The Doctor-Public Relationship: How Physicians Can Communicate to Foster Resilience and Promote Mental Health During COV
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and Joshua C. Morganstein, MD1
1
Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, MD, USA; 2Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.
J Gen Intern Med DOI: 10.1007/s11606-020-06243-w © Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply) 2020
we are traditionally taught to diagnose and A streatphysicians, one patient at a time. The doctor-patient relationship, that empathic alliance at the heart of medicine, reflects our abiding commitment to caring for individual patients who are suffering. However, during the COVID-19 pandemic, suffering is occurring on a massive scale that threatens to overwhelm the “one patient at a time” approach. Previous large-scale national disasters, potentially less impactful than COVID-19, resulted in significant mental health costs to society.1 This suggests that the mental health “footprint” of the current pandemic will be far-reaching and long-lasting, and that proactive, preventive public health measures must be taken to address the rapidly evolving, ongoing, and future mental health effects of COVID-19.2 Disaster psychiatry, which combines elements of population health and preventive medicine, offers insights into the public health measures that can be taken to mitigate the mental health effects of this pandemic and other disasters. In particular, it teaches us that communication with the public is key: effective risk and crisis communication techniques3 that promote a sense of safety, calming, self- and community-efficacy, social connectedness, and hope4 can alter the trajectory of recovery for entire communities and populations. Physicians have a critical role to play in communicating with the public during the current crisis. We are de facto public health leaders: our patients, institutions, and communities look to us for expert guidance on the health consequences, including mental health impacts, resulting from COVID-19 and steps to effectively address those. We may have the opportunity to provide resources or comments to media outlets,
Received August 25, 2020 Accepted September 11, 2020
hospital/clinic committees, community organizations (e.g., schools, places of worship), and other venues. As such, we are ideally positioned to support public health by establishing, in addition to a doctor-patient relationship between ourselves and our patients, a “doctor-public relationship” between ourselves and the communities looking to us for guidance. Yet the role of public health leader and crisis communicator during a pandemic or other disaster may be difficult for physicians to intuit, as it requires us to speak to a diversity of lay audiences in varied settings rather than to specific patients in our offices. Here, we present a few important principles and actionable steps in communication, gleaned from field experience and research literature in disaster psychiatry, tha
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