A note from the author: The COVID-19 pandemic has drastically impacted everyone, and healthcare professionals are on the front lines working tirelessly, selflessly, to take care of others. Those who are on the front lines need our support now more than ever. Neither I nor anyone at VITAL WorkLife has any intent to make light of this tremendous challenge to all healthcare providers and those who stay at home adapting to our new realities. I am sharing some new thoughts and suggestions below on SELF CARE, still just as important to avoid burnout and help us all be the providers we want to be.
Sending much love and caring to all!
Barbara Wingate MD
There is certainly a lot of talk about burnout, a very real and common condition for physician and providers, with significant trickle-down effects on patients, our loved ones and care teams. But so many of the drivers of burnout are related to issues we can do little about. However, learning to prioritize what you might be able to change, or improve, is helpful, without overly focusing on what you cannot control.
It is disheartening to think about how many doctors are unhappy. I entered the medical profession late. I felt incredibly lucky to start my career as a psychiatrist at the age of 41 after years of training as a licensed medical social worker. I was not green. I had done home visits as a hospice worker. I had worked on projects to better educate women about breast cancer from early diagnosis on. I loved the medical field and wanted more knowledge, education, control and financial security. The long road to becoming a doctor was totally worth it to me on every level, and I continue to enthusiastically encourage anyone with a desire to be a doctor to go for it!
Perhaps my age, or my natural personality orientation, has allowed me to enjoy medicine from the very beginning and to this day. I am not a naïve Pollyanna, but by effort, good fortune in my upbringing and most importantly by choosing my jobs, leaders and activities with great care, I continue to find new ways to experience pleasure in my work life.
Of course, I have had troublesome days that don’t measure up to “love.” But in the grand scheme of things, not many. I have had the fortune of treating many doctors in my private practice and I now have the pleasure of being a peer coach for VITAL WorkLife. These relationships work both ways. I pass on what I have learned about well being to them, and I have also learned from those in great pain about how to get to a better place.
How can you reclaim some of your own passion for practice even within the changing landscape of medicine?
Number one rule: Take care of yourself.
Despite knowing that self-care is a vitally important part of health and overall well being, many physicians overlook their own self-care, according to a survey conducted by The Harris Poll, on behalf of the Samueli Integrative Health Programs. Lack of time, job demands, family demands, being too tired and burnout are the most common reasons for not practicing their desired amount of self-care.
With all of the barriers to practicing self-care, you must dedicate some genuine authority and commitment to your practice (of self-care), or you will not sustain it. It requires discipline.
Bring Lightness and Humor to Your Life and Practice
If you don’t practice self-care you will feel a sense of “heaviness”—as in you are carrying the weight of the world, which certainly affects how you behave and how others experience you.
Without self-care you lose your manners, your compassion, your curiosity, your listening skills, your important intuitive skills about patients or staff members—and what they need to succeed—for you to be a good team player. Very importantly you lose your sense of HUMOR. Yes I mean humor! You don’t have to be a joker—but humor gives us a lightness that is contagious and healing.
I have had the pleasure of seeing the Dalai Lama in person more than once. He smiles, laughs, wears a baseball cap and giggles. That is lightness of being personified. Read Norman Cousin’s classic 1989 book on healing himself: Headfirst: the Biology of Hope. We, as physicians, and other healthcare workers, can learn much from his wisdom. He uses funny movies to lighten up! Do you have a few in your toolkit? I have several and Sandra Bullock and Betty White often have a role. What else makes you feel light? Family? Books? Your kids? Pets? Friends?
How to Practice Self-Care
There are any number of ways to address self-care. Think about what you eat, how much sleep you get, your level of exercise and adding a purposeful practice of any form of meditation, spirituality or formal religious practices. Research related to physicians practicing meditation reveals the following findings:
- Physician participation in a mindful communication program was associated with short-term and sustained improvements in well being and attitudes associated with patient centered care.
- Participating in an abbreviated mindfulness training course adapted for primary care clinicians was associated with reductions in indicators of job burnout, depression, anxiety and stress.
- Mindful physicians engage in more patient-centered communication and have more satisfied patients.
Use whatever works for you. Nature walks count. For instance, in Japan, these are called forest bathing and they are prescribed for stressed individuals!
Can you do a self-assessment to see what may have fallen by the wayside or what new things you can try? Set up your own plan for energy restoration or resilience upgrades. Ask yourself—do you want external support for navigating this path? With your VITAL WorkLife Well Being Resources, you have access to peer coaching, face-to-face counseling or in-the-moment telephonic support. A coach, like myself, can help you set up guidelines for finding much needed time for yourself, and chart a pathway to well being.
Number two rule: Follow the number one rule—take care of yourself.
National Doctor’s Day is March 30th
National Doctors Day is celebrated worldwide on various dates, and March 30 is the date in the U.S. What a perfect opportunity to reflect on why you went into medicine, and start to bring some joy, lightness and fun back into your practice. Medicus Healthcare Solutions shared 10 ways to recognize physicians for their hard work, dedication to patients, communities, clinics, hospitals and healthcare systems, and there was something for every budget.
While some of these ideas are not applicable during the COVID-19 pandemic, it is still important to share and mention many of these can be done virtually. Here is a summary version of their ideas:
- Share a few nice words with your colleagues–totally free and can be done by sending a quick text, email or phone call
- Host a luncheon or breakfast, and invite all staff to participate (could be done virtually, via video conferencing, or in-person later in the year)
- Give a virtual red carnation–the symbolic flower representing love, charity, bravery and courage
- Arrange for doctors to receive a 10-minute massage from a certified massage therapist (I like this one, but better suited after the COVID-19 pandemic has subsided)
- Invite patients to write a virtual Happy Doctors Day note via email or an "ecard" (could also be from staff if the doctor doesn’t see patients directly)
- Add a special “National Doctors Day” section to your website highlighting resources for your physicians and sharing positive stories
- Create a “thank you video” and send it to your physicians and providers
- Make sure physicians always know they are valued and supported–use independent contractors to fill gaps from open positions and vacations.
- Provide opportunities for patients, co-workers and friends to donate to a favorite charity
- Look on social media and other venues to figure out a way to celebrate doctors
Whether you are a physician, advanced practice provider, in your residency, fellowship or medical school, this is a wonderful profession and if you are not experiencing it in that way, then please go back to rule number one and take care of yourself.
Behave like the loving caring doctor you always wanted to be and still want to be. What goes around comes around... I am going to be unabashedly proud to be a doctor and if what I get is a few kind words of appreciation on March 30th—well that is fine. I am doing this work because I want to and love it. In a time when so many are hurting, let’s celebrate that you and I are able to be part of healing. Think of a way to compliment a colleague on National Doctors Day—and every day.
Love and caring to all,
Barbara Wingate, MD