Caring for Me Is Caring for You: The Power of Physician Self-Care and Personal Transformation

 

Want to see change in your team, your organization, or beyond? Start by filling your own tank.

Fam Pract Manag. 2020 Mar-Apr;27(2):17-22.

Author disclosure: no relevant financial affiliations disclosed.

“One A Day” is a multivitamin designed to promote good health. It also represents the approximate number of physicians who die by suicide daily in the United States.1 Even one preventable death is too many, and it is a tragedy that as health professionals we are often not able to care for ourselves as well as we care for our patients.

Many stressors contribute to the rising cycle of burnout, depression, and suicide among health professionals.1 Chronic stress that results from workload exceeding workforce, lack of time and control, and feelings of inadequacy and hopelessness are just a few of the causes. The stigma around mental health and self-care often limits professionals from seeking help or even acknowledging they need a break. Additionally, despite having the knowledge and skills to diagnose and treat others, physicians do not effectively recognize burnout in themselves.2

After delivering a workshop on physician wellness recently, I met a participant named Marta who slipped me her personal business card with a note scribbled on the back. It read, “I need help.” The conversation we had that afternoon echoed words I've heard in my own head and from colleagues across all fields and all types of medical practices: “I can't relax because there is so much to do, and it will never be done,” “I've slipped so far from what I envisioned myself doing as a doctor that I have lost my sense of purpose and belonging,” “I feel so isolated,” “I have no control,” “I'm too busy to even know what to change or do about it,” and “I feel guilty that I just don't care anymore.”

These words paint a vivid and distressing picture of burnout. Marta compared her work to the definition of insanity attributed to Albert Einstein — “doing the same thing over and over again and expecting different results.”

How can physicians break out of this cycle and achieve a state of peacefulness, integrity, belonging, accomplishment, autonomy, agency, and compassion?

For doctors in crisis, the National Suicide Prevention Lifeline (1-800-273-TALK) is critical, but for other physicians, self-care is a viable solution. This article will highlight a critical shift in thinking — one that prioritizes caring for oneself as an effective means of caring for others. The emphasis will be on role modeling self-care, including practicing mindfulness and improving physical health, because personal transformation is the cornerstone for leading change broadly.

KEY POINTS

  • A broken system is not an excuse to not care for ourselves. It is a call to action.

  • Physicians should consider a critical shift in thinking — one that prioritizes caring for oneself as an effective means of caring for others.

  • Two strategies for self-care include practicing mindfulness and improving physical health.

PERSONAL TRANSFORMATION OR SYSTEM CHANGE?

ABOUT THE AUTHOR

Dr. Pipas is a family physician and Professor of Community and Family Medicine, The Dartmouth Institute for Health Policy and Clinical Practice, and the Department of Medical Education at the Geisel School of Medicine at Dartmouth. She is the author of A Doctor's Dozen: 12 Strategies for Personal Health and a Culture of Wellness, and has been recognized as a leader in wellness, education, research, and clinical care. Her recent awards include the 2019 Society of Teachers of Family Medicine Humanism Award and the 2019 Family Medicine Education Consortium This We Believe Award. Dr. Pipas serves as the chief wellness officer for CaseNetwork.

Author disclosure: no relevant financial affiliations disclosed.

References

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1. Andrew, LB. Physician suicide. Medscape. Aug 1, 2018. https://emedicine.medscape.com/article/806779-overview#a1. Accessed Feb. 7, 2020....

2. Dyrbye LN, Satele D, Sloan J, Shanafelt TD. Ability of the physician well-being index to identify residents in distress. J Grad Med Educ. 2014;6(1):78–84.

3. National Academy of Medicine. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Washington, DC: The National Academies Press; 2019.

4. Fjorback LO, Arendt M, Ornbøl E, Fink P, Walach H. Mindfulness-based stress reduction and mindfulness-based cognitive therapy: a systematic review of randomized controlled trials. Acta Psychiatr Scand. 2011;124(2):102–119.

5. Fortney L, Luchterhand C, Zakletskaia L, Zgierska A, Rakel D. Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians: a pilot study. Ann Fam Med. 2013;11(5):412–420.

6. MacKillop J, Anderson EJ. Further psychometric validation of the Mindful Attention Awareness Scale (MAAS). J Psychopathol Behav Assess. 2007;29:289–293.

 
 

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