A Few Things of Interest: A Weekly Roundup: Topic = Physician/Surgeon Suicide

Since we couldn’t post recently, we’ll post one longer post now.

Weekly Roundup: Physician Suicide (in order of publication)

MacDonald, H. (2017). Crossing the Rubicon: Death in ‘The Year of the Transplant’. Medical history, 61(1), 107-127.
Rothenberger, D. A. (2017). Physician Burnout and Well-Being: A Systematic Review and Framework for Action. Diseases of the Colon & Rectum, 60(6), 567-576.
Currie, J., & MacLeod, W. B. (2017). Diagnosing expertise: Human capital, decision making, and performance among physicians. Journal of Labor Economics, 35(1), 1-43.
Shanafelt, T. D., & Noseworthy, J. H. (2017, January). Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. In Mayo Clinic Proceedings (Vol. 92, No. 1, pp. 129-146). Elsevier.
Kuhn, C. M., & Flanagan, E. M. (2017). Self-care as a professional imperative: physician burnout, depression, and suicide. Canadian Journal of Anesthesia/Journal canadien d’anesthésie, 64(2), 158-168.
Damasceno, K. S., de Sousa Barbosa, É., Pimentel, J. V. C., Júnior, A. G. T., de Meneses, A. C. P., Júnior, J. G., … & Biruel, E. P. (2017). Suicide among Physicians and Methodological Similarities of MEDLINE/PubMED and BVS/BIREME Open Access Bibliographic Databases: A Systematic Review with Metanalysis. Health, 9(02), 352.
Ho, C., Siegfried, J., Remo, K., & Laskin, J. (2017). P1. 05-060 Adherence to Surveillance Guidelines in Resected NSCLC: Physician Compliance and Impact on Outcomes. Journal of Thoracic Oncology, 12(1), S651-S652.
Shorter, E. (2017). Doctors and their patients: A social history. Routledge.
Stain, S. C., & Farquhar, M. (2017). Should doctors work 24 hour shifts?. BMJ, 358, j3522.

Media

Dr. Pamela Wible

Our apologies for the low quality video.

Here’s another helpful  video by Dr. Wible:

Tools / Tips

What to do when your coworker tells you that they are suicidal:

  1. If the situation is serious, call 911  (or  the emergency number in your country). If you aren’t comfortable with that, or at least the Suicide Prevention Lifeline: tel:1-800-273-8255:  More information here: http://www.sprc.org/resources-programs/role-co-workers-preventing-suicide-sprc-customized-information-series
  2.  Do some research. Here are some examples:

3. Check in with the person, and invite them to have a conversation. Make some excuse to engage them.

4. Don’t ignore signs of trouble and assume HR will intervene.  Research whether your workplace has an employee assistance program. Some people with depression feel too emotionally exhausted to take these kinds of steps to help themselves, so just doing this can help them immensely.

5. A goal oriented approach often helps more than a problem-based approach, when helping people overcome depression.

6. Call your Employee Assistance Plan (EAP) phone number for advice.

These are only a few ways to help. We recommend that you research other ways to help and seek expert guidance as needed.

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Thur Tools and Tips: Improving Cultural Competence

This week, we’ll be sharing a few tips on improving cultural competence.  This is a crucial part of our globalized workplaces, and a key for companies and individuals who what to stay on the cutting edge.  Here are a few tips:

  1. Recognize the worldview of the individuals around you. Culture is not limited to skin color, ethnicity or country. It is far deeper. Learn about the individuals and cultures represented in  your workplace. This will help your work team function most effectively.images
  2.  Get to know your patients’ cultures. Don’t assume you already know their cultures based on their last name or other prejudice. Optimize the short time you have with your patients to learn about them and complete the task at hand.
  3. Determine your cultural effectiveness.  How well do you understand culture and cross-cultural research? Do your homework and brush up on some of the latest research.  Look for strengths and weaknesses of your own worldview based on psychological and sociological studies.
  4. Make your patients feel “at home.” If possible, your staff should reflect your area’s cultural makeup and understand the cultures represented.
  5. Conduct culturally sensitive evaluations, and learn about your patients expectations and preferences.  Don’t treat cases like a factory worker treats a broken machine. Think of the human behind the physical ailment.
  6.   Be willing to learn by making mistakes. You won’t  be able to do it 100% perfectly all the time. Use failure as an opportunity for learning.
  7.  Attend conferences outside of your discipline once in a while to learn more about what’s happening in the arena of cross-cultural competence.
  8. Expand your horizons and interact with groups of people who are outside of your cultural or work bubble. Joining clubs can be a great way to do this if you have a little spare time.
  9.  Find out what resources your department has to help you learn more about other cultures and worldviews. Set aside some time for learning.

