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  • 29 Jan 2024 4:13 PM | Maggie Gruennert (Administrator)

    Written by Kathy Russeth, MD

    As a physician deeply invested in organizational ethics and the dynamics of physicians in the workplace, I reflected on the implications of Dr. Neil Berman's article ‘A Reason to Retire?’ (Berman 2023). He takes us through his career and discusses changes in his perspective, defenses, and physician-patient relationships as he approaches the latter stages of his career. The title, posed as a question, provokes an unsettled feeling. Berman seems to suggest, albeit indirectly, that growing empathy might inversely correlate with a physician’s ability to function effectively within the healthcare system, potentially marking a time for transition.

    Separating personal growth from changes in the medical field, and considering the former problematic without fully delineating issues with the latter, is problematic. Yes, Dr. Berman touches on these factors, citing long working hours, increasing administrative burden, and rising caseloads,” but he does not go far enough. When the maintenance of distance from patients is seen as necessary for function or when intellectualization is seen as the way to maintain objectivity, something is wrong with the expectations in medicine.

    Physicians can rely on their extensive medical knowledge, diagnostic skills, and evidence-based decision-making even in moments of diminished empathy. However, empathy does not mean identifying too much” or that the physician must be  “as scared or as overwhelmed” as the patients are at any point. Feeling something real in a moment does not equal losing one’s cool head;” rather it can provide valuable insight into the patient’s experience.

    Empathy aids in finding ways to connect with patients, personalize care, and support treatment adherence. Empathy also helps to facilitate informed consent and shared decision-making, which are essential for best outcomes and true patient satisfaction (Fitzgerald 2018). Furthermore, empathy has the potential to deepen as clinical experience and wisdom accumulate over decades of practice. Rather than viewing the development of empathy as a burden, it should be recognized as a crucial and valuable contribution to the healthcare field.

    Loss of the professionals who have grown in empathy and connection represents not just a personal loss for the individual but a broader loss for the field, which benefits greatly from the balance of scientific acumen and compassionate care. Instead of viewing one’s increase in empathy and connection as a signal to exit the profession, this needs to be a signal that expectations within the medical field need to change.

    Heavy workloads have long been associated with burnout, emotional exhaustion and loss of empathy (Williams 2020). Increased demands require increased effort and resources, but rarely are those demands met with compensatory opportunities for recuperation. Depersonalization, emotional distancing, and other defenses are coping strategies to conserve resources and deal with exhaustion (DiGuiseppe 2021). However, this is not optimal and should not be looked to as the ideal or the solution. The challenges in managing heavy workloads, with high demands and diminished resources, are not the personal failings of physicians. These are structural and operational issues within healthcare systems that require urgent addressing. 

    Healthcare systems have always been challenged, particularly in fitting a humanistic service industry into a business model. The expectations for efficiency in the healthcare system are overt and regularly reinforced. They exploit healthcare employees’ natural tendencies to strive for excellence and do more for their patients and overshadow the humanistic aspects of medical care. This phenomenon, although significantly intensified during the pandemic, was present both before and continues past the acute COVID-19 crisis.

    The response by physicians and other healthcare professionals has been to leave medicine (Berg 2023). Whether one chooses to retire early, leave medicine for non-clinical pursuits, take on a more administrative role, or transition to private practice, to manage this distress, the real request is a more sustainable future. Even for those who stay, without effective resources and recuperation, the level of empathic care and ability to sustain employment becomes tenuous at best.

    Instead, we need to advocate for a system where empathy and human connection are valued as much as our clinical expertise. Adapting from successful models elsewhere, we can push for reforms that offer more autonomy, control over our work, workload management, and performance metrics that truly reflect quality of care. A sustainable and fulfilling career in medicine is still an achievable goal. However, this requires healthcare structures and systems that prioritize and safeguard the well-being of both patients and healthcare providers. Let us, as dedicated medical professionals, unite in this endeavor to shape a healthcare system that truly reflects our values and commitment to the well-being of all.

    Berg, S. The COVID-19 emergency’s over, but 1 in 2 doctors report burnout, AMA, June 23, 2023. Accessed https://www.ama-assn.org/practice-management/physician-health/covid-19-emergency-s-over-1-2-doctors-report-burnout

    Berman, N. “A Reason to Retire?” N Engl J Med 2023 Oct; 389:1354-1355. Accessed: https://www.nejm.org/doi/full/10.1056/NEJMp2306534

    DiGuiseppe, MD and Perry CJ. The Hierarchy of Defense Mechanisms: Assessing Defensive Functioning With the Defense Mechanisms, Front Psychol. 2021; 12: 718440. Accessed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555762/

    Fitzgerald-Yau N, and Egan J. Defense Styles Mediate the Association Between Empathy and Burnout Among Nurses. J Nero Meant Dis. 2018 Jul;206(7):555-561. Accessed: https://pubmed.ncbi.nlm.nih.gov/29905665/

    Williams ES, Rathert C. Buttigieg SC. “The Personal and Professional Consequences of Physician Burnout: A Systematic Review of the Literature”. Med Care Res Rev. 2020 Oct,77(5):371-386. Accessed https://pubmed.ncbi.nlm.nih.gov/31216940/


  • 20 Dec 2023 8:44 AM | Maggie Gruennert (Administrator)

    APA Area 4 Assembly Presents:
    4th Annual Reverend Dr. Martin Luther King, Jr. Program

    Reframing Anti-Black Racism and White Supremacy as Illness
    Guest Speaker: Dante D. King, MS, M. Ed, CHRM

    Saturday, January 13, 2024
    10am-12pm EST

    RSVP for Zoom Link: Eileen@themcgees.net 


  • 9 Nov 2023 9:19 AM | Maggie Gruennert (Administrator)

    APA/APAF Fellowships provide psychiatry residents with the experiential learning, training and professional development they need to be leaders in the field of psychiatry.

