More on climate change and mental health, burnout among surgeons

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More on climate change and mental health, burnout among surgeons

More on climate change and mental health

Your recent editorial (“A toxic and fractured political system can breed angst and PTSDCurrent Psychiatry, September 2023, p. 11-12,28-28b, doi:10.12788/cp.0393) warned of a toxic and fractured political system and suggested a potential healing role for our psychiatric profession. However, I believe this critically important message was then summarily undermined in the article “Climate change and mental illness: What psychiatrists can do” (Current Psychiatry, September 2023, p. 32-39, doi:10.12788/cp.0389), which was published in the same issue. The latter article addressed the psychiatric concerns associated with climate change and suggested how psychiatrists can contribute to addressing these issues. While I appreciate the authors’ efforts to shed light on this critical topic, I believe it is essential to offer an alternative perspective that may foster a more balanced discussion.

The article suggested that psychiatrists are unequivocally tasked with managing the psychological aftermath of climate-related disasters. However, it is crucial to acknowledge that this is an assumption and lacks empirical evidence. I concur with the authors’ recognition of the grave environmental concerns posed by pollution, but it is valid to question the extent to which these concerns are fueled by mass hysteria, exacerbated by articles such as this one. Climate change undoubtedly is a multifaceted issue at times exploited for political purposes. As a result, terms such as “climate change denialism” are warped expressions that polarize the public even further, hindering constructive dialogue. Rather than denying the issue at hand, I am advocating for environmentally friendly solutions that do not come at the cost of manipulating public sentiment for political gain.

Additionally, I would argue trauma often does not arise from climate change itself, but instead from the actions of misguided radical environmentalist policy that unwittingly can cause more harm than good. The devastating destruction in Maui is a case in point. The article focuses on climate change as a cause of nihilism in this country; however, there is serious need to explore broader sociological issues that underlie this sense of nihilism and lack of life meaning, especially in the young.

It is essential to engage in a balanced and evidence-based discussion regarding climate change and its potential mental health implications. While some concerns the authors raised are valid, it is equally important to avoid fomenting hysteria and consider alternative perspectives that may help bridge gaps in understanding and unite us in effectively addressing this global challenge.

Robert Barris, MD
Flushing, New York

I want to send my appreciation for publishing in the same issue your editorial “A toxic and fractured political system can breed angst and PTSD” and the article “Climate change and mental illness: What psychiatrists can do.” I believe the issues addressed are important and belong in the mainstream of current psychiatric discussion.

Regarding the differing views of optimists and pessimists, I agree that narrative is bound for destruction. Because of that, several months ago I decided to deliberately cultivate and maintain a sense of optimism while knowing the facts! I believe that stance is the only one that strategically can lead towards progress.

I also want to comment on the “religification” of politics. While I believe secular religions exist, I also believe what we are currently seeing in the United States is not the rise of secular religions, but instead an attempt to insert extreme religious beliefs into politics while using language to create the illusion that the Constitution’s barrier against the merging of church and state is not being breached. I don’t think we are seeing secular religion, but God-based religion masking as secular religion.

Michael A. Kalm, MD
Salt Lake City, Utah

 

 

More on physician burnout

I am writing in reference to “Burnout among surgeons: Lessons for psychiatrists” (Current Psychiatry, August 2023, p. 23-27,34-35,35a-35c, doi:10.12788/cp.0383). I have spent the last 8 years caring primarily for medical students and residents from osteopathic and allopathic medical schools. While I have collected data on rates of depression, anxiety, attention-deficit/hyperactivity disorder, and stress, this article hit upon a more nuanced set of observations. I ask every new person at the time of intake about which specialty interests them. Most new patients I see are not interested in the surgical specialties. I recognize that this is anecdotal evidence, but it is pertinent. How and why is the burnout rate so high among surgeons? We know physicians have high rates of depression, anxiety, and suicide. But I wonder if this is even more of a problem among surgeons (beginning when these individuals enter medical school). The path to seeking mental health care is unfortunately ridden with barriers, including stigma, cost, and confidentiality concerns. Are these barriers even more problematic in those who self-select into the surgical subspecialities? In other words: Do medical students interested in surgery struggle to attend to their mental health even more so than the average medical student? If so, why?

