Physicians’ Emotional Reactions to Patients

Smith, Robert C.; Zimny, George H.

doi:10.1016/s0033-3182(88)72339-7

Cited by 44 publications

(38 citation statements)

References 4 publications

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“…8,9,11,20 A small body of research has examined the consequences of physician emotion on medical care [21][22][23] …”

Section: Consequences Of Unexamined Physician Emotion On Patient Carementioning

confidence: 99%

“…Such emotions can often be traced to a variety of causes rather than a single etiology, and the connections are not always explainable (Box 2). 23,29,46,48,82 One important etiology stems from a patient or another physician unconsciously reminding the physician of an important relationship 83,84 or difficult experience. Some attempt to understand the sources of the emotion may help the physician identify effective coping or compensatory mechanisms.…”

Section: Differential Diagnosismentioning

confidence: 99%

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The Inner Life of Physicians and Care of the Seriously Ill

Meier

Back

Morrison

2001

JAMA

576

416

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Seriously ill persons are emotionally vulnerable during the typically protracted course of an illness. Physicians respond to such patients' needs and emotions with emotions of their own, which may reflect a need to rescue the patient, a sense of failure and frustration when the patient's illness progresses, feelings of powerlessness against illness and its associated losses, grief, fear of becoming ill oneself, or a desire to separate from and avoid patients to escape these feelings. These emotions can affect both the quality of medical care and the physician's own sense of well-being, since unexamined emotions may also lead to physician distress, disengagement, burnout, and poor judgment. In this article, which is intended for the practicing, nonpsychiatric clinician, we describe a model for increasing physician self-awareness, which includes identifying and working with emotions that may affect patient care. Our approach is based on the standard medical model of risk factors, signs and symptoms, differential diagnosis, and intervention. Although it is normal to have feelings arising from the care of patients, physicians should take an active role in identifying and controlling those emotions.

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“…8,9,11,20 A small body of research has examined the consequences of physician emotion on medical care [21][22][23] …”

Section: Consequences Of Unexamined Physician Emotion On Patient Carementioning

confidence: 99%

Section: Differential Diagnosismentioning

confidence: 99%

The Inner Life of Physicians and Care of the Seriously Ill

Meier

Back

Morrison

2001

JAMA

576

416

View full text Add to dashboard Cite

show abstract

“…Patients are willing to accept greater or lesser toxicities in exchange for even a minor survival benefi t in their attempt to avoid dying at any cost [1,22]. In this situation, it is often easier to recommend another line of chemotherapy instead of providing painful and diffi cult explanations of why we do not consider active cancer therapy is indicated [22][23][24][25]. Certain cancers, i.e., breast, colon, ovarian or small-cell lung are chemosensitive and may respond to palliative chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Limited impact of palliative chemotherapy on survival in advanced solid tumours in patients with poor performance status

et al. 2011

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“…These statements were categorized as "threats to physician integrity or selfesteem." There was no difference in time in practice with respect to severity of reaction against these comments (Smith & Zimny, 1988). One might postulate that those physicians who are most skilled in psychodynamic technique will be the ones that will be better able to engage these patients in treatment while maintaining their own sense of selfesteem.…”

Section: Doctor-patient Relationshipmentioning

confidence: 99%

Psychodynamic Psychiatry in the General Medical Setting

Kent

Blumenfield²

2011

The Journal of the American Academy of Psychoanalysis and Dynam

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For more than half a century analytically trained psychiatrists have been making observations about psychodynamic factors impacting on medical illness and treatment. Some of these reports have been subsequently supported by evidence-based research while others have been found to be clinically useful to varying degrees even if not substantiated by research. In this article we have presented some of the highlights of the application of psychodynamics to the treatment of physical illness in the general medical setting. It is not meant to be a comprehensive review but we hope it will demonstrate how psychodynamic thinking has permeated many aspects of care in the general medical setting. Topics considered include onset of disease (giving up complex, specificity, role of stress, anniversary reactions), reactions to illness (psychological defenses, fantasies, role of psychotherapy), specific conditions (pregnancy, cancer, human immunodeficiency virus, conversion and alexithymia, heart disease, death and dying), and the doctor-patient relationship.

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Physicians’ Emotional Reactions to Patients

Cited by 44 publications

References 4 publications

The Inner Life of Physicians and Care of the Seriously Ill

The Inner Life of Physicians and Care of the Seriously Ill

Limited impact of palliative chemotherapy on survival in advanced solid tumours in patients with poor performance status

Psychodynamic Psychiatry in the General Medical Setting

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