    In addition, APA/APAF Fellows get exclusive opportunities to be a part of APA leadership councils and network with APA members from around the country.

    Applications are now open, the deadline to apply is March 15, 2024

    Learn more & view open opportunities here


  • 10 Oct 2023 9:59 AM | Maggie Gruennert (Administrator)

    Analytic Candidate Sees Changes Afoot in Psychoanalysis

    Dr. Himanshu Agrawal, A psychoanalyst in training, is adamant that the cost of psychoanalytic treatment and training is a threat to the profession. Read more here. (featured on pages 9 & 12)


  • 29 Aug 2023 9:44 AM | Maggie Gruennert (Administrator)

    Congratulations to WPA Member, Steven Moffic, MD on receiving the Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry, to be presented at the annual APA meeting next May in New York.  

    The Abraham L. Halpern Humanitarian Award is bestowed by the American Association for Social Psychiatry for extraordinary achievement in advancing human rights. Recipients have championed causes of importance directly or even indirectly to the best practice of psychiatric medicine. Advances in ethics and professionalism, medical education, civic action, reform of legal jurisprudence, significant advances in medical practice and/or treatment, leadership taken at a political, societal or cultural level – anywhere that one person’s efforts have made all the difference in the world and thereby contributed to improved mental health care and psychological wellness.

  • 14 Jun 2023 8:43 AM | Maggie Gruennert (Administrator)

    Wisconsin Health News; June 13, 2023

    Sen. Tammy Baldwin, D-Wis., introduced legislation last week that would require federal surveys to collect information about sexual orientation and gender identity.

    Baldwin said the measure could prove critical in closing mental healthcare access gaps facing LGBTQ+ populations, who have disproportionate rates of self-harm and suicide. 

    “It’s hard to claim with great reliability how much greater risk gay, lesbian, bisexual, transgender children and adults are at risk for suicide,” she said at Politico’s healthcare summit last week. “It is really important that we get that data because it helps us make our arguments for greater resources and greater services.”

    Baldwin touched on other healthcare topics at the summit too. While pleased the U.S. didn’t default thanks to a deal raising the debt-ceiling, she is concerned about its spending constraints. The new law provides “arguably level funding” for the next two years, and costs are set to rise, Baldwin noted. 

    “We are experiencing, as a nation, a mental health crisis,” she said. “Whether it's our ability to close healthcare disparities or fund basic research in cancer and Alzheimer's, I’m concerned about how we are going to rise to the challenges."

    She noted lawmakers are discussing supplemental funding.

    Baldwin also said filibuster reform is a “near-term goal,” saying legislation that would guarantee access to abortion would pass if it didn’t need to clear a 60-vote threshold. 

    “We have half the nation with fewer rights than their parents and grandparents had,” she said. “We have to have the goal of having sufficient votes in the United States Senate to reform the filibuster, followed on by passing this legislation.”


  • 16 May 2023 1:23 PM | Maggie Gruennert (Administrator)

    Wisconsin Psychiatric Association President Dr. Tony Thrasher discusses the state's growing rate of suicides and a bill to fund training for staff at gun shops and ranges to recognize risk signs.

    Watch the full interview here!

  • 15 May 2023 8:30 AM | Maggie Gruennert (Administrator)

    WPA joins organizations representing mental health advocates, county human service agencies and providers across Wisconsin’s 72 counties in a sign on letter urging the Joint Finance Committee to fully fund the proposal in the 2023-25 budget bill.  WPA along with these organizations are committed to strengthening mental health and substance use services for children and adults throughout Wisconsin.

    Read the full letter here. 

  • 19 Apr 2023 11:34 AM | Maggie Gruennert (Administrator)

    WPA and more than 400 other national, state, and local medical, public health, and research organizations sing on urging Congress to support funding for gun violence prevention research. The letter urges support providing $35 million for the Centers for Disease Control (CDC), $25 million for the National Institute of Health (NIH), and $1 million for the National Institute of Justice (NIJ) for firearm morbidity and mortality prevention research as part of FY 2024 appropriations. This research is critical for developing a comprehensive, evidence-based approach to reducing firearm-related violence, including suicides, violent crime, and accidental shootings.

    Read the full letter here.

  • 24 Mar 2023 3:35 PM | Maggie Gruennert (Administrator)

    Congratulations to WPA's own Dr. Laurel Bessey! The highly competitive and prestigious Viste Award was established in 2006 in memory of Dr. Viste, a compassionate and passionate physician leader who exemplified commitment to patients, community and the profession of medicine. Nominations for this award must come from physician peers and the recipient must demonstrate activities and values that promote Dr. Viste’s exceptional legacy.

    Dr. Bessey, a psychiatrist with UW Health Wisconsin Psychiatric Institute and Clinic and the Associate Program Director for Psychiatry Residency, received multiple nominations highlighting her advocacy and leadership at the local, state and national level. The Foundation Board felt strongly that she was an outstanding physician to carry on Dr. Viste’s legacy and join the other notable recipients of this award.

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