It would behoove institutions to teach methods to mitigate burnout starting with first-year medical students instead of waiting until the increased stress, workload, and responsibility of their intern year. Knowing there is a potential negative downstream effect on patient care, in addition to the negative personal and professional impact on surgeons, is significant. By taking the time to engage all medical students in confidential, affordable, accessible mental health care, institutions would not only decrease burnout in this population of physicians but decrease the likelihood of negative outcomes in patient care.

Elina Maymind, MD
Mt. Laurel, New Jersey

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More on climate change and mental health

Your recent editorial (“A toxic and fractured political system can breed angst and PTSDCurrent Psychiatry, September 2023, p. 11-12,28-28b, doi:10.12788/cp.0393) warned of a toxic and fractured political system and suggested a potential healing role for our psychiatric profession. However, I believe this critically important message was then summarily undermined in the article “Climate change and mental illness: What psychiatrists can do” (Current Psychiatry, September 2023, p. 32-39, doi:10.12788/cp.0389), which was published in the same issue. The latter article addressed the psychiatric concerns associated with climate change and suggested how psychiatrists can contribute to addressing these issues. While I appreciate the authors’ efforts to shed light on this critical topic, I believe it is essential to offer an alternative perspective that may foster a more balanced discussion.

The article suggested that psychiatrists are unequivocally tasked with managing the psychological aftermath of climate-related disasters. However, it is crucial to acknowledge that this is an assumption and lacks empirical evidence. I concur with the authors’ recognition of the grave environmental concerns posed by pollution, but it is valid to question the extent to which these concerns are fueled by mass hysteria, exacerbated by articles such as this one. Climate change undoubtedly is a multifaceted issue at times exploited for political purposes. As a result, terms such as “climate change denialism” are warped expressions that polarize the public even further, hindering constructive dialogue. Rather than denying the issue at hand, I am advocating for environmentally friendly solutions that do not come at the cost of manipulating public sentiment for political gain.

Additionally, I would argue trauma often does not arise from climate change itself, but instead from the actions of misguided radical environmentalist policy that unwittingly can cause more harm than good. The devastating destruction in Maui is a case in point. The article focuses on climate change as a cause of nihilism in this country; however, there is serious need to explore broader sociological issues that underlie this sense of nihilism and lack of life meaning, especially in the young.

It is essential to engage in a balanced and evidence-based discussion regarding climate change and its potential mental health implications. While some concerns the authors raised are valid, it is equally important to avoid fomenting hysteria and consider alternative perspectives that may help bridge gaps in understanding and unite us in effectively addressing this global challenge.

Robert Barris, MD
Flushing, New York

I want to send my appreciation for publishing in the same issue your editorial “A toxic and fractured political system can breed angst and PTSD” and the article “Climate change and mental illness: What psychiatrists can do.” I believe the issues addressed are important and belong in the mainstream of current psychiatric discussion.

Regarding the differing views of optimists and pessimists, I agree that narrative is bound for destruction. Because of that, several months ago I decided to deliberately cultivate and maintain a sense of optimism while knowing the facts! I believe that stance is the only one that strategically can lead towards progress.

I also want to comment on the “religification” of politics. While I believe secular religions exist, I also believe what we are currently seeing in the United States is not the rise of secular religions, but instead an attempt to insert extreme religious beliefs into politics while using language to create the illusion that the Constitution’s barrier against the merging of church and state is not being breached. I don’t think we are seeing secular religion, but God-based religion masking as secular religion.

