Physicians' emotional responses to patients' deaths increase with care length, says Pitt

8 percent of surveyed physicians cared for the patient longer than a week. As a result, 62 percent classified their relationship to the patient as "not close." Providing care for a longer period of time was associated with stronger doctor-patient ties, with 11 percent of physicians describing their relationship as "very close."

Thirty-one percent of doctors reported having a strong emotional reaction to a patient's death; 23 percent found the death "disturbing;" and 6 percent reported feelings of grief.

"Surprisingly, a physician's level of training was not the variable that pointed to a stronger emotional reaction to the patient's death," said first author Dr. Ellen Redinbaugh, Ph.D., a research instructor in the department of psychiatry at the University of Pittsburgh. "Instead, emotional reaction was determined primarily and consistently by the duration of the doctor-patient relationship." The reactions also were stronger among female physicians than among males.

While most doctors surveyed reported requiring little emotional support from their colleagues, interns and residents required the most support, and females reported needing more than males. However, most residents and interns found the support they needed from one another or their families instead of from attending physicians, and attending physicians in need of support reported finding no one to help them.

"This study points to a major gap in the clinical education of interns and residents, with a culture of silence about emotions that are bound to surface in physicians many times during their careers," said Dr. Arnold. "Educators must address this issue and know how to identify clinicians who may be at risk of higher levels of emotional distress, then provide guidance in dealing with these emotions."


Contact: Kathryn Duda
University of Pittsburgh Medical Center

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