Viewpoint: Improve physician resiliency with a 'badness' plan

"Badness" events build the invisible graveyard of every physician's career, but with a plan, physicians can be prepared to manage emotional distress, Maryna Mammoliti, MD, wrote in a March 5 post on Medpage Today's

Because of their medical training, many physicians struggle to describe or acknowledge their emotions, especially around distressing patient cases. The word "badness" describes a painful, complicated, tragic, or adverse clinical experience. It can describe complex medical cases, medical or systematic errors, patient deaths and complications, patient complaints and lawsuits, or other situations. Some physicians turn to substance use or develop PTSD or other disorders or quit medicine to deal with the unresolved emotions, Dr. Mammoliti, who practices at Sunrise Health & Clinical Excellence Centre in Toronto, wrote.

She said creating a badness plan can help physicians manage emotional distress triggered by such an event.

Step 1: Embrace radical acceptance. Radical acceptance means accepting that life is full of pain and disappointment without agreeing or accepting that it is OK for bad events to happen. Radical acceptance accepts reality instead of wishful thinking or blame and allows people to accept the situation and move toward problem-solving.

Step 2: Allow yourself to have an emotional experience from badness.

Step 3: Meet your bio-psychosocial needs once a badness event occurs. Here are questions to ask when physicians experience heightened emotions:

  • Biological: Do you need time or space to cry? Do you need a break from people or to be around someone? Would sleep help? Do you need a cold shower or to exercise?

  • Psychological: Would a therapist help? Do you need confidential peer support or to call a crisis line?

  • Social: Do you need some time off? Do you have a trusted medical peer who can review the case development with you? Do you need to call your malpractice lawyer? How can your family and friends support you?

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