We guarantee if you take these steps, you will be on your way towards cross-cultural competence. These are not the only ways to develop cross-cultural competence, but they are a great start. Developing cross-cultural competence will help you avoid miscommunications  and misunderstandings that could be very costly.

Research on Patient Care and Communication

Dear Readers,

Here is some recent research on patient care and communication. We trust that you fill find this useful.

Foo, P. K., Frankel, R. M., McGuire, T. G., Zaslavsky, A. M., Lafata, J. E., & Tai-Seale, M. (2017). Patient and Physician Race and the Allocation of Time and Patient Engagement Efforts to Mental Health Discussions in Primary Care: An Observational Study of Audiorecorded Periodic Health Examinations. The Journal of Ambulatory Care Management40(3), 246-256.

Cole, K. O. W., Gudzune, K. A., Bleich, S. N., Cheskin, L. J., Bennett, W. L., Cooper, L. A., & Roter, D. L. (2017). Providing prenatal care to pregnant women with overweight or obesity: Differences in provider communication and ratings of the patient-provider relationship by patient body weight. Patient education and counseling100(6), 1103-1110.

Kurlander, J. E., Chey, W. D., Morris, C. B., Hu, Y. J. B., Padival, R. K., Bangdiwala, S. I., … & Drossman, D. A. (2017). Development and validation of the Patient‐Physician Relationship Scale among patients with irritable bowel syndrome. Neurogastroenterology & Motility.

Ibe, C., Bowie, J., Roter, D., Carson, K. A., Lee, B., Monroe, D., & Cooper, L. A. (2017). Intensity of exposure to a patient activation intervention and patient engagement in medical visit communication. Patient Education and Counseling.

Epstein, R. M., Duberstein, P. R., Fenton, J. J., Fiscella, K., Hoerger, M., Tancredi, D. J., … & Kaesberg, P. (2017). Effect of a patient-centered communication intervention on oncologist-patient communication, quality of life, and health care utilization in advanced cancer: the VOICE randomized clinical trial. JAMA oncology3(1), 92-100.

Tang, L., & Guan, M. (2017). Rise of Health Consumerism in China and Its Effects on Physicians’ Professional Identity and the Physician–Patient Relationship and Communication. Health Communication, 1-7.

Turner, K., Samuel, C. A., Donovan, H. A., Beckjord, E., Cardy, A., Dew, M. A., & van Londen, G. J. (2017). Provider perspectives on patient-provider communication for adjuvant endocrine therapy symptom management. Supportive Care in Cancer25(4), 1055-1061.

Fernandez, J. M., Cenador, M. B. G., Millan, J. M. L., Méndez, J. A. J., & Ledesma, M. J. S. (2017). Use of Information and Communication Technologies in Clinical Practice Related to the Treatment of Pain. Influence on the Professional Activity and the Doctor-Patient Relationship. Journal of medical systems41(5), 77.

Reeve, B. B., Thissen, D. M., Bann, C. M., Mack, N., Treiman, K., Sanoff, H. K., … & Moultrie, R. (2017). Psychometric evaluation and design of patient-centered communication measures for cancer care settings. Patient Education and Counseling.

Pellegrini, C. A. (2017). Trust: the keystone of the patient-physician relationship. Journal of the American College of Surgeons224(2), 95-102.

Lorusso, D., Bria, E., Costantini, A., Di Maio, M., Rosti, G., & Mancuso, A. (2017). Patients’ perception of chemotherapy side effects: Expectations, doctor–patient communication and impact on quality of life–An Italian survey. European journal of cancer care26(2).

Xiang, J., & Stanley, S. J. (2017). From online to offline: Exploring the role of e-health consumption, patient involvement, and patient-centered communication on perceptions of health care quality. Computers in Human Behavior70, 446-452.

Schieber, A. C., Kelly-Irving, M., Génolini, J. P., Membrado, M., Tanguy, L., Fabre, C., … & INTERMEDE Group. (2017). Integrating multidisciplinary results to produce new knowledge about the physician–patient relationship: A methodology applied to the INTERMEDE project. Journal of Mixed Methods Research11(2), 174-201.

Ernstmann, N., Weissbach, L., Herden, J., Winter, N., & Ansmann, L. (2017). Patient–physician communication and health‐related quality of life of patients with localised prostate cancer undergoing radical prostatectomy–a longitudinal multilevel analysis. BJU international119(3), 396-405.

Tan, S. S. L., & Goonawardene, N. (2017). Internet health information seeking and the patient-physician relationship: A systematic review. Journal of medical Internet research19(1).

Scott, K. M., Nerminathan, A., Alexander, S., Phelps, M., & Harrison, A. (2017). Using mobile devices for learning in clinical settings: A mixed‐methods study of medical student, physician and patient perspectives. British Journal of Educational Technology48(1), 176-190.

