title: Physicians Experiencing Intense Emotions While Seeing Their Patients: What Happens?
abstract: Physicians often deal with emotions arising from both patients and themselves; however, management of intense emotions when they arise in the presence of patients is overlooked in research. The aim of this study is to inspect physicians' intense emotions in this context, how these emotions are displayed, coping strategies used, adjustment behaviors, and the impact of the emotional reactions on the physician-patient relationship.
  
  
  
  A total of 127 physicians completed a self-report survey, built from a literature review. Participants were recruited in 3 different ways: through a snowball sampling procedure, via institutional e-mails, and in person during service meetings.
  
  
  
  Fifty-two physicians (43.0%) reported experiencing intense emotions frequently. Although most physicians (88.6%) tried to control their reactions, several reported not controlling themselves. Coping strategies to deal with the emotion at the moment included behavioral and cognitive approaches. Only the type of reaction (but not the emotion's valence, duration, relative control, or coping strategies used) seemed to affect the physician-patient relationship. Choking-up/crying, touching, smiling, and providing support were significantly associated with an immediate positive impact. Withdrawing from the situation, imposing, and defending oneself were associated with a negative impact. Some reactions also had an extended impact into future interactions.
  
  
  
  Experiencing intense emotions in the presence of patients was frequent among physicians, and the type of reaction affected the clinical relationship. Because many physicians reported experiencing long-lasting emotions, these may have important clinical implications for patients visiting physicians while these emotions last. Further studies are needed to clarify these results.
authors.affiliation: Intern Physician of Otorhinolaryngology Head and Neck Surgery in Vila Nova de Gaia/Espinho Hospital Center, Portugal. mimed07112@med.up.pt.
authors.forename: Joana Vilela Da
authors.initials: JV
authors.lastname: Silva
authors.affiliation: Professor of Clinical Neurosciences and Mental Health at Oporto University in Portugal. irenec@med.up.pt.
authors.forename: Irene
authors.initials: I
authors.lastname: Carvalho
mesh_terms: D000328:Adult; D000368:Aged; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D057566:Self Report