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Medical Economics Journal

Medical Economics September 2023
Volume100
Issue 9

A physician’s guide to a mentally healthy workplace

With stressful conditions increasing and mental health decreasing, what is a primary care physician to do?

Medical professionals in the United States offer first rate care. Doctors and their staff strive to maintain high quality standards even though they have ever-increasing client loads. Unlike days-gone-by, the business of medicine has changed such that medical practices experience less and less autonomy. Health care workers experience long work hours, rotating and irregular shifts, intense physical and emotional labor, exposure to human suffering and death and increased risk of exposure to disease and violence. As a result, healthcare workers are experiencing increasing rates of mental health issues.

Andrew E. Colsky, JD, LLM, LPC: ©Andrew E. Colsky

Andrew E. Colsky, JD, LLM, LPC: ©Andrew E. Colsky

A 2020 survey found that:

  • 93% of healthcare workers reported being stressed out and stretched too thin
  • 82% shared being emotionally and physically exhausted, and
  • 45% of nurses reported that they were not getting enough emotional support

Other studies found:

  • 22% of healthcare workers experienced moderate depression, anxiety and post-traumatic stress disorder
  • 69% of physicians reported experiencing depression and 13% had thoughts of suicide
  • 64% of physicians reporting burnout were women
  • Nurses, frontline, and younger workers reported more severe psychological symptoms.

With stressful conditions increasing and mental health decreasing, what is a primary care physician to do?

Take care of yourself: Primary care physicians and staff care about their patients and can easily adopt a feeling of responsibility to cure everyone. Even though this is not possible, the desire remains. Self-care is not new. It can only be effective, however, when implemented. This can include engaging in regular exercise, practicing mindfulness or meditation, maintaining a healthy diet, getting sufficient sleep, and finding time for hobbies or activities they enjoy.

Take care of your staff: Staff can feel extra stress due to a desire to support the practice. They may feel a moral responsibility to skip breaks or meals as well as stay late to catch up on work. Consider offering flexibility if they struggle with child care issues or attend school. It does not make sense to spend time hiring and training staff only to have them leave due to scheduling problems.

Check-Ins and Feedback: Conduct regular check-ins with personnel to gauge their well-being and provide a platform for expressing concerns or challenges. Encourage open and honest feedback, and be responsive to addressing any issues that may arise.

Boundaries: The desire to help others and a passion for the job can lead one to work excessive hours. Prioritize setting clear boundaries between work and personal life. This may involve defining specific working hours and sticking to them, avoiding excessive overtime, and taking regular breaks to recharge. Disconnect from work during off-hours and engage in activities to relax and rejuvenate.

Stress Management: Use stress management techniques such as deep breathing exercises, progressive muscle relaxation, meditation, or mindfulness techniques. These practices can help individuals cope with stress, manage anxiety, and promote overall well-being.

Mental Health Resources: Ensure that primary care physicians and staff have access to mental health resources, such as employee assistance programs (EAPs) or counseling services. Provide information about available resources and promote their utilization without fear of judgment or stigma.

Let’s be real

The suggestions above are valid and important and the chances of a practitioner implementing them on their own are slim. That is because an individual’s personality and circumstances are such that what they are doing now is the best they have been able to achieve given their real-life situation. For example, they will probably find it difficult to engage in self-care or set boundaries on their own. In order to do so, one must understand what has led to their current circumstances and what they may need to learn about themselves in order to improve their situation.

Remember, the state of health care worker’s mental health is declining for a reason. My professional clients share similar stories. They are depressed, anxious, confused and have trouble maintaining healthy relationships with friends and family. They are often reminded that they work too much and come home exhausted. At the same time, they feel trapped and unable to make the changes they know they need to make.

Mental health

Mental health professionals are trained to help people become mentally healthy. Clients find it difficult to make necessary changes because they either do not know what changes to make, how to make the changes, or both. I have found that it is not uncommon for a patient to be absorbed in their work because they are avoiding some difficult issues. That can be a co-occurring disorder, trauma, relationship troubles and more.

Existing troubles are exacerbated when a practitioner turns to substance use as a means of relief. Common substances abused by health care workers include alcohol, prescription medications (e.g., opioids, benzodiazepines, stimulants), marijuana and more. Relief is short-lived as the addiction to the substance of choice takes hold.

A health care worker experiencing any mental health issue should seek help sooner rather than later. The work done with a therapist can be challenging, and quite honestly should be challenging in the short term if it is to be effective. Once a client gains clarity and identifies the work to be done, they will be well on their way to achieving more balance in life.

It is rewarding when I see a patient who came to me on the verge of suicide who now has a new appreciation for a mentally healthy life. When they do the work to understand themself and the reasons they are in their current situation, they open themselves to resolving past pain and developing healthy lives. The outcomes of therapy are improved self-care, improved relationships with others and a general sense of well-being.

Andrew E. Colsky, JD, LLM, LPC is an attorney and mental health counselor serving professionals at Center for Professional Counseling, PLC.He is licensed in Florida and Virginia.

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