Both physicians and patients are suffering. Here’s how to cure it.

De-HumanizingPhysician burnout is an epidemic, affecting not just doctors, but their practices and ultimately their patients. Numerous global studies involving nearly every medical and surgical specialty indicate that approximately one in three physicians are experiencing burnout at any given time, with some studies showing the prevalence as high as 60 percent. It is no wonder with the high stress of the medical profession, combined with the ever-changing healthcare playing field. Physician dissatisfaction has negative consequences far outside the hospital or exam room, from lower patient satisfaction to an increase in medical errors. So, what can be done? Double Board Certified facial plastic surgeon Rich Castellano, M.D. says the answer is simpler than we think.

Dr. Rich, as he likes to be called, spends his days making patients look good on the outside. His practice’s motto is “Look Good, Feel Good, Do Good!” However, he is even more concerned with how patients feel on the inside. Dr. Rich is the author of the Wall Street Journal best-selling book called ‘The Smile Prescription’ that advocates a simple philosophy: It takes courage to bring ourselves and others to smile in difficult situations. Are you up to the challenge?

The more we smile at people around us, the more we open the door to personal relationships, and personal growth. His advice for doctors: “My number one tip for physicians is the same as I would give to any of my patients, seek family, friends, or role models that are happy with what they are doing, and do what they do! We will become who we spend time with.

We are often too hard on ourselves, and we never see ourselves the way that others do. For example, cosmetic patients can often fixate on “facial imperfections” and be unhappy with their appearance that actually looks quite good. Doctors can be the same way. If we are too perfectionistic, we fail to celebrate our accomplishments and realize that we have it better than most. Learning to be more accepting and be forgiving of “Life or Work Imperfections” will reduce the burnout and compassion fatigue.

Dr. Rich says many physicians today suffer from anhedonia. The Merriam-Webster dictionary describes it as ‘a psychological condition characterized by the inability to feel pleasure’.

“Why do doctors today suffer from that? Because medicine can be dehumanizing. Even medical training can be dehumanizing. When I meet a medical student, the first thing I tell them is how amazing they are and how beautiful it is that they are dedicating their career and life to serving others in medicine. Please don’t lose sight of how important and awe-inspiring that is! No matter how tough it gets or how angry the people around you may become, please don’t forget how kind you are,” says Dr. Rich.

The prescription, according to Dr. Rich, is to celebrate life, during small moments, each day. That includes in the exam room, or the hospital room, with their patients.


“This is what I call re-humanization. You need to humanize each of your patients. Celebrate them in the exam room. It doesn’t take a lot. You don’t need to know a lot about a patient to connect with them on a personal level and say, ‘How is your day going?’. ‘How is your kids/family” “How was that trip you took?”.’ Smile at them. Connect with them. Then do that again, and again and again, day after day.”

One of the best ways to connect with people Dr. Rich says it’s to smile at them. In fact, as any good physician, he has come up with a scientific approach. He calls it the ‘smile scale’, ranging from high to middle to low smile categories. Dr. Rich says he can predict a person’s behavior using this simple formula. What’s more, a physician’s smile score can either help or hinder their practice, and their bottom line.

“Some people smile no matter what happens to them. Others never smile under any circumstances. Doctors need to ask themselves ‘What would my average patient say my smile score is?’ I have a suspicion that a majority would say low or middle. Yet, patients worry that low smiling doctors may not care as much, or perhaps they are stressed or in a hurry. When patients see a smiling doctor, they are more at ease, they feel the doctor cares, and they feel more connected to their physician. That is the best medicine they will ever receive, and they will come back again and again because that doctor makes them feel good.”

So, what can you do to get out of the cycle of anhedonia?

1) Smile at a stranger. How many times have you been in an elevator and avoided eye contact? “People think smiling is a small and simple thing, but it actually takes a great deal of courage in many circumstances. If you have the courage to smile at someone new, you will make a new friend. Smiling represents kindness. It creates connection on a deep level that is common to us all,” says Dr. Rich.

2) Connect with your patients on a personal level. When you walk into an exam room, ask questions that are outside what is ailing the patient, and what their previous diagnosis is. Ask them how their family is doing, or if they have been on a vacation recently. If you can make them smile or laugh, and make them feel comfortable, you are solidifying that relationship, and also fulfilling yourself.

3) Never forget your humanity. “This world can be hard. We just went through Hurricane Irma, and Hurricane Maria, down in Puerto Rico, that affected so many of our relatives and friends. As doctors, it’s important to remember that many of our patients are going through a lot. It’s okay to shed a tear with them, and then when you’re done, help them make a plan and move on. This too shall pass.

Dr. Rich’s philosophy is clear: “We need to re-humanize the world of medicine, and it all can start with just a simple smile.” Please – have the courage to share your smile, even when it is difficult to do so. The life you save may be your own ( :

Dr. Rich is based in Tampa and The Villages Florida, and he is proud to train doctors in bedside manner and business success from all across the country through the online coaching and mentoring program He will be teaching these strategies and more in his live 2-day event “Heal the Healer,” assisting doctors with reducing burnout and getting the most out of their patient relationships and their practices.

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