Michael A. Kalm, MD
Salt Lake City, Utah

 

 

More on physician burnout

I am writing in reference to “Burnout among surgeons: Lessons for psychiatrists” (Current Psychiatry, August 2023, p. 23-27,34-35,35a-35c, doi:10.12788/cp.0383). I have spent the last 8 years caring primarily for medical students and residents from osteopathic and allopathic medical schools. While I have collected data on rates of depression, anxiety, attention-deficit/hyperactivity disorder, and stress, this article hit upon a more nuanced set of observations. I ask every new person at the time of intake about which specialty interests them. Most new patients I see are not interested in the surgical specialties. I recognize that this is anecdotal evidence, but it is pertinent. How and why is the burnout rate so high among surgeons? We know physicians have high rates of depression, anxiety, and suicide. But I wonder if this is even more of a problem among surgeons (beginning when these individuals enter medical school). The path to seeking mental health care is unfortunately ridden with barriers, including stigma, cost, and confidentiality concerns. Are these barriers even more problematic in those who self-select into the surgical subspecialities? In other words: Do medical students interested in surgery struggle to attend to their mental health even more so than the average medical student? If so, why?

It would behoove institutions to teach methods to mitigate burnout starting with first-year medical students instead of waiting until the increased stress, workload, and responsibility of their intern year. Knowing there is a potential negative downstream effect on patient care, in addition to the negative personal and professional impact on surgeons, is significant. By taking the time to engage all medical students in confidential, affordable, accessible mental health care, institutions would not only decrease burnout in this population of physicians but decrease the likelihood of negative outcomes in patient care.

Elina Maymind, MD
Mt. Laurel, New Jersey

More on climate change and mental health

Your recent editorial (“A toxic and fractured political system can breed angst and PTSDCurrent Psychiatry, September 2023, p. 11-12,28-28b, doi:10.12788/cp.0393) warned of a toxic and fractured political system and suggested a potential healing role for our psychiatric profession. However, I believe this critically important message was then summarily undermined in the article “Climate change and mental illness: What psychiatrists can do” (Current Psychiatry, September 2023, p. 32-39, doi:10.12788/cp.0389), which was published in the same issue. The latter article addressed the psychiatric concerns associated with climate change and suggested how psychiatrists can contribute to addressing these issues. While I appreciate the authors’ efforts to shed light on this critical topic, I believe it is essential to offer an alternative perspective that may foster a more balanced discussion.

The article suggested that psychiatrists are unequivocally tasked with managing the psychological aftermath of climate-related disasters. However, it is crucial to acknowledge that this is an assumption and lacks empirical evidence. I concur with the authors’ recognition of the grave environmental concerns posed by pollution, but it is valid to question the extent to which these concerns are fueled by mass hysteria, exacerbated by articles such as this one. Climate change undoubtedly is a multifaceted issue at times exploited for political purposes. As a result, terms such as “climate change denialism” are warped expressions that polarize the public even further, hindering constructive dialogue. Rather than denying the issue at hand, I am advocating for environmentally friendly solutions that do not come at the cost of manipulating public sentiment for political gain.

Additionally, I would argue trauma often does not arise from climate change itself, but instead from the actions of misguided radical environmentalist policy that unwittingly can cause more harm than good. The devastating destruction in Maui is a case in point. The article focuses on climate change as a cause of nihilism in this country; however, there is serious need to explore broader sociological issues that underlie this sense of nihilism and lack of life meaning, especially in the young.

It is essential to engage in a balanced and evidence-based discussion regarding climate change and its potential mental health implications. While some concerns the authors raised are valid, it is equally important to avoid fomenting hysteria and consider alternative perspectives that may help bridge gaps in understanding and unite us in effectively addressing this global challenge.

Robert Barris, MD
Flushing, New York

I want to send my appreciation for publishing in the same issue your editorial “A toxic and fractured political system can breed angst and PTSD” and the article “Climate change and mental illness: What psychiatrists can do.” I believe the issues addressed are important and belong in the mainstream of current psychiatric discussion.

