Department of Pediatrics, University of California San Diego School of Medicine, San Diego, California
Ann Fam Med. 2018 May;16(3):267-270. doi: 10.1370/afm.2223.
Physicians and physician trainees are among the highest-risk groups for burnout and suicide, and those in primary care are among the hardest hit. Many health systems have turned to resilience training as a solution, but there is an ongoing debate about whether that is the right approach. This article distinguishes between unavoidable occupational suffering (inherent in the physician's role) and avoidable occupational suffering (systems failures that can be prevented). Resilience training may be helpful in addressing unavoidable suffering, but it is the wrong treatment for the organizational pathologies that lead to avoidable suffering- and may even compound the harm doctors experience. To address avoidable suffering, health systems would be better served by engaging doctors in the co-design of work systems that promote better mental health outcomes.
医生和医学生是职业倦怠和自杀风险最高的群体之一，而初级保健医生的情况最为严重。许多医疗系统已经将韧性培训作为一种解决方案，但对于这是否是正确的方法，一直存在争议。本文区分了不可避免的职业痛苦（医生角色固有的）和可避免的职业痛苦（可以预防的系统故障）。韧性培训可能有助于解决不可避免的痛苦，但对于导致可避免痛苦的组织病理学来说，它是错误的治疗方法，甚至可能加剧医生所经历的伤害。为了解决可避免的痛苦，医疗系统最好让医生参与共同设计工作系统，以促进更好的心理健康结果。