Petrič, G., Atanasova, S., & Kamin, T. (2017). Impact of Social Processes in Online Health Communities on Patient Empowerment in Relationship With the Physician: Emergence of Functional and Dysfunctional Empowerment. Journal of medical Internet research19(3).

Brenk-Franz, K., Strauß, B., Tiesler, F., Fleischhauer, C., Schneider, N., & Gensichen, J. (2017). Patient-provider relationship as mediator between adult attachment and self-management in primary care patients with multiple chronic conditions. Journal of Psychosomatic Research97, 131-135.

 

Research of the Week: On Physician and Surgeon Burnout

The following articles  include some very relevant research on phsycian and surgeon burnout.

Chakravarti, A., Raazi, M., O’Brien, J., & Balaton, B. (2016). Anesthesiology Resident Wellness Program at the University of Saskatchewan: curriculum content and delivery. Canadian Journal of Anesthesia/Journal canadien danesthésie,64(2), 199-210. doi:10.1007/s12630-016-0773-0.
Cicchinelli, L. D. (2017). Comments from a Veteran Mission Surgeon. The Journal of Foot and Ankle Surgery,56(2), 223. doi:10.1053/j.jfas.2017.01.032
Deb, A. (2017). Practical Considerations in Addressing Physician Burnout. CONTINUUM: Lifelong Learning in Neurology,23, 557-562. doi:10.1212/con.0000000000000461.
Fumis, R. R., Amarante, G. A., Nascimento, A. D., & Junior, J. M. (2017). Moral distress and its contribution to the development of burnout syndrome among critical care providers. Annals of Intensive Care,7(1). doi:10.1186/s13613-017-0293-2.
Grocott, H. P., & Bryson, G. L. (2016). The physician at risk: disruptive behaviour, burnout, addiction, and suicide. Canadian Journal of Anesthesia/Journal canadien danesthésie,64(2), 119-121. doi:10.1007/s12630-016-0782-z.
Hirayama, M., & Fernando, S. (2016). Burnout in surgeons and organisational interventions. Journal of the Royal Society of Medicine. doi:10.1177/0141076816666810.
Mendelsohn, D., Despot, I., Gooderham, P., Singhal, A., Redekop, G., & Toyota, B. (2017). B.01 Impact of work-hours and sleep on well-being and burnout for physicians-in-training: the prospective RATE Study. Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques,44(S2). doi:10.1017/cjn.2017.72.
Meyer, R. A. (2017). Burned Out or Bummed Out. Journal of Oral and Maxillofacial Surgery. doi:10.1016/j.joms.2017.04.047
Nahai, F. (2016). When Love Is Not Enough. Aesthetic Surgery Journal. doi:10.1093/asj/sjw223.
Nguyen, M. C., & Moffatt-Bruce, S. D. (2017). Surgical Quality and Safety: Current Initiatives and Future Directions. The SAGES Manual Transitioning to Practice,125-144. doi:10.1007/978-3-319-51397-3_9.
Stein, S. L. (2017). The Changing Face of Surgery Today. Annals of Surgery,1. doi:10.1097/sla.0000000000002337.
Swendiman, R. A. (2017). Cognitive Dissonance in Training. Annals of Surgery,265(6), 1062-1063. doi:10.1097/sla.0000000000002145.
Winkel, A. F., Nguyen, A. T., Morgan, H. K., Valantsevich, D., & Woodland, M. B. (2017). Whose Problem Is It? The Priority of Physician Wellness in Residency Training. Journal of Surgical Education,74(3), 378-383. doi:10.1016/j.jsurg.2016.10.009.
Wuest, T. K., Goldberg, M. J., & Kelly, J. D. (2016). Clinical Faceoff: Physician Burnout—Fact, Fantasy, or the Fourth Component of the Triple Aim? Clinical Orthopaedics and Related Research®,475(5), 1309-1314. doi:10.1007/s11999-016-5193-5.

 

 

Troubleshooting

This post will focus on  misunderstandings cross-culturally. Everyone at some point will experience a cultural misunderstanding if they interact for a long enough with another country.  Most of the time they can be resolved quickly and painlessly. However, there are certain occaisions where more detailed explorations into culture and asumptions.

Here are a few tips:

  1. Identify cultural assumptions
  2.  Be willing to learn about other cultures perspectives on the topic.
  3.  Have self- awareness of your own cultural practices, prejudices, bias etc. This will help you solve the conflict easier.
  4. Empathy is important.
  5.  Examine your own cultural values to see where they might clash with another person’s values.
  6. Learn about how the culture in question resolves conflicts.
  7. Build on common ground between you and the other party.
  8. Break down the power structure.  Work to empower them to share their side of the story.
  9. Look for a mediator who understands both cultures if possible.  Hire an expert if necessary.
  10. Remember that the process of resolving serious misunderstandings can take time.