As rheumatologic care and treatments become more complex and the landscape of physician care becomes more demanding, rheumatologists are at increased risk for becoming “second victims,” according to Albert Wu, MD, MPH, professor of health policy and management and professor of medicine at Johns Hopkins University, Baltimore. In 2000, Dr. Wu first coined the term second victim in an article in the British Medical Journal to define the emotional trauma a provider experiences when a medical error occurs.1
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However, Dr. Wu cautions the second victim phenomenon can be brought on by stressors other than medical errors, including an unexpected or disappointing patient outcome. Additionally, the many chronic stressors physicians experience with patients and practice demands can make them vulnerable. Without support, any physician, including rheumatologists, can experience serious emotional harm and burnout.
Rheumatologists as Second Victims
Although rheumatologists may consider themselves to be at lower risk of becoming second victims compared with a surgeon who loses a patient unexpectedly, Dr. Wu believes rheumatologists are still at risk for several reasons.
“Rheumatologists are exposed to many stressors in providing longitudinal care for patients with multiple chronic conditions who are prone to disappointing outcomes, as well as increased risk for medical errors as treatment regimens become more complex,” Dr. Wu says. “Rheumatologists also face a range of stressors associated with their practice, such as productivity and financial pressures, as well as stressors associated with care requirements such as electronic health documentation.”