HealthMarch 09, 2020

Stress management for doctors: More than yoga

By: Melissa Welby, MD
Stress management for doctors won’t solve all the problems in healthcare, but it may keep burnout at bay. Here are three ways to take back control and thrive.

Drawn to the medical field by the desire to help others, physicians often find that they’re unable to meet the needs of their patients to the extent they wish to—and that they’re even more unable to take care of themselves. Administrative burdens, a lack of control over work conditions and frequent high-stakes decisions can all take an emotional toll and eat away at job satisfaction.

Often, proposed solutions for burnout can feel burdensome because they put the onus on the individual to change without addressing the system that drives it. Still, stress management for doctors can help keep you functioning at a high level. It won’t solve all the problems of healthcare delivery, but it may help keep burnout at bay by restoring balance and a sense of control.

Here’s a look at three common sources of physician stress and how to alleviate them.

1. Lack of time

Where the stress comes from

For most of us, work pressures will remain for as long as we practice. (Home stress can take its toll on our well-being at work, too, as Porto Biomedical Journal points out.) Since no one has figured out how to extend a day beyond 24 hours, we must improve efficiency and protect our downtime.

To prevent burnout, we’re often told that we must improve our self-care by getting adequate sleep and proper nutrition as well as exercising and taking part in pleasurable activities. This type of stress management for doctors sounds fantastic, but without time away from work, self-care can’t happen. If you spend every evening charting, attending committee meetings or taking care of personal administrative tasks like paying past-due bills, there’s not much left over for exercise, sleep and pleasure.

How to alleviate it

Time management is an essential skill for physicians, as the International Journal of Surgery: Short Reports notes. Start by thinking about where and how you spend your time. Are there items you can offload? For example, consider:

  • Hiring a cleaning service for your home
  • Paying for a scribe to help with charting
  • Signing up for a meal delivery service
  • Hiring weekly help to do chores like laundry, dry cleaning and grocery shopping

From there, set mechanisms in place to keep yourself honest in your off hours. Put personal priorities like a friend’s birthday party on your calendar to prevent work responsibilities from taking over. Get a trainer if this will help you prioritize exercise. Schedule a recurring movie or game night with your family.

2. Perfectionism

Where the stress comes from

Perfectionists tend to have higher levels of stress because nothing feels like enough, and anything less seems like failure. This sets unrealistically high expectations for achievement. Some decisions we make in medicine do carry this gravity—people can die if we don’t do certain things correctly. But perfectionists forget that every action isn’t life-threatening.

How to alleviate it

First take time to reflect on your beliefs regarding failure and perfectionism. Are they causing you unnecessary stress? Are you holding yourself to unattainable, superhuman performance standards?

Going forward, make more effort to note what went well each day rather than focusing on what didn’t. Yes, you may have snapped at your kids (or your medical assistant) because you were stressed, but you also apologized and role-modeled accountability and conflict resolution.

Instead of idealizing physicians who go the “extra mile,” let’s stop equating self-sacrifice with altruism. These unrealistic expectations can make doctors feel they are failing everywhere.

3. Unbalanced needs

Where the stress comes from

We are trained to focus on what is best for the patient. There are good reasons for this, of course, and violations happen when physicians lose sight of these ethics. But does this mean we should always put the needs and welfare of patients above our own?

Overstressed doctors have usually spent years putting their needs last, and unfortunately, it isn’t only the doctors who end up suffering. According to the American Academy of PAs, studies show that burned-out medical professionals provide worse care for patients and face more malpractice claims.

How to alleviate it

A key to providing compassionate, quality care for others is to recognize when you are getting depleted and taking steps to recharge.

  • Understand your limits – Doing your best at work shouldn’t mean sacrificing your mental health and quality of life. To understand what is draining your energy, identify employers, friends or associates who don’t respect your time and needs.
  • Set boundaries – Often we don’t recognize a boundary until it is crossed or until we already feel resentment. Once you recognize them, learn from those moments when disrespect for your boundaries caused you frustration. Address the issue up front to prevent it from happening again.
  • Say no – Being a team player is a wonderful quality, but it can be detrimental if taken too far. Before saying yes to a colleague who needs help, determine if the request is in line with your goal of not becoming depleted. If it isn’t, the answer should be “No.”

Stress management for doctors

To begin to change the issue of stress in medicine, we as physicians need to be convinced that we have a duty to care for ourselves as well as our patients. We can’t wait for broken systems to mend to improve our quality of life.

Stress management for doctors involves changing our expectations of ourselves, setting better boundaries and finding creative ways to save ourselves time. These steps can make the difference between burnout and healthy living, improving our work for our patients and ourselves alike.

Melissa Welby, MD
Solutions
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