From the Editor

Stress is a fact of life in health care — whether one is a patient or a care provider. The sources of stress abound: Patients may find it in the physical burden of illness or injury and the sometimes-harrowing twists and turns they encounter in dealing with health plans; and physicians may find it in the crushing pace of work, the volume of patients they see each day and the emotional toll that can result from having to make what are sometimes life-or-death decisions. When medical issues emerge that have to be addressed, via difficult regulatory proceedings, the stress is compounded. No one looks forward to navigating an investigation by a medical board — whether it's a patient, a family or a physician. But what's to be done? In this issue of JMR, we offer one common perspective that can help in the stressful health care environment we face: It's the act of listening and learning. Our lead article, from authors at the Australian Health Practitioner Regulation Agency, offers direct input from those who file regulatory complaints and the physicians who subsequently undergo investigation. Listening to the opinions of more than 1,200 complainants and 1,600 practitioners, the authors found that impressions could be quite different between those who filed complaints and the practitioners being investigated, especially with regard to outcomes. But there was agreement that the regulatory process was extremely stressful and that communication during the proceedings in Australia could be nebulous. The authors hope that improvements can emerge from their findings. Our second article, explores the unique stresses of those in solo medical practice, noting that keeping current with business and medical advancements and evolving medical regulatory statutes can be overwhelming for such physicians. They often have little or no time to tend to their own well-being and have a higher likelihood of malpractice or regulatory inquiries. With input from a variety of sources and insights to better understand solo-physician stress, the article offers several strong suggestions for relief. The key takeaway from this issue of JMR is that we regulators must respectfully listen and deeply understand both physicians and patients as we go about our work. To listen is to learn.