Successful physician support groups are profoundly therapeutic, but they're not group therapy,” says William Zeckhausen, DMin, a pastoral counselor and facilitator of physician support groups in New Hampshire. “Physicians attend not because they're impaired and trying to resolve some pathology, but rather because they see the group as a personal and professional resource to help their functioning as physicians and as people.”
Zeckhausen facilitated his first support group in 1983. Most members of that original group still participate. “They'll probably keep coming forever because they realize the value of it, just like exercise or good nutrition,” he says. Physicians in the groups meet weekly to discuss a wide range of issues that may include “anything from dealing with sexual temptation to discussing the dynamics of referring to a specialist or how to relate to a dying patient.”
Zeckhausen wrote about his 1995 FPM article.1 Since then, he says, the groups have continued to provide wisdom and acceptance to their members. The groups' value is the feedback and compassionate understanding physicians receive from their peers and the deeper connections physicians make to themselves, their patients, their colleagues and each other.
Zeckhausen provides these examples: “A physician in one of my groups once said, ‘When I came into medicine, I looked at doctors as basically unfriendly and I wasn't terribly proud of being a physician. But through my experience in the group I've learned that physicians are compassionate and are resources for my healing. As a result, I feel more positive toward physicians and toward myself as a physician.’
“Another physician recently shared that 10 years earlier he'd made a horrendous error that he thought may have caused the death of a patient. His guilt and shame were so strong that he had never shared this with anyone, including his spouse. His colleagues responded with compassionate understanding, and several shared that they had similar experiences. So that was a healing experience for him.”
The sharing that occurs in physician support groups is great prevention for burnout. Zeckhausen recalls a physician telling fellow group members, “This is the one place where I feel most deeply understood as a physician. There's nowhere else I can get that, including from my non-physician spouse.”
Several years ago, before speaking to a group of pre-med college students, Zeckhausen asked his groups what they would have wanted to hear when they were pre-med students. “One physician said, ‘You can tell them that being a physician is an incredible privilege because we have the opportunity to relate to patients person-to-person and soul-to-soul. But in order to do that, we need nourishment for our own souls, and we receive that in this support group.’”
Finding a support group
Physicians may have to actually create their own support group in order to join one. “Unfortunately they're too rare,” Zeckhausen says. If you're interested in starting a group locally, Zeckhausen suggests looking for four to eight physicians who are also interested. Sharing articles on professional support groups is one way to gauge the interest of fellow physicians.
To find a good facilitator, ask around for recommendations and interview the candidates with other members of your group. Although the facilitator doesn't have to be a group therapist, Zeckhausen advises choosing someone who is skilled in group process, sensitive and committed to empowering the group, not fostering dependency.
Zeckhausen cautions against meeting without a facilitator. “I've been told by others who've been in groups without an outside facilitator that they tend to get stuck when conflicts arise involving members of the group,” he says. “Sometimes the group doesn't know how to deal with conflict safely and constructively. The facilitator can get away with pushing a little bit more because he or she is not a colleague.”
According to Zeckhausen, the need for physician support groups is “profound.” “I think most physicians have issues to deal with, but they haven't found a place or choose not to share or get help,” he says. “I often wonder how they survive. With managed care and the escalating number of lawsuits, their already stressful profession is more stressful than ever.”