Professional Loneliness and the Loss of the Doctors' Dining Room.

Historically, family physicians moved among all the venues of medical care- office, hospital, community-and were a part of a connected professional community. That connected community was sustained in great part through informal gatherings of clinicians in hospitals, clinics, and professional organizations. The current fragmentation of medicine into narrowly defined, boundaried workspaces and job descriptions, as well as the increasing size of practices has negatively affected the professional culture in which physicians work. These structural changes have led to an increasing sense of professional loneliness that not only threatens the quality of clinical care by replacing personal discussions about patients but also poses risks to physician personal and professional wellbeing.