Emphasizing altruism is problematic for physicians

As a family physician in small-town Ontario, my heart sank when I read the CMAJ commentary “Mitigating the Psychological Effects of COVID-19 on Health Care Workers.”1 At first I wasn’t sure why, but on further reflection, it was the following statement that worried me: “Emphasizing the altruism of working in health care and serving of the greater good will help health care workers to be reminded of their purpose in a time of crisis.”

I fear that the call to altruism may lead to worsening compassion fatigue and burnout among my colleagues. I would like to suggest that we encourage each other in the pursuit of meaning in our careers. Altruism and meaning are quite different concepts.

Altruism is defined by Google as “the belief or practice of disinterested and selfless concern for the well-being of others.”

I believe that, as physicians, we limit ourselves by seeking only to be altruistic. Having a “selfless concern” for others implies putting my own needs last or, even worse, that meeting my needs and my patient’s needs are mutually exclusive concepts. I believe that couldn’t be further from the truth! Physician burnout contributes to poor patient outcomes, poor patient satisfaction and increased health care costs.2 The personal toll burnout can have on a doctor’s life is also grim — contributing to the physician suicide rate being double that of the general population.3

Altruism is not the solution. I suggest that we encourage ourselves to reconnect with meaning, our “why” that we are in medicine.

The pursuit of meaning may be what brought us to medicine in the first place. As young doctors, we may have felt drawn to fulfill an inexplicable calling, to leave a legacy or to develop important connections with our patients. In their book Burnout, Emily and Amelia Nagoski define meaning as “the nourishing experience of being connected to something larger than ourselves.”4

As physicians we have the unique privilege of being part of our patients’ lives in profoundly meaningful ways. We participate in life from birth to death, pandemic or no pandemic. Sometimes we offer heroic treatments, sometimes we are a listening ear or a quiet presence. Connecting with why I am a physician goes way beyond altruism; finding meaning enriches my life and my patients’ lives as well.

So let’s stop putting altruism on a pedestal. It is short-sighted and diminishes the humanity in each physician. Instead, as physicians battling the coronavirus disease 2019 pandemic, we should remember now more than ever to put on our own oxygen mask first, then turn to those around us and help however we are able. By caring for ourselves, we will be vastly better equipped to care for our patients.