Medical resilience and morality: a survey study on the opinions and actions of exemplary family physicians.
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2021
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BMC Family Practice
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Abstract
Background: Studies conducted to understand how family doctors develop resilience and deal with the challenges
posed by work-related stress, usually have focused on identifying the elements that generate resilience from psychological
perspectives and their impact on coping strategies. Few have explored the role that personal qualities and
values that traditionally motivate family physicians can play as drivers of well-being and resilience.
Objectives: To explore attributes that exemplary family physicians (EFP) consider important for their work and the
elements that, for them, are source of gratification and resources in the face of the adversities they encounter in their
practice.
Methods: This is an exploratory study carried out by online survey. Eighty six doctors regarded as exemplary by
their colleagues answered 7 close and 4 open-ended questions that explored their job satisfaction, the elements of
their work that reward them, the difficulties and problems they usually encounter, the resources they use to cope
with those problems, and the personal qualities they consider central to their work. Four researchers conducted a
thematic (deductive and inductive) analysis of the free text responses received. Based on the results obtained, and
through an iterative discussion process, the researchers proposed an integrated set of qualities at the core of their
professionalism.
Results: 88.4% (76) of the doctors said they were satisfied with their work. However, they face problems (202 comments),
including demanding patients, insensitive managers with unshared interests/care goals, excessive paperwork,
work overload, or time pressures. Sources of gratification point to personal identity; clinical, relational, and collaborative
efficiency; a holistic and comprehensive practice (centred on individuals); and a continuous search for excellence
(149) and the root of their resources (135). These elements, in turn, corresponded to the attributes considered essential
for the practice of family medicine (131).
Conclusions: For EFPs, certain professional values give meaning to their clinical practice and are a source of wellbeing
and resources. This central focus on professional values and qualities can help for better understand the burnout
nature and expand the type of action that promotes resilience. Further studies using a less structured qualitative
research will be needed to confirm/expand these results.
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Keywords
Burnout, Resilience, Professionalism, Medical values, Qualitative research, Medical ethics, Family medicine