BY ERIKA MCCARTHY, SENIOR EDITOR AND WRITER, BASED ON AN INTERVIEW WITH DR. ERAN METZGER
Dr. Eran Metzger
In the often-isolating world of clinical practice — despite being part of group practices or hospital teams — physicians can feel profoundly alone in navigating the emotional complexities of patient care. Eran Metzger, MD, a geriatric psychiatrist, discovered
a unique forum that helps physicians process those moments of frustration, doubt, or moral distress that often go unspoken: Balint groups.
Dr. Metzger's journey into Balint work began unexpectedly when a colleague leading a group had to step away. Intrigued by the concept, Dr. Metzger trained formally and has been leading groups ever since. What he found was not just a tool for physicians
to explore clinical uncertainty but a rare space to process the emotional side of care — a space that can help prevent burnout, foster resilience, and build connection.
What Is a Balint Group?
Named after Hungarian psychoanalyst Michael Balint, these groups date back to the 1950s and were created for primary care physicians who struggled with the emotional weight of practice. In a Balint group, clinicians bring cases that "keep them up at night"
— not because of diagnostic puzzles, but because of the emotional, relational, or ethical challenges involved. A noncompliant patient. A difficult family dynamic. A therapeutic impasse.
Unlike traditional case conferences or support groups, Balint groups aren’t about problem-solving or medical analysis. As Dr. Metzger describes, "Participants are not charged with coming up with solutions." Instead, the group listens, imagines what it
might feel like to be the physician — or the patient — and reflects on the dynamics at play. It’s a process that often leads to new insights, often not just about the case but about oneself.
One internist, for instance, presented a longtime patient — a successful businessman with access to care — who consistently refused needed tests, continued smoking, and avoided lifestyle changes. Despite years of effort, she felt she couldn’t break through.
The group explored not only her frustration but the possible emotional undercurrents in the patient’s behavior and how their relationship might be playing a role. That shift in perspective, Dr. Metzger notes, “opened up possibilities she hadn’t considered
before.”
How Balint Groups Help Today
In a time when physicians spend as much time documenting as they do seeing patients, the risk of emotional exhaustion and moral distress is high. “We can’t change the fact that we’re spending twice as much time in front of computers,” says Dr. Metzger.
“But we can reduce the isolation that comes with that reality.”
Dr. Metzger’s group currently meets in person and on Zoom, allowing participation from members who’ve moved out of state but remain committed. Groups typically include 8 to 12 clinicians from a variety of fields.
Why Join a Balint Group?
Many physicians haven’t heard of Balint groups — or mistake them for group therapy. “They’re not therapy,” Metzger clarifies. “But participants do feel supported.” Unlike clinical case conferences, Balint discussions focus on the doctor-patient relationship,
not the diagnosis. And unlike support groups, the emphasis is on reflection, not catharsis.
Over time, participants often report feeling less alone, more aware of their emotional reactions, and more attuned to the non-medical dynamics affecting care. “Balint has reinforced for me the value of talking about feelings that come up in challenging
cases, rather than keeping them under wraps,” Dr. Metzger reflects.
A Quiet Revolution in Medicine
There are now a handful of Balint groups active across Boston, including two or three within the Mass General Brigham system. The Balint Society of America also offers virtual groups for physicians who are curious but don’t have a local option.
For those interested, Balint work offers more than personal growth — it’s a professional tool that supports clinical insight, communication, and well-being. “When we care for ourselves — by reflecting, connecting, and acknowledging the emotional reality
of our work— we become more effective healers,” says Metzger.
Interested in joining or learning more about a Balint group? Contact Dr. Eran Metzger or visit the American Balint Society for more information.
