Top Challenges Number 5: Caring for yourself

It has never been such a challenging time to be a physician. Every physician, whether they own their own practice or are employed by a hospital or larger health system, must navigate a host of obstacles each and every day: Payment hassles, staffing issues, patient communication obstacles, technology burdens, long hours and burnout, and much more. 

Each December, Medical Economics presents its list of the top challenges facing physicians going into the next year. This year we focused not only on the challenges, but also practical tips physicians can start using right away to make practicing easier.

Challenge 5: Caring for yourself

Physicians are caregivers by nature. But many neglect to care for themselves.

Physician burnout is one of the most pressing challenges facing medicine, and there are myriad reasons for it. But one cause of burnout, many physicians argue, is that they are trained to focus exclusively on the needs of patients. The unintended consequence of this is that physicians neglect themselves, says Rebekah Bernard, MD, a physician and author. That leads to stress, burnout and even a lack of empathy for patients-which runs counter to the goal of focusing on patient needs above all else.

This starts in medical training, Bernard says. “The message: Patient needs come first. Doctors’ needs are a mere inconvenience, something to be ignored and overcome,” she says.

In order to provide the type of care that patients deserve, physicians must prioritize their own needs, says Geni Abraham, MD, an internist and wellness expert. “We’ve got to get back to the fundamentals of personal healthcare,” says Abraham. “We need to be doing exactly the things that we are telling our patients.”

She recommends that doctors start by focusing on the following aspects of self-care:

Nutrition.

“I don’t care if you want to follow a vegan or a keto diet, as long as you are eating whole foods and a balance of nutrients,” says Abraham. It’s also important for physicians to practice mindful eating-actually tasting and enjoying food, rather than gulping it down as if they are on 24/7 duty and expecting to be called to a patient’s bedside at any moment.

Abraham notes that eating is a social activity, and great enjoyment can be gained from eating in the company of others. Schedule and plan meals with family and friends, rather than eating over the sink or in your car.

Exercise.

“Exercise is the cheapest drug for anxiety and mild to moderate depression,” says Abraham. “It’s also one of the best ways to help students and residents learn, as movement has been shown to promote learning.” But while physicians certainly understand the benefits of exercise, often the challenge is finding the time to do it.

Even if you can only do 10 or 15 minutes, schedule that time into your week and make it non-negotiable. For physicians strapped for time, consider an exercise that can be done quickly at home, Abraham advises.

Sleep.

“Lack of sleep causes memory loss, irritability, and chaotic thinking,” says Abraham. “And chaotic thinking doesn’t help our patients or ourselves.” Abraham recommends getting enough sleep and practicing good sleep hygiene. “Put your phone upside down to avoid the blue light that it emits and avoid watching intense television shows before bedtime.” Instead of looking at screens before bed, Abraham recommends practicing mindful meditation or deep breathing exercises.

Nontoxic relationships.

Physicians need support from family, friends, and colleagues. They need to take the time to nurture those relationships by scheduling activities, like date-night with your spouse and lunch with a colleague. Show up for medical society meetings and physician socials. Knowing that we are all dealing with similar issues can provide a great deal of support.

Mindful self-compassion.

Abraham suggests that physicians pay attention to how they talk to themselves. She reminds us that humans are wired to pay more attention to negative thoughts than to positive ones, and that we need to practice and work to counteract negativity in our lives. “It takes five positive thoughts to overcome one negative thought,” she says. One way to achieve mindful self-compassion is to keep a journal of emotions, and to take a moment at the end of each day to focus on the things that went well.