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Why impaired wellness may be inevitable in medicine, and why that may not be a bad thing.

Publication ,  Journal Article
Bynum, WE; Varpio, L; Teunissen, P
Published in: Med Educ
January 2021

CONTEXT: A wellness crisis exists among physicians and medical trainees. High rates of burnout, depression, stress and other states of impaired wellness have driven a sense of urgency to create solutions, and the medical education community has mobilised impressively. However, we argue-and data suggest-that this rush to find solutions has outpaced our efforts to more fully understand the nature of impaired wellness in medicine. This, we believe, has led to the implementation of solutions informed by limited understanding of the problems we intend to solve. METHODS: In this paper, we explore three contributors to this situation: (i) shaky definitions and conceptualisations of wellness, (ii) the predominance of deductive, quantitative research informing our understanding and current solutions, and (iii) the reliance on a 'disease-focused' approach to addressing impaired wellness in physicians and trainees. We discuss how these contributors have led to the current state of the science of wellness in medicine: one characterised by an expanding array of solutions built upon narrow conceptualisations of wellness and how it can be impaired. DISCUSSION: Moving beyond the current state of the science on wellness in medicine will require three critical developments: (i) consistent use of clear definitions of wellness; (ii) expanding our methodologies to include those utilising direct interaction with participants; and (iii) moving beyond solutions informed by a disease-model approach. We propose a different way of thinking about wellness: one based on what we view as an inherent-and potentially unavoidable-risk of experiencing impairment during a career in medicine. We argue that efforts to extinguish and eliminate all states of impaired wellness may also eliminate opportunities to develop constructive coping mechanisms and future resilience, and that wellness may best be conceptualised as healthy and authentic engagement with the inevitable adversity of a career in medicine.

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Published In

Med Educ

DOI

EISSN

1365-2923

Publication Date

January 2021

Volume

55

Issue

1

Start / End Page

16 / 22

Location

England

Related Subject Headings

  • Physicians
  • Medicine
  • Medical Informatics
  • Humans
  • Health Status
  • Education, Medical
  • Burnout, Professional
  • 3904 Specialist studies in education
  • 3901 Curriculum and pedagogy
  • 17 Psychology and Cognitive Sciences
 

Citation

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Bynum, W. E., Varpio, L., & Teunissen, P. (2021). Why impaired wellness may be inevitable in medicine, and why that may not be a bad thing. Med Educ, 55(1), 16–22. https://doi.org/10.1111/medu.14284
Bynum, William E., Lara Varpio, and Pim Teunissen. “Why impaired wellness may be inevitable in medicine, and why that may not be a bad thing.Med Educ 55, no. 1 (January 2021): 16–22. https://doi.org/10.1111/medu.14284.
Bynum WE, Varpio L, Teunissen P. Why impaired wellness may be inevitable in medicine, and why that may not be a bad thing. Med Educ. 2021 Jan;55(1):16–22.
Bynum, William E., et al. “Why impaired wellness may be inevitable in medicine, and why that may not be a bad thing.Med Educ, vol. 55, no. 1, Jan. 2021, pp. 16–22. Pubmed, doi:10.1111/medu.14284.
Bynum WE, Varpio L, Teunissen P. Why impaired wellness may be inevitable in medicine, and why that may not be a bad thing. Med Educ. 2021 Jan;55(1):16–22.
Journal cover image

Published In

Med Educ

DOI

EISSN

1365-2923

Publication Date

January 2021

Volume

55

Issue

1

Start / End Page

16 / 22

Location

England

Related Subject Headings

  • Physicians
  • Medicine
  • Medical Informatics
  • Humans
  • Health Status
  • Education, Medical
  • Burnout, Professional
  • 3904 Specialist studies in education
  • 3901 Curriculum and pedagogy
  • 17 Psychology and Cognitive Sciences