Physician Wellness Essential for Patient Care

Dr. Rebekah Bernard | Family Physician, Gulf Coast Direct Primary Care, Fort Myers, FL

Practicing medicine in our current health care system is making physicians sick, with levels of burnout and mental strain increasing across every specialty. Burnout has become so bad that physicians are increasingly leaving the workforce, with the 2016 Physicians Foundation Report showing that 49% of doctors were actively making plans to decrease patient care either by entering early retirement, changing to a nonclinical role, or switching to a lower volume concierge-type practice.” And even more sadly, about 400 physicians per year stop seeing patients for the most tragic of cause: because they take their own lives.

Dr. Rebekah Bernard of Fort Myers, FL

The good news is that there are steps that physicians can take to improve our well-being so that we can continue to care for our patients.

1. Start by taking care of yourself. News flash: Doctors, like everyone else, are human. The problem is that after years of sacrifice and delayed gratification during medical training, physicians often start to develop a delusional sense of indispensability and martyrdom. We expect ourselves to somehow be able to survive on less sleep, handle more stress, and work more hours than everyone else. And since physicians tend to be highly motivated, intelligent, and resilient, we can get away with burning the candle at both ends for a very long time. But unfortunately, at some point, we just can’t keep up. And when this happens, we are devastated with our own failure.

If we want to do the right thing for our patients, we must change this attitude and prioritize our own essential needs – sleep, a healthy diet, exercise, family time, and recreation. Taking care of ourselves isn’t selfish. It is good. It is necessary, and it is vital for our very survival.

2. Learn how to say ‘no’ to things that don’t bring you value.

It’s tough to say ‘no’ when we feel so darn needed by everyone, but if we don’t learn to take control, eventually there won’t be anything left to give. We must practice setting boundaries and sticking to them, and that means only saying ‘yes’ to activities that are in line with our future goals.

We often hesitate to say ‘no’ because of fear – we are afraid we will disappoint someone, afraid of missing out, or we fear being seen as inadequate or incapable. Identifying these emotions and realistically thinking them through can be helpful. Before you say yes, understand your motivations for doing so. Will joining this committee be a jump start to a job you want higher up in the organization? Or is it just a token position that doesn’t provide any value to your life?

Keep in mind that ‘no’ is a complete sentence. Avoid lengthy explanations that can result in you (or someone else) talking you into doing something that you don’t want to do.

3. Talk it out. The simple act of talking with others about emotions and stressors can have a positive impact on physician wellness. ii Get together once or twice a month with a friend or colleague for coffee or a meal – put it on your calendar and make it a priority. When talking to a friend isn’t enough, consider talking with a professional, like a psychologist – someone who can help you think through your emotions and help you to clarify your decisions.

I strongly believe that every physician should have a personal psychologist – here’s why: People who really need to see a psychologist usually won’t go. They don’t think they have a problem. That’s why the rest of us have to – so that we can learn to interact more effectively with difficult people in our lives, a challenging patient, a difficult boss, or a churlish coworker.

4. Get efficient. It’s easy to get bogged down by a clunky electronic health record or a disorganized check-in system. Whenever you can, create your own work-arounds by making templates, forms, and handouts. Keep coding cheat-sheets and reference materials at your fingertips and streamline your processes. Force yourself to complete your notes in “real time” so you aren’t spending hours of pajama time reconstructing the medical record. None of these things are easy but putting in the effort will pay off. You can find more tips about office efficiency in my book “How to Be a Rock Star Doctor.”

5.Take back control of your life. Sometimes doctors feel completely trapped – perhaps by medical school debt, a no-compete contract, or a large mortgage. But the reality is that even when the choices don’t look great, we still do have choices. We can continue to work in our current system, using psychology to learn strategies to work around the challenges. Or we can decide to make a complete change by switching to a different job, working Locum tenens, or even stepping outside of the system completely by transitioning to a direct care practice. It’s your one and only life - you get to choose how you want to live it. And hopefully by taking control, you will find the path back towards those who really need you – your patients.

http://www.physiciansfoundation.org/uploads/ default/Biennial_Physician_Survey_2016.pdf ii https://www.mayoclinicproceedings.org/article/ S0025-6196(16)30625-5/pdf