How physicians can transform pain management through self-awareness and compassion

Physicians routinely treat pain, yet they often neglect to address their own. Understanding the root causes of pain—both in patients and within themselves—can lead to a more compassionate and effective approach to care. Amelia Bueche, an osteopathic physician, recently appeared on The Podcast by KevinMD to discuss her KevinMD article, “This perspective will change how physicians address pain and recovery.” In her conversation, she reflected on the lessons she gained from the documentary Tipping the Pain Scales and how it influenced her approach to pain management in both clinical and coaching settings.

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A film’s impact on addressing pain

Amelia initially watched Tipping the Pain Scales to support friends in recovery from substance use, but as a neuromusculoskeletal medicine physician, she quickly recognized the film’s broader implications. While the documentary touches on the opioid crisis, it primarily explores how pain is addressed in health care and society. The film follows multiple narratives, including that of a psychiatrist discussing the mismanagement of pain and the importance of asking deeper, core questions.

For Amelia, the film resonated beyond patient care—it highlighted how physicians themselves experience pain, often without acknowledging it. She found herself reflecting on the ways physicians internalize stress and trauma, sometimes manifesting in overworking and overachieving rather than dysfunction. Inspired by the film’s message, she immediately drafted four different articles, one of which became the piece published on KevinMD.

Pain as a professional burden and personal challenge

In her coaching practice, Amelia encounters physicians who are deeply affected by the pain they witness in their patients. Clinicians regularly face difficult questions: How should pain be managed? Are medications the only answer? Do they have enough time to explore a patient’s deeper struggles? The constraints of modern medicine often limit the ability to ask meaningful questions, forcing physicians to focus on immediate treatment rather than long-term healing.

Physicians also struggle with their own pain. Many high-achieving professionals mask their struggles through excessive work rather than addressing underlying emotional or psychological burdens. With physician suicide rates at alarming levels, Amelia emphasizes the importance of self-awareness and peer check-ins. Simply asking a colleague, “How are you, really?” and making space for an honest response can be transformative.

Asking better questions about pain

One of Amelia’s key insights is that physicians may not always be asking the right questions when treating pain. A patient with chronic pain or substance use disorder often has a history rooted in trauma. Instead of focusing solely on symptom management, clinicians should explore when and why the issue began. Was there an event that triggered substance use? What emotional or physical pain was present at the time? Did the patient have healthy coping mechanisms?

Physicians often avoid such conversations due to time constraints and concerns about destabilizing a patient. However, Amelia argues that if a patient repeatedly presents with unresolved pain, it may be a sign that a different approach is needed. Rather than continuing the same ineffective interventions, physicians can shift their focus to uncovering the root causes of suffering.

Practicing self-compassion in medicine

Amelia also underscores the necessity of self-compassion for physicians. Often, clinicians are so accustomed to caring for others that they fail to recognize their own needs. In her coaching sessions, she frequently encounters physicians who struggle to answer the simple question, “What do you need?” Because their training prioritizes patient care over self-care, they may not have considered their own well-being.

Acknowledging personal pain and unmet needs is the first step toward self-compassion. This process does not necessarily require major external changes; sometimes, it is a matter of shifting perspective. By recognizing and addressing their own struggles, physicians can create a healthier and more sustainable approach to their work.

The role of coaching in physician well-being

Amelia credits coaching as a pivotal part of her own professional evolution. Moving from clinical medicine to coaching allowed her to help other physicians reconnect with their inner wisdom and resilience. Unlike traditional therapy, coaching is about reflection and awareness. When working with a physician struggling with professional burnout or emotional exhaustion, Amelia focuses on holding space for their experiences.

Through coaching, physicians can recognize patterns in their thoughts and behaviors. Many are surprised by how much stress they have normalized in their daily lives. By fostering self-awareness and making space for emotional processing, coaching helps clinicians reconnect with their original motivations for entering medicine.

Addressing stigma around substance use in medicine

The conversation also touched on substance use among medical professionals and the stigma surrounding it. While alcohol consumption is widely accepted in medical culture—such as a glass of wine after work—it is important for physicians to evaluate whether they are using substances to mask deeper struggles. Acknowledging this reality is difficult, as seeking help can carry professional and licensure risks.

Amelia advocates for more supportive systems that allow physicians to seek help without fear of career repercussions. While formal intervention programs exist, not all are safe or effective. Creating spaces—both online and in-person—where physicians can discuss these challenges without judgment is crucial for addressing this issue.

Systemic change starts with individual awareness

One of the documentary’s key messages is that addressing pain at a systemic level begins with recognizing pain on an individual level. Amelia describes how certain experiences—such as watching Tipping the Pain Scales or attending a Yo-Yo Ma concert where he spoke about “planetary humanism”—resonate on a deep, cellular level. These moments remind her of the interconnectedness of medicine, coaching, and personal well-being.

She encourages physicians to pay attention to experiences that activate their full selves—not in a reactive way, but in an invigorating one. These moments of alignment can serve as guideposts for personal and professional growth.

Final thoughts

Amelia’s key message is that physicians must enhance their ability to recognize pain—not only in their patients but also in themselves. Pain does not always present in obvious ways, and recognizing it is not a sign of weakness but an opportunity for growth. By bringing more curiosity, awareness, and self-compassion into their practice, physicians can improve both patient care and their own well-being.