Alienation and Stress among Doctors: Dilemmas and Possible Solutions

Studies of alienation, stress, burnout, and dissatisfaction among doctors are plagued by unclear and varied definition of these terms. Many are small, local, and short, which limit insights. How much they harm patients is usually not studied but may be slight. A focus on patient evaluations, though resented, has led to defining quality standards that did not exist when autonomy reigned. But using consumer-oriented competition can have pernicious effects. Pharmaceutical influences are undermining trust and professionalism. But non-profit models of shared, collaborative initiatives increase morale and clinical quality as well.