Physician Well-being: Addressing Downstream Effects, but Looking Upstream.

Physicians today feel guilty that they cannot spend enough time with each patient. They are embarrassed that short shifts and multiple providers threaten the continuity of care and that their patients often are not even sure who their physician is. They are dismayed that, based on insurance, some patients have too little medical care, while others are burdened with overtreatment and iatrogenesis. They are appalled by the financial burden their patients and their families experience. They, like their patients, have a sense that our titanic health care system no longer primarily supports the physician-patient dyad but serves myriad external interests.