title: "Building through the grief": vicarious trauma in a group of inner-city family physicians.
abstract: BACKGROUND
  Vicarious trauma is an understudied phenomenon among Canadian family physicians.
  
  
  OBJECTIVE
  This phenomenological study set out to explore the experiences of a group of inner-city family physicians caring for women using illicit drugs.
  
  
  METHODS
  Ten family physicians working in Toronto and Ottawa, Canada, participated in in-depth interviews. The data were analyzed using an iterative and interpretive process.
  
  
  RESULTS
  The first major theme emerging from the data analysis was the emotional impact of the work. Participants shared the challenges, sorrows, and joys they experienced as they struggled to care for their patients. The sub-themes identified were as follows: tragedy and death, difficult behaviors, and isolation from mainstream medical community. The second major theme identified was coping strategies. Participants were open, thoughtful, and eloquent as they reflected on the three primary coping strategies reported: adaptation and evolution of practice style, teamwork, and modification of expectations.
  
  
  CONCLUSIONS
  Participants, narratives of loss, grief, and compassion were consistent with vicarious trauma and therefore participants risked developing compassion fatigue--a specific form of burnout. These are new and important findings. Further research exploring vicarious trauma as a possible contributor to burnout among family physicians is warranted.
authors.affiliation: South Riverdale Community Health Centre, Toronto, Ontario, Canada. swoolhouse@srchc.com
authors.forename: Susan
authors.initials: S
authors.lastname: Woolhouse
authors.forename: Judith Belle
authors.initials: JB
authors.lastname: Brown
authors.forename: Amardeep
authors.initials: A
authors.lastname: Thind
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000523:psychology*; D003643:Death; D004645:Empathy; D005260:Female; D006117:Grief; D019538:Health Care Surveys; D006801:Humans; D007400:Interprofessional Relations; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology*; D036301:Qualitative Research; D019966:Substance-Related Disorders; D019037:Urban Health Services