicians and trainees that are subject to them.
The most resilient creatures can't survive a toxic environment that subjects them to no control and little reward. Newly minted physicians are facing unpredictable residency selection, mountains of debt, uncertain job opportunities, all the while handcuffed to an EMR; where the workload seems endless and prescribed, and the horizon looks nothing like what they dreamed of.
So, when it comes to physician wellness, resilience is a term we need to respectfully retire until we get a hold on the things that make the most resilient physicians unwell: loss of autonomy, lack of control, and loss of meaning. Many terms come to mind but why don’t we start with a simple, albeit massive, one - change.
“Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.” ~ Margaret Mead