As doctors, we spend at least the first three decades of life dedicated to becoming a doctor. We study, practice, test, train, learn, and grow. We are completely dedicated to the end goal of becoming a physician and have little time for anything else. It is not a career decision, it is a life decision. We neglect our family, relationships, and ourselves in this process. We miss weddings, funerals, birthdays, vacations, and holidays, and act like this is normal. Physician burnout is so common, it is expected.
The Old Days
Several years ago the mentality of training was to see as much as possible. You are a slave for the hospital, and what doesn’t kill you makes you stronger! Residents worked absurd hours, often doing 3 day straight shifts, being on call every other day. This was studied extensively and several studies show this is not the way to learn. Yes, you are exposed to more patients and therefore leave training having seen more. But not sleeping for 3 days does not lead to good learning or patient care.
Changes Being Made
As a result, programs now have to answer to certain rules set by the ACGME, the governing body of residency programs. Many of these rules include how many patients you are allowed to care for at one time, how many hours in a row you can work, and how many hours you get in between each shift. Programs across the nation ensure residents are logging hours every week to ensure complicity. But how many times do you think residents lie? We are still being told we need to see and do more. Some attending’s will make you feel bad for not working more. They love to tell us the stories of their training and how many hours they worked. It is their badge of honor and they expect nothing less from us.
These rules have helped and resident burnout is improving, or so we assume. But doctors continue to have the highest rate of suicide in all professions. So despite all of these changes, our profession continues to struggle with maintaining a healthy balance in life. We deal with death and illness everyday. Lives are in our hands and we are responsible for every decision made. Our stress level is incredibly high but we are never taught how to deal with it. In fact we are taught the opposite; work harder, stay longer, give everything. This mentality has to change.
Change Your Mentality
When you have vacation, take it! Get out of town, no staycations because you just log onto the EMR and check on your patients. It is incredibly difficult to shutoff doctor mode. Have you ever gone out to dinner with other doctors? We spend the night talking about medicine and running ideas by each other. This life consumes us.
When you don’t have vacation time, you still need to find those moments to get away. Exercise is a great option. It helps relieve stress and clear your mind. Massage therapy and yoga are also great ways to relax and let your mind slip away.
Take time for yourself everyday no matter what, even if it is sitting for 15 minutes in a quiet room. If you are still in medical school, start now! Get in the habit of taking this time for yourself. Make a habit of not talking about medicine while at the dinner table. When you are out of the hospital, turn off the medicine! I realize this is easier said then done. I have had several nights were I actually round on my patients in my dreams. But trying to make these habits will eventually make it easier to shut off.