The individuality of being well

New-to-practice rural family physician Dr. Chelsea Wilgenbusch discusses the demands of medicine, staying well and how the path to wellness is different for everyone

By Maria Ryhorski

The importance of fostering wellness in the medical community is gaining recognition across the country. The Canadian Medical Association (CMA) and the Saskatchewan Medical Association (SMA) have named physician health and wellness as priorities, and the SMA is in the process of expanding its Physician Health Program to better support physicians in all parts of the province. Honest conversations about mental health are growing more prevalent, as individuals and organizations work to reduce the stigma of mental illness and normalize the importance of seeking help. Physicians know themselves best when it comes to wellness – their struggles and what they find helpful. The SMA approached Dr. Chelsea Wilgenbusch, a new-to-practice family physician in Melfort and physician mentor for the SMA’s Roadmap Program for Students and Residents, to share her perspective on staying well and how we prepare our learners to face the demands of a career in medicine.

SMA: You’re now a year into a rural family practice. Medical school and residency are behind you. The demands of a medical career can make it difficult to look after your own well-being. Can you tell me a bit about that?

CW: I think there are a lot of barriers to staying well as a physician that are both intrinsic to the health-care system and extrinsic to it. The system itself requires 24/7, 365 day service, in a stressful environment where errors can be unforgiving and life altering.

Our personality also plays a distinct role. Physicians by nature are highly motivated, compassionate individuals who put high expectations on themselves to achieve and to do good for their patients. The very nature of what makes us excellent doctors also makes us highly vulnerable to burnout or compassion fatigue.

SMA: What do you see as some of the barriers to physicians staying well?

CW: Time is a big one. It’s just a race against the clock to log your hours at work, finish your paperwork, be physically active, have hobbies, be a supportive spouse, talk to your parents, see your kids, walk your dogs, etc. It’s difficult to balance all of that when you’re spending 60-80 hours of the week at work.

Lack of coverage is another issue, especially in rural areas where you just can’t seem to get the time off you would like, as these areas are often under serviced. And culture plays in as well. Everyone else is also working hard so you feel like you don’t want to burden your colleagues by working less.

SMA: You’re fairly recently out of medical school and residency. Looking back on your experience, do you think we are doing a good job preparing students to take care of themselves?

CW: I think we are trying, but we need to broaden our perspective. I don’t think that mandatory wellness hours or exposure to mindfulness are the only avenues for promoting wellness. I think the bigger issue is that we are working in a system that supports physicians working more hours and having more demands on them constantly. I think systemic change would be more impactful than teaching people how to combat burnout, therefore I think focusing on creating strong physician leaders who will advocate for this change should be one priority in our wellness initiatives.

And when it comes to supporting wellness – particularly for medical learners – I think we should be supporting a wide array of activities that students/residents say enrich their lives as human beings first and doctors second. For some people that may be gardening, walking their dog, seeing an afternoon movie with their spouse or having coffee with an old friend. I think we need to broaden our scope of what constitutes “wellness” and recognize that being well looks and feels different for everyone.

SMA: What would you say to medical students who are beginning to feel worn out? What advice do you have for them?

CW: It’s OK to not be OK. No one is always happy all the time. No one is inherently good at setting limits for their personal and professional life either, but it is so important to learn how to do this.

Do things you are passionate about … but recognize when you’ve taken on too much and learn how to graciously say “I appreciate you thinking of me, but I am happy with my current work and don’t need another role.”

Take time to reflect on your life before medicine and the things that brought you joy, and consider how you can incorporate those things into your life now, and going forward throughout your career. And accept that what makes you feel “whole” isn’t the same as what makes someone else feel well, and that is perfectly OK!

SMA: You raised an important point – that activities that foster wellness often don’t fit into a mold and are different for everyone. What do you do to stay well?

CW: I like to go to the gym and I like to run outside. I truly feel exercise is the most underutilized anti-depressant and anxiolytic in existence. Expending energy really helps to reset my mood and energy levels.

Practising gratitude is also important. I try to maintain an attitude of gratefulness in everything I do, remembering that we are fortunate to live and practice medicine in a First World country.

Hiking and walking with my dogs is also big for me – related to exercise which I already mentioned – but with the addition of enjoying nature with my dogs, who are always happy regardless of where I take them.

Taking time to spend intentional time with my spouse – going to movies, golfing, running, eating meals together.

Ultimately, anything that reminds me that life is bigger than work and medicine, and recognizing that maintaining my humanity is ultimately what makes me a better doctor.◆