• Reframing Common Challenges

    The day-to-day of family medicine can present its share of challenges, from the sting of a patient’s rude comment to the tedium of administrative tasks to doubts about making a difference. While it’s true that you can’t keep challenges from cropping up, a strategy known as “reframing” may help you change the way you view and respond to challenges, according to Jay Winner, MD, FAAFP. Winner is a family physician who is the founder and director of the Stress Management Program for Sansum Clinic in Santa Barbara, California. He recommends a number of ways to put reframing into practice when you’re dealing with the following common challenges:

    • Patient personalities
    • Paperwork and technology
    • Loss of meaning and purpose


    Patient Personalities

    Some patient visits are more frustrating than others. When you’re dealing with a patient who makes a rude comment, it may be tempting to respond in kind. Instead, Winner says, try to put yourself in the patient’s shoes and understand that a patient may be rude because he or she is suffering. This perspective may help you feel less annoyed and more empathetic. Reframing can also help reduce your frustration with other challenging patients. For example, if a patient isn’t following his or her treatment plan, it may help to see yourself as a consultant or coach instead of as the boss. If a patient is vague and can’t effectively articulate his or her symptoms, switching to an active listening  approach may be useful.

    Paperwork and Technology

    Dealing with paperwork and technology can dampen the enthusiasm of even the most dedicated physician, says Winner. One way to reframe routine tasks, such as reviewing labs and imaging results, making decisions about refills, and responding to phone and electronic messages, is remembering that this work is also an essential part of patient care. 

    In addition, it’s worth your time to evaluate tasks that are not related to direct patient care and delegate them to trained staff, if possible. Work that you can’t delegate might be more manageable if you take a new approach, like accomplishing it while listening to your favorite music or podcast.

    If technology has become an obstacle in your job, Winner recommends seeking advice from a technologically savvy colleague or an electronic health record (EHR) expert. Taking advantage of existing time-saving EHR templates may also make your life easier.

    “Physicians got into their jobs most often to work with patients, and then find about half of their time is spent dealing with paper and computer work, much of which might not really take their expertise,” Winner says. “A team approach to patient care can make a huge difference.”

    Loss of Meaning and Purpose

    Doing any job day after day can become so routine that it’s easy to lose a sense of meaning in the work. To help avoid this, Winner suggests looking for opportunities to remind yourself of the difference you make as a family physician, especially when it comes to preventive health care. When you help a patient get his or her blood pressure under control, you may be preventing a stroke. When you encourage a patient to have a colonoscopy, you may be preventing a death from colon cancer. Making a point to notice times when your compassionate care has a positive impact on a patient’s life is one way to reframe your daily routine. Doing this on a regular basis can increase your motivation and sense of purpose, which, in turn, improves the quality of patient care.


    Electronic Medical Records (EMR) Templates

    Written by AAFP editorial staff.

    Jay Winner, MD, FAAFP, is the founder and director of the Stress Management Program for Sansum Clinic in Santa Barbara, California. He is author of the books Relaxation on the Run and Take the Stress Out of Your Life, and he frequently speaks and writes on the topic of stress management for physicians, corporations, military personnel, and other groups.