You’ve got a waiting room full of patients, and you’re running behind. You just received notice of rising malpractice premiums, and yet your reimbursement rates continue to drop. And you haven’t been home in time for dinner in what feels like weeks.
You’re feeling stressed, exhausted, burned out, frazzled, and frustrated.
Sound familiar?
This kind of chronic stress — that is, the day-to-day shuffle that is your job — can’t be cured with a warm bubble bath and a cup of hot tea. It’ll take more than a few deep breaths to ease your mind and regain control of your practice and your life.
Ignoring the signs of stress or simply brushing off the burden as an occupational hazard can only make it worse, and could lead to unhappiness, depression, or even a clinical mistake. So before you let yourself be crushed by a stressor snowball, it’s time to find a real, permanent fix. But don’t toss out the rubber ducky quite yet — there’s a place for stress-relieving soak time, too.
Acknowledge your stress
Physicians typically aren’t taught to acknowledge their stress, and instead tend to deny it, says Barry Bub, a physician and director of Advanced Physician Awareness Training, which provides career counseling and workshops for physicians dealing with trauma. “We are desensitized, because [stress is] an ongoing thing we have had our entire professional careers,” he says.
Bub makes a distinction between stress and trauma, the latter referring to specific moments, such as making a medical error or receiving a court summons, which can be particularly debilitating.
“When stress is overwhelming, it becomes toxic and unhealthy. When it’s beyond that, it’s trauma,” he says. “Medical practice equals chronic stress with moments of trauma.”
Although it may seem commonplace for most docs, Bub points out that it is not, in fact, normal to be sleep deprived, constantly fearful of mistakes, or perpetually short on time. It’s no wonder skyrocketing burnout and higher-than-average suicide rates plague the profession.
The long-held beliefs of the profession, passed down during medical school and proliferated among practices, are part of the problem, Bub says. Starting with the grueling hours during residency, the culture rewards those who can handle the long hours and being on call for days at a time, not to mention always being available with the right answers for patients. The image of the superhuman physician is glorified — to the detriment of the profession.
Take for example the whole notion of time. Rather than cultivating best practices that will save time in the long run — such as listening to a patient — physicians tend to rush through visits so they can see more patients. Time spent building a connection with the patient could lead to a more engaged (and thus, potentially healthier) patient — and certainly a more fulfilled physician, Bub says.
Physicians have fallen into the trap of thinking that time spent listening and building relationships is not productive time, he says. They have to break out of this cycle, perpetuated by the profession, to truly set out on the path toward less stress.
Wayne Sotile, a Winston-Salem, N.C.-based consultant and author of “The Resilient Physician,” credits an erosion of physician control and support for the soaring burnout rates and pull-your-hair-out stress physicians are experiencing.
Where there was once was camaraderie, there now tends to be acrimony, Sotile says, as physicians circle the wagons to protect their revenue and patient load. Many doctors are just trying to hang in there, becoming more isolated and disgruntled.
Dissect your stress
One of the first steps to tackling your mounting stress is determining the source — or sources, because it’s probably more than just the fact that you are running behind and can’t find a patient’s chart. It’s time to dig into the layers of frustration in an exercise one consultant calls a “stress biopsy.”
“If we don’t get a comprehensive view of where the stress is coming from, then we are bad clinicians, because we aren’t looking at multiple sources,” says Kernan Manion, a psychiatrist whose own burnout led him to found Work/Life Design, a coaching firm for people in healthcare. Manion’s method evokes the diligence of daily journaling, which can really help uncover the heart of the matter. “We begin to dialogue with ourselves, become more inquisitive and more reflective, and become more observant about what is going on,” he says.