Regarding the differing views of optimists and pessimists, I agree that narrative is bound for destruction. Because of that, several months ago I decided to deliberately cultivate and maintain a sense of optimism while knowing the facts! I believe that stance is the only one that strategically can lead towards progress.

I also want to comment on the “religification” of politics. While I believe secular religions exist, I also believe what we are currently seeing in the United States is not the rise of secular religions, but instead an attempt to insert extreme religious beliefs into politics while using language to create the illusion that the Constitution’s barrier against the merging of church and state is not being breached. I don’t think we are seeing secular religion, but God-based religion masking as secular religion.

Michael A. Kalm, MD
Salt Lake City, Utah

 

 

More on physician burnout

I am writing in reference to “Burnout among surgeons: Lessons for psychiatrists” (Current Psychiatry, August 2023, p. 23-27,34-35,35a-35c, doi:10.12788/cp.0383). I have spent the last 8 years caring primarily for medical students and residents from osteopathic and allopathic medical schools. While I have collected data on rates of depression, anxiety, attention-deficit/hyperactivity disorder, and stress, this article hit upon a more nuanced set of observations. I ask every new person at the time of intake about which specialty interests them. Most new patients I see are not interested in the surgical specialties. I recognize that this is anecdotal evidence, but it is pertinent. How and why is the burnout rate so high among surgeons? We know physicians have high rates of depression, anxiety, and suicide. But I wonder if this is even more of a problem among surgeons (beginning when these individuals enter medical school). The path to seeking mental health care is unfortunately ridden with barriers, including stigma, cost, and confidentiality concerns. Are these barriers even more problematic in those who self-select into the surgical subspecialities? In other words: Do medical students interested in surgery struggle to attend to their mental health even more so than the average medical student? If so, why?

It would behoove institutions to teach methods to mitigate burnout starting with first-year medical students instead of waiting until the increased stress, workload, and responsibility of their intern year. Knowing there is a potential negative downstream effect on patient care, in addition to the negative personal and professional impact on surgeons, is significant. By taking the time to engage all medical students in confidential, affordable, accessible mental health care, institutions would not only decrease burnout in this population of physicians but decrease the likelihood of negative outcomes in patient care.

Elina Maymind, MD
Mt. Laurel, New Jersey

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Mothers in medicine: What can we learn when worlds collide?

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Thu, 08/24/2023 - 13:57

Across all industries, studies by the U.S. Department of Labor have shown that women, on average, earn 83.7 percent of what their male peers earn. While a lot has been written about the struggles women face in medicine, there have been decidedly fewer analyses that focus on women who choose to become mothers while working in medicine.

Elina Maymind
Dr. Elina Maymind

I’ve been privileged to work with medical students and residents for the last 8 years as the director of graduate and medical student mental health at Rowan-Virtua School of Osteopathic Medicine in Mt. Laurel, N.J. Often, the women I see as patients speak about their struggles with the elusive goal of “having it all.” While both men and women in medicine have difficulty maintaining a work-life balance, I’ve learned, both personally and professionally, that many women face a unique set of challenges.

No matter what their professional status, our society often views a woman as the default parent. For example, the teacher often calls the mothers first. The camp nurse calls me first, not my husband, when our child scrapes a knee. After-school play dates are arranged by the mothers, not fathers.

But mothers also bring to medicine a wealth of unique experiences, ideas, and viewpoints. They learn firsthand how to foster affect regulation and frustration tolerance in their kids and become efficient at managing the constant, conflicting tug of war of demands.

Some may argue that, over time, women end up earning significantly less than their male counterparts because they leave the workforce while on maternity leave, ultimately delaying their upward career progression. It’s likely a much more complex problem. Many of my patients believe that, in our male-dominated society (and workforce), women are punished for being aggressive or stating bold opinions, while men are rewarded for the same actions. While a man may sound forceful and in charge, a women will likely be thought of as brusque and unappreciative.

