Speaker: Your patients won’t get better until you achieve wellness for yourself
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Physicians need to make wellness a priority for themselves and their teams if they want to enjoy their career and improve patient care, according to Maeve O’Connor, MD.
“Wellness is near and dear to my heart, not only for myself, but for my staff, my team and every patient I interact with,” O’Connor told Healio.
An allergist and immunologist with three practices in North Carolina, O’Connor spoke with Healio about tips on improving practice wellness and efficiency that she discussed during her presentation at this year’s American College of Allergy, Asthma & Immunology Annual Scientific Meeting in New Orleans.
Burnout and wellness
O’Connor called physician burnout — which is a physical or mental collapse caused by stress or overwork — a “horrible” problem. It is job-related dysphoria and dysfunction, she said, not just a bad mood triggered by a rough couple of days.
More importantly, she continued, burnout can cascade throughout the practice to impact the health of the patients themselves.
“If you’re not well, you can’t make your staff well. And if you can’t make your staff well, then you’re certainly not going to help any patients,” she said.
The only solution for burnout, she said, is to achieve wellness and avoid getting burned out in the first place. But just as burnout is more than stress, wellness is more than the absence of disease, she said.
“It’s really having quality of life, enjoyment of life, feeling you make a difference and having relationships,” she said. “You’re basically thriving, not surviving.”
O’Connor said that doctors can identify burnout in themselves if they are feeling emotional detachment or physically ill without any identifiable cause. Other signs include a lack of joy or fulfillment in work. When doctors are snappy, irritable, cynical and less friendly, burnout may be on the horizon.
“One may think, ‘Why am I doing all this anyway?’ There can be a fatalistic sort of mentality that doctors get when they’re burned out,” O’Connor said.
Wellness, however, prevents burnout.
“You need to take care of yourself first. You’ve got to eat well and have good nutrition. You need to sleep well. Exercise. Take time for yourself. Take time for hobbies,” she said.
But it is easier said than done, she said, as physicians are notorious for saying yes to everyone and trying to do everything.
“You have to say no to some external pressures — or desires or asks, if you will — and start saying yes to yourself,” she said.
O’Connor encourages physicians to spend time alone and use that time to reflect and meditate.
“Go for a walk and literally smell the roses,” she said.
Personal relationships feel the strain of burnout too, she continued, noting the high divorce rates among doctors. Suicide is prevalent as well, she added. She urged doctors to nurture the people they are closest to, which is healthy for everyone including the doctors’ families, friends, teams and patients.
But the best strategy for achieving wellness may be simply letting go, she said. Doctors don’t always have to control everything. Delegating tasks is a healthier choice, she said.
“Doctors need to realize that they’re people too and that they need to ask for help and use their resources,” she said. “Normalize asking for help before you reach crisis mode.”
A happy staff
Assigning more responsibilities to your team doesn’t just make you happier, O’Connor said. It elevates the team’s wellness as well.
“Your team wants to feel empowered. Teams need to feel fulfilled and like they have a purpose,” she said.
Communication is vital too, but it needs to be frequent, consistent and authentic. O’Connor has meetings at her practices every day, and her staff is welcome to share their feelings and ideas. She encourages team retreats as well. These meetings also are opportunities to recognize individuals for their contributions.
“It’s so easy to point out people’s negatives. But what about shouting out about their positives?” she said.
Beyond these meetings, doctors should have genuine conversations with the individuals on their team. These chats are opportunities to watch for burnout.
“Just don’t say ‘How are you?’ and they say ‘Fine’ and walk away,” she said. “Ask specific questions. There are validated surveys that look for burnout. You don’t have to have them sit down and do the survey. You could just ask them one or two questions from it, just to get the temperature of your team.”
Incentives also help, but it is not just about more money.
“What else do they want to do? Do they want to have an education? Do they want to go out into the community and promote your practice and educate?” she said.
“There are so many ways, but the bottom line is asking your staff how they are and making sure you know how they are. Open those lines of communication,” she added.
This communication extends to soliciting suggestions for how the practice should be run.
