Climate Change, Physician Burnout
— H. Steven Moffic, MD
The Way It Is (1)
“There’s a thread you follow. It goes among
things that change. But it doesn’t change.
People wonder about what you are pursuing.
You have to explain about the thread.
But it is hard for others to see.
While you hold it you can’t get lost.
Tragedies happen; people get hurt
or die; and you suffer and get old.
Nothing you do can stop time’s unfolding.
You don’t ever let go of the thread.”
The thread in this poem that ties together physician burnout, climate change, and psychiatry seems to be capitalism (2). It is this capitalistic dominance of business intruding into medicine that correlates with the epidemic rise of physician burnout, including among psychiatrists. And it is the capitalistic dependence on fossil fuel that has allowed climate change to endanger our health and mental health.
For both of these social problems, organized psychiatry has been slow to respond, indeed slower than any other medical specialty and mental health disciples. Reasons expressed for that is that we are too busy, the stress in our day to day work, or that these challenges are not important and do not comports patient care.
The grave irony in the relative absence of psychiatrists from these social challenges is that our special expertise could contribute much to the solutions (3). We are uniquely qualified to know how denial, disavowing, fear of change, misinformation, narcissism, learned helplessness, green, and guilt, among other psychological processes, often unconsciously prevent us from accepting reality - that human behaviors are the major contributor to climate change.
Likewise, we know, too, that these and other psychological processes - such as a counter-phobic response to fulfilling our calling adequately - prevent physicians from recognizing the development of burnout within themselves and allows a continuing false sense of work satisfaction.
Moreover, these challenges are also threaded together as an ethical principle. Section 7 of our APA principles (4) state that “A physician shall recognize a responsibility to participate in activities contributing to an improved community”. Join the Climate Psychiatry Alliance to do so.
So, now is the time to change “the way it is” by using our psychiatric expertise to show how high the cost is for replacing burned out physicians and burned out environments.
- Stafford W: The Way It Is: New and Selected Poems. Graywolf Press, 1999.
- Ehrenreich J: Third Wave Capitalism: How Money, Power, and the Pursuit of Self-Interest Have Imperilled the American Dream. Ithaca, NY., 2016.
- Weintrob S (ed): Engaging with Climate Change. Taylor & Francis, 2012.
- American Psychiatric Association: The Principles of Medical Ethics, With Annotations Especially Applicable to Psychiatry. American Psychiatric Association Press, 2013.