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How Doctors Cope

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How Doctors Cope

Easing stress in high-pressure health-care organizations

Behind the scenes, in health-care organizations all across the country, thousands of physicians and allied health care providers are struggling with “compassion fatigue.”Overworked and overstressed, health care professionals are suffering from a wide range of unhealthy behaviors: negativity, apathy, feelings of depletion, preoccupation and compulsive disorders. And the mental and physical exhaustion doesn’t just take a toll on providers’ bedside manner; it also degrades the teamwork dynamic as well, with increased absenteeism, flexibility, resistance to change, and other serious issues.Fortunately, there are reasons to be hopeful. Some organizations have arisen recently to support beleaguered health care professionals.Thinking about the daily reality of overburdened providers reminds me of the amazing and  exemplary “stress-hardy” physicians that I have studied in recent years.With the cooperation of the American Medical Association, I was granted access to the winners of the annual Excellence in Medicine – Pride in the Profession Award given by the AMA.I interviewed some of the honorees to gather first-hand insights into what sets them apart from so many of their peers. The fact that they had been recognized as doctors who go “above and beyond,” made them people that I really wanted to understand.And I thought that younger and older practitioners alike could be inspired by peers who maintain a vision for their daily practice that includes a focus on hopefulness and determined perseverance.If any one of us went to the doctor today complaining of physical and emotional exhaustion, we can imagine the type of sensible advice we’d get: set appropriate limits on the demands put upon us. Enjoy some downtime with friends and family. Get regular exercise. Meditate or participate in the arts. Take scheduled vacations. Look for humorous moments in our lives.These strategies are not new or novel but I was struck by how consistently the award-winning physicians actually used these time-honored methods. Too often, it may seem that conventional methods for dealing with stress are only available to those whose lives are not stressful; yet these doctors’ lifestyles defied the idea that only the idle rich get respite.Here is what they say:“I have learned over the years . . . that you can’t do everything for everyone . . . You have to tell yourself every once in a while that ‘I’ve done what I can do, and now I have to either recoup my losses or turn my attention to someone else.’ ““Basically, I go home, I enjoy my kids, and I spend time with them. That's my elixir. My kids charge me up.”“Well, I’m sort of an exercise fanatic. I always run or do something an hour a day.“Personal reflection time, and that can be in the form of . . . meditation, knitting, music . . .”“To maintain optimism, you have to have a pretty well-developed sense of humor.”As demanding as these physicians’ careers are, they have all discovered ways to relate to these stresses without making them the total sum of their lives. The doctors identify caring for others as their primary objective, yet they realize the need to include self-care and compassion as well. I was also struck by the fact that these fine physicians drew much of their personal sustenance from their spiritual beliefs. Most spoke about some kind of larger life force guiding them. Whatever their faith, these physicians believe that their personal spirituality is best reflected in their connection to others. They try to make sure that they always exhibit and display mutual dignity, respect, and caring.We are living in an era of managed care, medical tourism and health care disparities. Many Americans have lost faith in health care and their practitioners. So I’m especially pleased that doctors who embody the best values of the medical profession have shared their inspiring stories with me. Their dedication enriches their patients’ lives, colleagues’ work and shared communities. I hope that the honorees’ words of wisdom will make a real difference for working physicians and the next generation of health care professionals as we figure out how to best reform the system in the months and years ahead.Helen Meldrum is associate professor, Natural and Applied Sciences at Bentley University.

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