A Message to Stressed Out Physicians

Medicine is one of those professions in which stress is an occupational hazard. Unfortunately, it is not just the nature of the work that is stressful; it is exacerbated by the rigid rules of managed health care. In all specialties, the patient’s health care provider places just as many (if not more) restrictions on the physicians than the needs of the patient. The amount of time doctors can spend explaining procedures and practicing good bedside manners is rapidly becoming a thing of the past. In order to survive in a managed health care environment, doctors must make every minute count towards activities and procedures that health insurance carriers will pay for. The lack of physician attention to patient care and availability inspires frustration in patients.

Health care consumers generally have limited understanding of the problems doctors face dealing with (and being compensated by) managed health care organizations. This lack of information results in tension, anger, and unrealistic expectations on the part of the patients relative to which procedure can or cannot be provided by their doctor.

As a consequence of pressure from patients on one side and managed health care companies on the other, doctors frequently are overworked, underpaid, and stressed to the max. One of the symptoms of stress that tends to be difficult to acknowledge, discuss, and deal with is anger. Despite the lack of candor regarding inappropriate displays of anger on the part of physicians, it is a problem that needs to be addressed.

Hospital Credential Committees, Disciplinary Committees, Risk Management Carriers, and State Medical Quality Assurance Boards are no longer willing to ignore the potential liability inherent in the bad (angry, rude, abusive) behavior of doctors. Increasingly, doctors are being mandated to attend anger management/coaching classes as a condition of the right to admit and treat their patients in most hospitals.
The ideal anger management/coaching program for physicians should not be a mental health/psychotherapy intervention. The American Psychiatric Association has appropriately determined that anger in a normal human emotion rather than a pathological condition. This it important, as no physician or surgeon is or should be willing to submit to a psychological assessment or psychiatric examination based on stress or anger. Any type of paper trail that implies mental or emotional problems can be a career disaster for any physician or surgeon. Anger is a lifestyle issue. It is problematic when it is too intense, occurs too frequently, lasts too long, is harmful to self or others, destroys work or personal relationships, or when it leads to aggression or violence.

Anderson & Anderson, based in Los Angeles, is the largest provider of anger management/executive coaching for physicians in the United States. All of our services are confidential and designed to assess for the physician’s level of functioning in recognizing stress and anger, level of assertiveness, and the degree of emotional intelligence. This assessment is really a MAP and not a psychological test. The final category is motivation to change. Physician participants are generally motivated to enhance their skills in managing anger, stress and improving communication and emotional intelligence.

The individual coaching is conducted over ten hours which can be taken in an accelerated format over a week-end or in weekly one or two hour sessions. These classes are available at our Brentwood office as well as a small number of affiliates throughout the nation. This class in approved by the California State Board of Medical Quality Assurance as well as Medical Boards in Texas, Tennessee, Pennsylvania and Florida.

Topics in this coaching class include:
• Assessment at intake focusing on the participant's level of functioning in managing stress, anger, communication and emotional intelligence. We do not provide psychological testing nor is our intervention considered counseling or psychotherapy.
• Two client workbooks that includes didactic information and exercises focusing on enhancing emotional intelligence, improving assertive communication, as well as behavioral strategies for recognizing and managing anger and stress.
• Complimentary "Gaining Control of Ourselves DVD" along with follow-up kit.
• Post-test at termination designed to determine the level of change during the course.
• Our general 26 session group class is also available for physicians who prefer a group environment.
• Our services are provided with the utmost in confidentiality for all participants.

For more information, or to make an appointment, call our office at 310-207-3591. www.andersonservices.com, www.anger-management-resources.org and www.aaamp.org
George Anderson, MSW, BCD, CAMF