Outside of work, many women may have more on their plate. A 2020 Gallup poll of more than 3,000 heterosexual couples found that women are responsible for the majority of household chores. Women continue to handle more of the emotional labor within their families, regardless of income, age, or professional status. This is sometimes called the “Mental Load’ or “Second Shift.” As our society continues to view women as the default parent for childcare, medical issues, and overarching social and emotional tasks vital to raising happy, healthy children, the struggle a female medical professional feels is palpable.

Despite the very real and difficult challenges in finding a perfect balance and having it all, both at home and at work, the role of mother and physician must be intimately intertwined. Raising kids requires a parent to consistently dole out control, predictability, and reassurance for a child to thrive. Good limit and boundary setting leads to healthy development from a young age.

Psychiatric patients (and perhaps all patients) also require control, predictability, and reassurance from their doctor. The lessons learned in being a good mother can be directly applied in patient care, and vice versa. The cross-pollination of this relationship continues to grow more powerful as a woman’s children grow and her career matures.

Pediatrician and psychoanalyst Donald Winnicott’s idea of a “good enough” mother cannot be a one-size-fits-all approach. Women who self-select into the world of medicine often hold themselves to a higher standard than “good enough.” Acknowledging that the demands from both home and work will fluctuate is key to achieving success both personally and professionally, and lessons from home can and should be utilized to become a more effective physician. The notion of having it all, and the definition of success, must evolve over time.

Dr. Maymind is director of medical and graduate student mental health at Rowan-Virtua School of Osteopathic Medicine in Mt. Laurel, N.J. She has no relevant disclosures.

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Across all industries, studies by the U.S. Department of Labor have shown that women, on average, earn 83.7 percent of what their male peers earn. While a lot has been written about the struggles women face in medicine, there have been decidedly fewer analyses that focus on women who choose to become mothers while working in medicine.

Elina Maymind
Dr. Elina Maymind

I’ve been privileged to work with medical students and residents for the last 8 years as the director of graduate and medical student mental health at Rowan-Virtua School of Osteopathic Medicine in Mt. Laurel, N.J. Often, the women I see as patients speak about their struggles with the elusive goal of “having it all.” While both men and women in medicine have difficulty maintaining a work-life balance, I’ve learned, both personally and professionally, that many women face a unique set of challenges.

No matter what their professional status, our society often views a woman as the default parent. For example, the teacher often calls the mothers first. The camp nurse calls me first, not my husband, when our child scrapes a knee. After-school play dates are arranged by the mothers, not fathers.

But mothers also bring to medicine a wealth of unique experiences, ideas, and viewpoints. They learn firsthand how to foster affect regulation and frustration tolerance in their kids and become efficient at managing the constant, conflicting tug of war of demands.

Some may argue that, over time, women end up earning significantly less than their male counterparts because they leave the workforce while on maternity leave, ultimately delaying their upward career progression. It’s likely a much more complex problem. Many of my patients believe that, in our male-dominated society (and workforce), women are punished for being aggressive or stating bold opinions, while men are rewarded for the same actions. While a man may sound forceful and in charge, a women will likely be thought of as brusque and unappreciative.

Outside of work, many women may have more on their plate. A 2020 Gallup poll of more than 3,000 heterosexual couples found that women are responsible for the majority of household chores. Women continue to handle more of the emotional labor within their families, regardless of income, age, or professional status. This is sometimes called the “Mental Load’ or “Second Shift.” As our society continues to view women as the default parent for childcare, medical issues, and overarching social and emotional tasks vital to raising happy, healthy children, the struggle a female medical professional feels is palpable.

Despite the very real and difficult challenges in finding a perfect balance and having it all, both at home and at work, the role of mother and physician must be intimately intertwined. Raising kids requires a parent to consistently dole out control, predictability, and reassurance for a child to thrive. Good limit and boundary setting leads to healthy development from a young age.

