The role of medical culture in the journey to resilience.

There is growing concern about the difficulty primary care practices are experiencing both recruiting and retaining practitioners. Frustrations stemming from integrating electronic medical records, satisfying external documentation requirements for oversight and billing, and the divide created between inpatient and ambulatory care teams all contribute to practitioner and staff burnout. Addressing the current culture of medical education and primary care is clearly an essential issue for health care leaders and medical educators.Using two experiences, a workshop on resilience with a large primary care practice group and a medical student studying for the United States Medical Licensing Examination Step 1, the author describes the cultural imperative, beginning in medical school, to sacrifice self-care for productivity and individual achievement. This approach has consequences for practitioners' levels of burnout and selecting primary care as a career. The author concludes by providing recommendations for both individual and organizational approaches to addressing these concerns.