Caring for the Carers: How to Look After Psychiatrically Ill Doctors-View Presentation

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Dr. Peter Yellowlees, an emeritus psychiatry professor and former chief wellness officer at UC Davis, shares extensive experience treating psychiatrically ill physicians. He emphasizes the distinction between burnout—a workplace-related syndrome—and formal psychiatric disorders such as depression, anxiety, bipolar disorder, and substance use, cautioning against conflating burnout with mental illness. Physicians often use "burnout" as a socially acceptable label to mask psychiatric problems due to stigma and fear of professional repercussions.<br /><br />Physicians typically start medical training relatively healthy but face unique developmental and professional stressors including intense performance demands, delayed gratification, and resistance to retirement. Key factors for physician well-being include autonomy, belonging, and competence. Treatment challenges stem from confidentiality concerns, physicians' VIP status, boundary issues, and potential conflicts with employers or medical boards.<br /><br />Yellowlees reports on anonymized case studies illustrating common psychiatric presentations in physicians, such as substance use disorder misdiagnosed initially as burnout, bipolar disorder masked by personality issues, and obsessive-compulsive disorder impacting practice management. Effective care involves rapid access to psychiatric specialists familiar with physician culture, long-term therapeutic relationships, combined in-person and telepsychiatry approaches, and clear communication about boundaries and legal issues.<br /><br />He advocates for multiple care pathways, education on differentiating burnout from illness, and support systems within healthcare organizations. Addressing systemic factors alongside individual treatment is vital. Yellowlees underscores the rewarding nature of treating physicians and the importance of continual self-education about physician culture, ethics, and implicit biases. Overall, management requires a nuanced, biopsychosocial approach respecting physicians’ professional context and specific mental health needs.

Keywords

Physician mental health

Burnout vs psychiatric disorders

Psychiatric treatment for physicians

Physician well-being factors

Confidentiality in physician care

Substance use disorder in physicians

Bipolar disorder in medical professionals

Telepsychiatry for physicians

Healthcare professional stigma

Biopsychosocial approach to physician care