Physicians want to do good. Physicians also have high rates of burnout, depression, and suicide. These 2 facts are closely associated. As a psychiatrist and psychoanalyst who has treated many physicians, I have repeatedly observed that the need to do good derives in part from hidden guilt and has substantial effects on how physicians experience themselves and their work. Among the many motives for wanting to be a physician, the one that applicants to medical school most commonly mention is wanting to do good. Medical literature on physician burnout, depression, and suicide, however, has focused on structural and cultural problems of medical practice and has paid little attention to physicians’ emotional lives.1 The hidden guilt and need to do good can facilitate the practice of medicine, but they also make an important, and perhaps unrecognized, contribution to physicians’ vulnerability to burnout, depression, and suicide.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Blum LD. Physicians’ Goodness and Guilt—Emotional Challenges of Practicing Medicine. JAMA Intern Med. Published online April 08, 2019179(5):607–608. doi:10.1001/jamainternmed.2019.0428
Browse and subscribe to JAMA Network podcasts!
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: