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STRESS AND COPING FOR TODAY’S PHYSICIAN

STRESS AND COPING FOR TODAY’S PHYSICIAN. ACP Maryland Chapter Kim K. Solberg, MD Feb 9, 2008. The road to becoming a physician is COMPETITIVE and INTENSE. WHAT IT TAKES. OBSESSIVENESS COMPULSIVENESS EXAGGERATED SENSE OF RESPONSIBILITY CHRONIC FEELINGS OF NOT DOING ENOUGH

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STRESS AND COPING FOR TODAY’S PHYSICIAN

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  1. STRESS AND COPINGFORTODAY’S PHYSICIAN ACP Maryland Chapter Kim K. Solberg, MD Feb 9, 2008

  2. The road to becoming a physician is COMPETITIVE and INTENSE

  3. WHAT IT TAKES • OBSESSIVENESS • COMPULSIVENESS • EXAGGERATED SENSE OF RESPONSIBILITY • CHRONIC FEELINGS OF NOT DOING ENOUGH • DIFFICULTY SETTING LIMITS

  4. TYPE APERSONALITY TRAITS

  5. DELAYED GRATIFICATION • The ability to delay personal and pleasurable self interests until more important goals are achieved • DOCTORS are MASTERS of this • The ability to delay attending to significant relationships and other sources of renewal until all the work is done BUT

  6. PHYSICANSare prone to marital and relationship problems

  7. THEN VS NOW Traditionally, doctors were men who were often married to a homemaker Today: 1/3 of doctors are women ½ of medical students are women Women struggle more with balancing home and work responsibilities

  8. What is distressful to one is exhilarating to another

  9. THE PRACTICE OF MEDICINE IS CHANGING • LONGER HOURS • MORE PAPERWORK • DECREASING COMPENSATION • STRINGENT GOVERNMENT AND INSURANCE REGULATIONS • MALPRACTICE ACCUSATIONS

  10. AUTONOMY?

  11. WE TRAINED TO BECOME PHYSICIANS WHO CARE FOR PATIENTS • WE ARE INCREASINGLY SEEN AS PROVIDERS WHO SERVICE CLIENTS WITH A GROWING SENSE OF MISTRUST

  12. STRESS

  13. STRESS • difficult to define • Physical, mental or emotional strain or tension • BMJ 1951-”stress is itself, is the cause of itself and is the result of itself • Good stress-eustress • Bad stress-distress

  14. STRESS • ACUTE STRESS- immediate response to a threat or stressor • CHRONIC STRESS: -long term acute stress -More subtle but lasting -Nagging -Unrelenting

  15. STRESS • A CONDITION EXPERIENCED WHEN A PERSON PERCEIVES THAT DEMANDSEXCEED THEIR PERSONAL AND SOCIAL RESOURCES • UNABLE TO COPE • HAVING LITTLE OR NO CONTROL IS ALWAYS DISTRESSFUL

  16. BURNOUT • The cumulative result of unaddressed stress • A state of physical, emotional and mental exhaustion • “an erosion of the soul” • “silent anguish of the healers” • A relationship gone bad

  17. BURNOUT • Grows gradually over time • Perhaps beginning in medical school or residency • Disillusioned • Cynical • It becomes very difficult to do a competent job

  18. COSTS OF BURNOUT • Personal and family losses • Decreased productivity • Medical mistakes • Physician turnover

  19. HEADLINES “Frustrated physicians find careers outside of medicine” “Suicide rate of women doctors in US is twice that of other working women” “Suicide rate high in female doctors” “Many doctors prone to stress”

  20. ADDRESSING STRESS AND PREVENTING BURNOUT Putting out the fire!

  21. BURNOUT PREVENTION • 1)Physician’s personal responsibility (INTRINSIC) but should include 2)help from the workplace (EXTRINSIC) • Should start in medical school! and continue through retirement • In 2001, the Joint Commission mandated that hospitals address physician well-being

  22. “PHYSICIAN HEAL THYSELF”

  23. HEALTH AND HAPPINESS INVENTORY -Listen to your SELF TALK -Are you content and satisfied? -Are you always complaining to yourself? -What causes you to feel stressed? -What makes you happy? Are you happy? Are you irritable? Anxious? Depressed?

  24. HEALTH AND HAPPINESS INVENTORY • How are your relationships going? • Is your practice going well? Is it what you expected? • What is your body telling you? -Are you tired? -Do you get enough sleep? -Do you have headaches? Back pain?

  25. SET GOALS • Set attainable personal and professional GOALS • Periodically re-evaluate your priorities • Choose a partner and others who support your goals • Make time for your family and friends

  26. SET GOALS • TAKE CARE OF YOURSELF! -Eat right -Exercise -Get enough sleep -Relax often

  27. GOALS • Work on self acceptance-let go of perfection as a goal • Autonomy-internallocus of self-evaluation • Always work towards personal growth

  28. PERSONAL GROWTH AND RENEWAL -Not only for life outside of work -Work does not have to be merely a domain of energy expenditure but also of energy renewal -Learn to receive support, healing and meaning while giving

  29. STRESS MANAGEMENT • Decrease level of arousal and moderate the stress response • Decrease feelings of tension and arousal • Increase sense of well-being and peacefulness • Increase sense of personal control • EASY to learn. EASY to do.

  30. GET ENOUGH SLEEP

  31. Nix Coffee?

  32. Massage

  33. YOGA

  34. WALKING

  35. RESISTANCE TRAINING

  36. VENTING

  37. MINDFULNESS • Fostered by MEDITATION • Being fully presentin the moment, to the person and the task at hand • COUNTERBALANCE for all the interrupted tasks and competing demands common to most work days

  38. CHANGES IN THE WORKPLACE • Establish a Physician Health Committee • Mentor program • Confidential support groups • Annual well-being retreat

  39. CHANGES IN THE WORKPLACE • Look at a physicians sense of meaning in their work and not just productivity • Membership to fitness clubs • CME on topics related to well-being • Flexible schedules • Decrease paperwork

  40. THANK YOU!GO GET ‘EM!

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