Chapter Ten - The Shamanistic Enclave: Building a Refuge for Healthcare Practitioners

Summary

Doctors, nurses and other healthcare workers spend a lot of time working in the medical environment away from home. In a medical career that spans four decades, a typical full-time healthcare practitioner spends approximately 36 percent of their lifetime on the job. This amounts to about 125,216 hours out of a total of 349,440 hours. For surgeons, this estimate of lifetime accumulation hours may be a low. And this time does not include the time spent in college: four years of medical school and three-to-four years of residency and internship. During their training years, medical trainees work day and night.

This chapter aims to focus on determining what is a refuge for healthcare practitioners. The word “refuge” is simply defined by the Merriam-Webster dictionary as: (1) A shelter or protection from danger or distress; (2) A place that provides shelter or protection; (3) Something to which one has recourse in difficulty. Can the medical environment as it exists today be considered a place of refuge? Of course, this is a dif-ficult question to answer in a historical period confronting the COVID-19 pandemic. Nowhere are healthcare practitioners safe from illness and death, not at the clinic and in their homes. Thousands of healthcare workers have died from the virus, including their relatives (Mollica et al. 2021, 1-4; Mollica and Fernando 2020, e84). Healthcare workers of color and their families have been especially hit hard by the COVID-19 pandemic. Prior to the pandemic, “burn-out” among physicians was high, that is, greater than 50 percent, but the COVID-19 pandemic has intensified the stress and danger on the medical profession. Key findings of The Physicians Foundation's 2021 Survey of America's Physicians reveal the following:

• 1. Eight in 10 physicians were impacted as a result of COVID-19:

  • a. 49 percent reported a reduction of income

  • b. 32 percent experienced a reduction in staff

• 2. 61 percent of physicians reported often experiencing symptoms of burn-out

• 3. More than half of physicians (57%) have felt inappropriate feelings of anger, fearfulness or anxiety because of COVID-19

• 4. Despite the high incidence of mental health symptoms, only 14 percent of physicians sought medical attention

• 5. Most physicians identify their family (89%), friends (82%), and colleagues (71%) as those helpful to their mental health and wellbeing

• 6. More than half (55%) of physicians know of a physician who has either considered, attempted or died by suicide.