Ethics of physician well-being: What the AMA Code says

Timothy M. Smith
Senior Staff Writer
AMA Wire
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Burnout is common to every medical specialty and can start as early as medical school. Physicians may sometimes feel at a loss for strategies to deal with the stress of the profession. The AMA Code of Medical Ethics offers ethical guidance on how to promote physician well-being, which is not only important for their health, but that of their patients.

What the Code says

In Opinion 9.3.1, “Physician health and wellness,” the Code explains:

When physician health or wellness is compromised, so may the safety and effectiveness of the medical care provided. To preserve the quality of their performance, physicians have a responsibility to maintain their health and wellness, broadly construed as preventing or treating acute or chronic diseases, including mental illness, disabilities and occupational stress.

To fulfill this responsibility individually, physicians should:

(a) Maintain their own health and wellness by:

(i) following healthy lifestyle habits;

(ii) ensuring that they have a personal physician whose objectivity is not compromised.

(b) Take appropriate action when their health or wellness is compromised, including:

(i) engaging in honest assessment of their ability to continue practicing safely;

(ii) taking measures to mitigate the problem;

(iii) taking appropriate measures to protect patients, including measures to minimize the risk of transmitting infectious disease commensurate with the seriousness of the disease;

(iv) seeking appropriate help as needed, including help in addressing substance abuse. Physicians should not practice if their ability to do so safely is impaired by use of a controlled substance, alcohol, other chemical agent or a health condition.

Collectively, physicians have an obligation to ensure that colleagues are able to provide safe and effective care, which includes promoting health and wellness among physicians.

AMA Principles of Medical Ethics: I, II ,IV

More go-to guidance

Chapter 9 of the Code,Opinions on professional self-regulation,” also features opinions on sexual harassment in the practice of medicine, disputes between medical supervisors and trainees, physician responsibilities to impaired colleagues, and physicians with disruptive behavior. The Code of Medical Ethics is updated periodically to address the changing conditions of medicine. The new edition, adopted in June 2016, is the culmination of an eight-year project to comprehensively review, update and reorganize guidance to ensure that the Code remains timely and easy to use for physicians in teaching and in practice.

 

 

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Comments

Under "(a) Maintain their own health and wellness by: (i) following healthy lifestyle habits;" Physicians shouldn't assume "healthy lifestyle habits" refer only to physical health. Stress leads to poor health habits for physical health, burnout, and assorted mental illnesses. It is important to develop resilience and coping skills to prevent using maladaptive coping such as alcohol and drugs, suppression, negative rumination, etc. and to minimize the amount of stress actually experienced. The circumstances don't cause the stress. Our circumstances interacting with our resilience and coping skills equals the stress we actually experience.
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