Annals of family medicine
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Annals of family medicine · Jul 2017
Swimming Against the Tide: Primary Care Physicians' Views on Deprescribing in Everyday Practice.
Avoidable hospitalizations due to adverse drug events and high-risk prescribing are common in older people. Primary care physicians prescribe most on-going medicines. Deprescribing has long been essential to best prescribing practice. We sought to explore the views of primary care physicians on the barriers and facilitators to deprescribing in everyday practice to inform the development of an intervention to support safer prescribing. ⋯ Interventions to support safer prescribing in everyday practice should consider the sociocultural, personal, relational, and organizational constraints on deprescribing. Regulations and policies should be designed to support physicians in practicing according to their professional ethical values.
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Over the span of their career, physicians experience changes to their professional role and professional identity. The process of continual adaptation in their work setting incurs losses. ⋯ Grief in the workplace is unsanctioned, and may contribute to physicians' experience of burnout (emotional exhaustion, depersonalization, low sense of achievement). Acknowledging loss, validating grief, and being prescient in dealing with physician burnout is essential.
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Annals of family medicine · Jul 2017
Cultivating the Inner Life of a Physician Through Written Reflection.
All of us have an "inner life" that forms the core of who we are. It shapes and is shaped by our actions and experiences. ⋯ We suggest that written reflections, as part of medical residency curriculum, can allow residents to explore their inner lives. The depth and range of residents' explorations show the value of adding brief, protected time for residents to explore their hopes, joys, struggles, and feelings, and to develop meaning from their experiences with patients.