How are you? Physicians Describe Peer Support

 

This research project investigates the experience of peer support between physicians using qualitative methods. Specifically, this study explores rural physicians’ positive experiences receiving emotional support from a peer for work-related stress. Common features that lead to a meaningful experience of support are identified. In addition, the role these experiences play in the overall well being of physicians is explored.

Introduction

The practice of medicine, by its very nature, exposes physicians to emotionally challenging situations. The literature tells us at these times, physicians desire peer support. However, common elements of medical culture, such as the conspiracy of silence, the blame culture of medicine, and the tendency to ignore our emotional distress, pose challenges to accessing peer support.

While formal peer support programs are described in the medical literature, there is a lack of research on informal peer support, which arises outside of formal support systems. We don’t know how valuable it is, what it looks like, and how physicians access this support.

Methods

This qualitative study involved interviews with 11 rural physicians with a rich experience of meaningful informal peer support, using a semi-structured interview guide. The interviews were coded and analyzed by using hermeneutic phenomenology.

Phenomenology is the study of lived experiences. Hermeneutics asks what the study of the lived experience can tell us about peer support itself. Hermeneutics also values the different experiences brought to the topic by respondents and the researcher. Experiences shaped by culture, context and time, with the interpretation leading to a fusion of these perspectives, deepening the understanding of the topic and leading to new insights.

This research project investigates the experience of peer support between physicians using qualitative methods. Specifically, this study explores rural physicians’ positive experiences receiving emotional support from a peer for work-related stress. Common features that lead to a meaningful experience of support are identified. In addition, the role these experiences play in the overall well being of physicians is explored.

Summary of Results

1. Peer support is Invaluable

Peer support was described as vital, essential and life-giving, and most participants felt it was essential to their continued practice in medicine.

2. Outcomes of receiving peer support

Physicians reported that peer support led to them enabled them to:

  • Having more compassion for patients
  • Be more able to ask for help from peers
  • Have deeper relationships with peers and patients
  • Improved their sense of self-worth
  • Led to improved recruitment and retention in rural medicine, and
  • Most importantly, helped them give better medical care.

3. Not Time Consuming
Most instances of peer support were not time consuming, and many were brief. Most were one-time conversations. One instance was a one-sentence text. One participant described a 5-minute conversation that held life long meaning. Some 25 years later, she sobbed while telling the story, “It was a seminal moment in my career and in my life.”

4. Asking “How Are You?”
Simply asking how someone is doing is an effective way to initiate peer support. The majority of peer support arose in 2 ways:

  • Peer asking, “how are you?”
  • Peer being nearby at the right time – often in a shared office space

Practitioners reaching out for support is not the norm, although it seems like receiving peer support permits practitioners to reach out in the future.

5. Qualities that led to the support being meaningful

  • Non-judgmental: “Someone who saw it through my eyes.”
  • Listening without fixing
  • Validating: “Yes, I understand why you feel this way’.
  • Normalizing: “Yes, it has happened to me too. It’s a part of our job. I survived and you can, too.’
  • Reframing: “I see you as a competent and valued colleague’.

 

Conclusion

This data illustrates the value of informal peer support. Knowledge translation of these findings can improve physicians’ support and potentially lead to enhanced practitioner wellness and medical practice retention.

Learn More

Taking care of each other during COVID-19 – peer support for physicians
This Changed My Practice article by Tandi Wilkinson MD CCFP-EM. Published on April 1, 2020. This Changed My Practice is a free online educational initiative from UBC Continuing Professional Development.

Contact connect@bcemergencynetwork.ca for more information on this project.

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