Last week, I enjoyed a much needed vacation with my family. We cruised from Seattle to Alaska and took an excursion to the Yukon. Along the way, we enjoyed spectacular vistas and the beauty of nature.
But being a physician, I couldn’t completely avoid work. I had the pleasure of meeting with medical colleagues from around the world at the 3rd annual Update in Hospitalist Medicine – over 16 hours of continuing medical education on topics ranging from kidney failure to cardiac arrythmias. It was organized by Hospitalist Consulting Solutions and SeaCourses.
I got to teach my colleagues on the topics of Improving Patient-Physician Communication and Practical Strategies for Maintaining Personal Health, Managing Stress & Nurturing Relationships.
Physician health is an oft neglected topic – particularly by doctors themselves when it comes to their personal well-being.
How healthy is your doctor?
When you see a physician, the focus is appropriately on your health. Seldom do we consider the health of physicians.
We encourage our patients to eat healthy, regular meals; get sufficient rest and daily exercise; and to do regular screening tests. But you would be surprised at how many doctors do not follow their own advice. In fact, physicians tend to neglect their own health, especially when it relates to the stress of their work.
Physicians are subject to the same illnesses as their patients. But because of personality traits common in the profession and the traditional culture of medicine, we are at increased risk for stress, work addiction, burnout, depression, suicide, alcohol abuse and drug abuse.
Physicians tend to self-treat and are reluctant to become patients themselves and seek help. They tend not to see their family doctors as regularly as they should. Many do not even have a family doctor.
The people that make it into medical school tend to share compulsive traits and perfectionism. This is great for patients but bad for doctors. You would want an extremely careful surgeon operating on you. You won’t have to worry about anything left undone or sponges left behind. Our compulsivity will ensure that we chart accurately and completely and that we follow-up on important test results.
Perfectionism can make us judgmental and overly critical of ourselves and others. This can have negative effects on our work and personal relationships.
The downside of compulsivity include rigidity, stubbornness, reluctance to delegate our work to others, self-doubt and excessive feelings of guilt. Compulsive doctors tend to have an exaggerated sense of responsibility and can be excessively devoted to work at the expense of their personal lives.
The culture of medicine acts synergistically with our personal vulnerabilities. Early in medical school we learn to dissociate our natural emotional reactions from our rational minds. We learn anatomy by dissecting cadavers. We learn to think and act professionally even when confronted with horrific trauma.
This emotional dissociation if carried to the extreme can put us out of touch with our own feelings. We may bottle up grief and anger. We may ignore the symptoms of depression, stress and anxiety. Doctors who are overly dissociated may come across as cold or clinical to patients.
A workaholic attitude has been a tradition of our profession. When we applied to medical school, we knew that we would be working hard and losing sleep during our studies, in residency and throughout our work lives.
We will give all that we have to our work; and our work will consume all that we can give. There is never a shortage of patients to be seen, shifts to take or paperwork to catch up on. We are invited to be involved in numerous committees and worthwhile organizations.
We are taught to put the wellbeing of each patient before our own. As a consequence, when a physician is overstressed and his life is out of balance, his personal health and relationships will be neglected long before his work. When a physician’s quality of work suffers, everything else in her life has likely fallen apart already.
Fortunately, our professional organizations are supportive of physician health. The Physician Health Program of B.C. provides counseling services for physicians and their families in addition to a variety of workshops to foster resilience.
Our Burnaby Division of Family Practice is a non-profit organization committed to improving the wellbeing of all members in our community, including physicians.
Some useful references:
ePhysicianHealth.com: excellent online modules from the Canadian Association of Interns and Residents (CAIR)
The Physician as Patient: a clinical handbook for mental health professionals by Mike Myers and Glen Gabbard, American Psychiatric Publishing 2008
The Resilient Physician: effective emotional management for doctors and their medical organizations by Wayne and Mary Sotile, American Medical Association 2003
physicianhealth.com: website for the Physician Health Program of British Columbia.
Next: Managing stress and burnout and achieving balance in your life.