Stanford Medical School Offers New Course on Finding Meaning and Balance in Medicine

A new course at Stanford’s Medical School, “Meaning in Medicine: Staying Connected to What Matters Most,” seeks to “immunize” students from future physician burnout by inspiring them to explore and connect with their personal motivations for entering medicine. 

Examples of weekly topics include: What Wellness Means to You, Spirituality and Faith in Medical Care, and Grief and Suffering. And mini lectures cover topics such as how to manage conversations with patients facing serious illness, distinguishing values from goals and preferences, and finding mentors. Each of the weekly sessions also leave space for open dialogue where students can entertain questions of faith, empathy, and what it means to care for a patient while also caring for themselves and their own wellbeing.

The course, developed by Henry Bair, a resident physician and Stanford Med alum, and Tyler Johnson, an oncologist at Stanford Health Care, was inspired by a podcast the two host together. The podcast, A Doctor’s Art, explores themes that seek to reconnect the practice of medicine to its mission, which all too often gets lost in the day-to-day burdens of administration, electronic health records, staffing, and corporatization. 

The response to the course has been overwhelming. Nearly a quarter of Stanford’s pre-clinical students have expressed an interest in taking the course before and just after it opened. And, at the conclusion of the course, every student who participated said that they would recommend the course to others. 

“In medicine, where science converges with art, suffering meets solace, and the human spirit confronts the limits of the body, it is increasingly easy to lose sight of our purpose and of ourselves. But our students have shown an eagerness to cherish their personal, intellectual, emotional, and spiritual motives for entering the profession; this eagerness, in turn, instills the courage and wisdom to seek balance and meaning. All medical trainees ought to be afforded the opportunity to do so, for this, ultimately, is just about the most effective way to individually prepare future clinicians against burnout,” Bair and Johnson wrote in an article for MedPage Today.

State Medical Boards Drop Broad Mental Health and Substance Abuse Questions from Licensure Applications

In a win for physician mental health, 21 states have opted to remove broad mental health or substance abuse questions from medical licensure applications, according to data gathered by the Dr. Lorna Breen Heroes Foundation.

Among these 21 states, the licensing application language is consistent with one of three options: it asks one question that addresses all mental and physical health conditions (consistent with the Federation of State Medical Board’s (FSMB) recommended language), does not ask about applicant health at all, or implements an attestation model with supportive language around mental health and “safe haven” non-reporting options for physicians who are receiving care.

The Dr. Lorna Breen Heroes Foundation, whose namesake died by suicide after experiencing severe burnout while working in emergency medicine during the early period of the covid pandemic in NYC, advocates for better mental health practices for physicians and policies that reduce physician burnout. Two components of the Foundation’s mission include working with state medical boards to remove mental health and substance abuse questions from credentialing applications, and increasing transparency around states’ policies.

The mission is personal for the foundation. Shortly before Dr. Breen’s death, she had shared her reluctance to seek help with family members. She feared that she would no longer be able to practice medicine if she did so. And, Dr. Breen’s hesitance is reflective of the physician population. According to Medscape’s 2023 Physician Burnout & Depression Report, 40 percent of physicians said that they would not seek help for burnout or depression out of fear of repercussions from their employer or state medical board.

The Foundation is not alone in advocating for changes that support clinician wellbeing. Other organizations within the medical community have also voiced support for reform. In 2020, over 40 professional medical organizations, including the AMA, the American Academy of Family Physicians and the American Psychiatric Association, signed a joint statement in support of changing disclosure practices about mental health. And, the AMA and FSMB recommendations support questions that focus only on current impairments rather than historical struggles.

According to the FSMB, "Application questions must focus only on current impairment and not on illness, diagnosis, or previous treatment in order to be compliant with the Americans with Disabilities Act." Similarly, the AMA recommends that any questions required of physicians be restricted to “conditions that currently impair the clinician’s ability to perform their job." And the Joint Commission, an organization that accredits hospitals, removed the requirement for hospitals to question applicants on their mental health history. “We strongly encourage organizations to not ask about past history of mental health conditions or treatment," they wrote in a statement. "It is critical that we ensure health care workers can feel free to access mental health resources."

Stay up-to-date on state policy using the Dr. Lorna Breen Heroes Foundation tracker, here.