Psychiatric patients (and perhaps all patients) also require control, predictability, and reassurance from their doctor. The lessons learned in being a good mother can be directly applied in patient care, and vice versa. The cross-pollination of this relationship continues to grow more powerful as a woman’s children grow and her career matures.

Pediatrician and psychoanalyst Donald Winnicott’s idea of a “good enough” mother cannot be a one-size-fits-all approach. Women who self-select into the world of medicine often hold themselves to a higher standard than “good enough.” Acknowledging that the demands from both home and work will fluctuate is key to achieving success both personally and professionally, and lessons from home can and should be utilized to become a more effective physician. The notion of having it all, and the definition of success, must evolve over time.

Dr. Maymind is director of medical and graduate student mental health at Rowan-Virtua School of Osteopathic Medicine in Mt. Laurel, N.J. She has no relevant disclosures.

Across all industries, studies by the U.S. Department of Labor have shown that women, on average, earn 83.7 percent of what their male peers earn. While a lot has been written about the struggles women face in medicine, there have been decidedly fewer analyses that focus on women who choose to become mothers while working in medicine.

Elina Maymind
Dr. Elina Maymind

I’ve been privileged to work with medical students and residents for the last 8 years as the director of graduate and medical student mental health at Rowan-Virtua School of Osteopathic Medicine in Mt. Laurel, N.J. Often, the women I see as patients speak about their struggles with the elusive goal of “having it all.” While both men and women in medicine have difficulty maintaining a work-life balance, I’ve learned, both personally and professionally, that many women face a unique set of challenges.

No matter what their professional status, our society often views a woman as the default parent. For example, the teacher often calls the mothers first. The camp nurse calls me first, not my husband, when our child scrapes a knee. After-school play dates are arranged by the mothers, not fathers.

But mothers also bring to medicine a wealth of unique experiences, ideas, and viewpoints. They learn firsthand how to foster affect regulation and frustration tolerance in their kids and become efficient at managing the constant, conflicting tug of war of demands.

Some may argue that, over time, women end up earning significantly less than their male counterparts because they leave the workforce while on maternity leave, ultimately delaying their upward career progression. It’s likely a much more complex problem. Many of my patients believe that, in our male-dominated society (and workforce), women are punished for being aggressive or stating bold opinions, while men are rewarded for the same actions. While a man may sound forceful and in charge, a women will likely be thought of as brusque and unappreciative.

Outside of work, many women may have more on their plate. A 2020 Gallup poll of more than 3,000 heterosexual couples found that women are responsible for the majority of household chores. Women continue to handle more of the emotional labor within their families, regardless of income, age, or professional status. This is sometimes called the “Mental Load’ or “Second Shift.” As our society continues to view women as the default parent for childcare, medical issues, and overarching social and emotional tasks vital to raising happy, healthy children, the struggle a female medical professional feels is palpable.

Despite the very real and difficult challenges in finding a perfect balance and having it all, both at home and at work, the role of mother and physician must be intimately intertwined. Raising kids requires a parent to consistently dole out control, predictability, and reassurance for a child to thrive. Good limit and boundary setting leads to healthy development from a young age.

Psychiatric patients (and perhaps all patients) also require control, predictability, and reassurance from their doctor. The lessons learned in being a good mother can be directly applied in patient care, and vice versa. The cross-pollination of this relationship continues to grow more powerful as a woman’s children grow and her career matures.

Pediatrician and psychoanalyst Donald Winnicott’s idea of a “good enough” mother cannot be a one-size-fits-all approach. Women who self-select into the world of medicine often hold themselves to a higher standard than “good enough.” Acknowledging that the demands from both home and work will fluctuate is key to achieving success both personally and professionally, and lessons from home can and should be utilized to become a more effective physician. The notion of having it all, and the definition of success, must evolve over time.

Dr. Maymind is director of medical and graduate student mental health at Rowan-Virtua School of Osteopathic Medicine in Mt. Laurel, N.J. She has no relevant disclosures.

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