“Make sure your practice is running as efficiently as it can. The more efficient your practice is, the happier your team is going to be. Part of that is taking a hard look and thinking about changes that need to be made,” O’Connor said.
Members of the team can make tasks simpler just by having some new ideas, O’Connor said.
“Ask your staff how to make things more efficient,” she said. “Inefficiency not only increases risk for burnout, but it also affects patient outcomes. If you’re not efficient and you’re not well, then patients are going to be hit twice.”
Doctors need to also remember that they are part of the team — not above it.
“Don’t just have a team under you, but be part of the team,” she said. “Make sure they have the tools they need, whether it’s printers or pens or scanners. Make sure there’s no time wasted looking for little stuff they need.”
That attitude extends beyond routine responsibilities. O’Connor promotes healthy diets and exercise at her practices, along with yoga and meditation.
It is a comprehensive approach, but it produces comprehensive results, O’Connor said.
“Health care providers need to embrace wellness for themselves, their team and their patients, and everyone will be better because of it,” she said. “Instead of fighting burnout after it happens, prevent it. Practice wellness as preventive care.”
Perspective
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Bruce V. Freeman, DDS, DOrtho, MSc
We are overwhelmed with wellness advice, from people shouting at us to “just breathe” to myriad apps clogging our phones. Your friends may say they have a passion for yoga, and passions are great. But if you try yoga too, don’t expect to succeed in the flying bird pose during your first class.
Finding a wellness routine will take some trial and error. Look inward, not outward, to see how your efforts feel, and don’t worry if your downward dog doesn’t look like what you have seen on Instagram.
The fact you are on the mat doing something and reintroducing your mind to your body is what matters, so you don’t walk into rooms and then wonder why you did so or drive to work and arrive without realizing how you got there.
I often think of what a former patient of mine, who is now a brilliant surgeon, said about focusing his practice on select procedures so he can build his confidence and skill: “I like to take small bites and chew them really well.”
Treat yourself like you would a friend or the family pet. In other words, be nice to yourself! Just because you didn’t meditate for an hour or you had a couple of cookies after lunch doesn’t make you a bad person. It is simply one page of the book of your life, and tomorrow is a clean new one.
Focus less on screenshotting how many days you have meditated and texting your friends, which will likely make them feel like they aren’t doing enough, as now you’ve turned what should be relaxing and pleasurable into a competition.
Shawn Achor discusses some ideas for wellness that are elegant in their simplicity in The Happiness Advantage, and I discuss them often with my residents and colleagues.
First, practice gratitude for an experience or a person, not for a thing. Make a list of what you have felt gratitude for so you can reread it when you’re having a rough day and your brain can relive these moments.
Next, try journaling. Jot down random thoughts and ideas. Express your feelings, frustrations, and successes. Miss a day or two? It doesn’t matter. By putting pen to paper, you will often see things more clearly. It’s a much better practice than scrolling your phone, looking at images that can make you feel bad about yourself no matter how much you tell yourself they don’t represent reality.
Also, there’s exercise. Movement teaches your brain that your behavior matters. It doesn’t have to be training for a marathon. A daily walk after dinner is a great place to start.
Meditation is another option. A great yoga teacher asked our training group, “Why do minds think?” The answer? Because that is what minds do. Let your thoughts come and go and see how you react. Simply observe, and don’t attach to the feeling or thought. Try to have a more inward focus with less attention on your five senses and let the thoughts come and go. Start with a minute or two throughout the day instead of mindlessly scrolling on your phone.
Finally, perform random acts of kindness. Keep a folder with emails that are congratulatory and kind, so when you need a lift, you can read through them. Send a text or email to someone to say how much you value them or congratulate someone on a good job. Hold the door open for someone or let them into your lane on the road. You will feel so much better for extending a helping hand.
We all choose how we want to act in the world. Wellness is a choice and taking the time to look after yourself is crucial. I always tell my residents and colleagues that self-care leads to the best patient care, so treat yourself with some kindness so you can do the same for others.
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O’Connor M. Ways to Improve Practice Wellness and Efficiency. Presented at: ACAAI Annual Scientific Meeting; Nov. 4-8, 2021; New Orleans.
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