Managing The Stress of a Life in the Chaos of Medicine

Let’s face it, the practice of medicine today is fraught with stress.  Physicians are not only expected to make critical decisions concerning the health and well being of their patients but are also needed to make real CEO-level business decisions every day.  Healthcare systems are purchasing practices and assimilating doctors like the Borg from the Star Trekseries.  More and more is being asked of providers with a concomitant reduction in reimbursement.  Physicians are also people, with families–spouses and children, homes and pets.  Often the stress of work brings unrest to the home as well.  In order to provide excellent care to our patients it is imperative that physicians are able to develop strategies to manage stress at work and at home.Many physicians are trained in residency and fellowship programs that include a military-like hierarchy; responsibility at every level and accountability at the top for all actions below.  This environment creates stressful situations and interactions and forms the foundation upon which many exceptional careers are built.  However, at no time during my training did I receive mentoring in stress management nor did I ever feel emotionally supported.  The long hours of residency are not the problem.  The lack of support is.  Medical education today needs to provide more of a focus on training the “whole physician”; not only training the hands and mind of young doctors but training their hearts.  Stress is a natural part of medicine and medical training.  What makes physicians more effective is how they deal with these daily pressures.  Many physicians in training are also beginning married life and starting to have families.  We have all heard the stories of divorce during residency.  In fact, some surgical programs  of actually unofficially boast about a 110% divorce rate (implying more than one failed marriage in their trainees).  All new marriages can be challenging but additional pressures are felt by those in training– financial burdens of student loans, lack of quality time together and sleep deprivation.  Families are an integral support group for physicians in training.  In my experience, one of the reasons I made it through my fellowship training was the relationship I had with my wife.

Physician burnout is real in today’s practice–the seeds may very well be planted in residency training and early practice.  Family relationships feel the strain and can be a very important support mechanism.  Although little is taught in medical school and residency, there are a few keys to managing this stress.  Here are my thoughts:

1.  Make time for family.  Incorporate family into routine activities such as grocery shopping, going to the drug store, laundry, etc.  Even though you may be accomplishing “household work” you can do it together.  There is always time for conversation while driving in the car (even with the kids)

2. Schedule “dates”.  Even though trainees are often on call as frequently as every 3rd night in some programs, it is very important to schedule a date with your significant other.  It may be as simple as a trip for coffee, ice cream or dinner and a movie.  Get a babysitter if you have kids and do this at least once a month.

3. Make daily “3 Minute Check Ins”.  Every day, no matter how busy you may be, take 3 mins to send a text, make a quick phone call, or send an email to your significant other.  It makes such a difference to the person on the other end to know that even though you may be incredibly busy, there is always time to check in.

4. Leave work at work.  Hang your work related problems on a hat rack. Although it is important to share frustrations and process challenges at work with your spouse or significant other, it is imperative that you do not project work related anger and frustration toward your family.

5. Ask for help.  Medicine breeds independence and self reliance.  Often asking for help is seen as a sign of weakness in training.  However, we must all learn to rely on others to help us process difficult emotions.  Many training programs and hospitals provide Physician Self Referral counselling and these should be taken advantage of during difficult times.

Medical education is vital to training the physicians of tomorrow.  In the US today, we are able to train some of the most successful and talented doctors in the world.  However, this training can be stressful and this stress may continue through years of practice.  We must learn to manage work related stress in more productive ways.  Habits die hard and many negative habits are learned in training.  It is my hope that residency training programs will continue to make advances in supporting the emotional needs of trainees.  Helping young physicians manage family life, demanding work schedules and stress will allow us to produce a new breed of doctors who are more equipped to avoid burnout.  By helping physicians manage stress and develop positive coping mechanisms, we will be better able to care for our patients in the years to come.

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3 responses to “Managing The Stress of a Life in the Chaos of Medicine

  1. Your best blog yet! But it should be, K Rock…you were one of the most stressed out, focused, determined people I’ve met. Certainly helped you be as successful as you are. Seems you’ve realized it’s a marathon, not a sprint. I find myself trying to remind myself of that most days. Keep it up, bro…I enjoy your blogs.

  2. Pingback: Managing the Stress of a Life in the Chaos of Medicine - The Doctor Weighs In | The Doctor Weighs In

  3. i havent slept a night in weeks, aca and meaningless use are running me ragged. I like emr, but i get the impression some applications are trying to keep tabs on me and learn how I take care of pts rather than help me take care of them. Pt satisfaction scores and hospital adherence to them gives me the impression they want me to follow my pts online medical advice rather than my own. I feel like clinical doctors are no longer involved in decisions about the healthcare system.

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