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Take time to work on the foundations of life
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When a year comes to an end, we often reflect on what has happened during the year and hope for good things in the coming year. For many, we are blessed with wonderful family members and friends, a great job in a great profession and numerous personal interests that enhance our lives. Sometimes, we forget or lack appreciation for the amazing opportunities that orthopedics provides. We cannot help but recognize the incredible gift of being able to change another person’s life in a positive manner, including the ability to take away pain, improve mobility and function and provide patients with a better quality of life.
However, the challenges we face every day may lead one to lose sight of our gifts and roles in society and in our family. We become ungrateful and complain about anything that does not feel right. We worry about our jobs, without recognizing it is rare for orthopedic surgeons to be let go because of external factors. When this happens, a mirror is usually the most insightful place to look.
We may be concerned about income and the ability to provide, yet we are in the top 10% of compensation in medicine. We develop lifestyles around this income and an involuntary reduction becomes intolerable. We worry about relationships with family members, including spouses or significant others, children and parents. Yet, we schedule another procedure on a weekend or make plans for meetings but not plans for vacations or family reunions.
Anthony A. Romeo
Live in the moment
The end of the year and holiday season is an opportune time to reflect on all for which one should be thankful. Recognize the events that seem small, but I beg you to live in the moment. Write a note to your significant other as you leave home, help children with homework, cherish the moment when a patient thanks you for changing his or her life. In other words, live in the moment. Be mindful of everything you should be grateful for everyday, and you will see how amazing life is. True happiness is not found in dreams and goals, but instead in acceptance and thankfulness for what we already have in life.
Some people may not feel grateful for the life they are living. In fact, one may have become dissatisfied with life, having lost the desire to pursue excellence. One could be emotionally exhausted and have lost the sense of personal identity and professional vision. These feelings affect work, how one interacts with patients, focus and behavior at home toward the special people in life. This is not the person who has achieved all that is necessary to get where one is today.
Watch for burnout
Being an orthopedic surgeon means you are a person who has excelled at every level of education, and often in endeavors outside of education, such as sports and leadership. Orthopedics attracts a person with these characteristics and the gauntlet of grade point average, test scores and selection committees have recognized these abilities.
The sense of emotional bankruptcy or depletion, with the treatment of others as objects instead of people, often with a loss of future vision and less effective communication, means one is experiencing burnout. Burnout among orthopedic surgeons is more common than mental illness, such as depression, substance abuse or suicide. Unfortunately, the most dedicated and conscientious person often experiences burnout. A high-stress work environment, emotional demands of the job, being responsible for the nonoperative and surgical treatment of patients, long hours and efforts to balance work demands with home responsibilities contribute to burnout. When one adds in the current health care environment with less autonomy and reimbursement, more paperwork and treatment of physicians as commodities, the forces that lead to burnout can seem overwhelming. In fact, nearly 50% of orthopedic surgeons may experience burnout during their careers.
The treatment of burnout is challenging. Counseling, therapy sessions, support groups and mindfulness interventions can be successful if we choose to participate in the process. However, many surgeons may believe we should be able to manage these issues ourselves. While interventions have demonstrated various degrees of success, we should accept that burnout is a real threat and preventative measures are critical.
The most important preventative measure we have control over is a healthy work-life balance. Work-life balance can be a therapeutic way to minimize the risk of burnout, stress, depression and other illnesses. It is not unique to surgeons. However due to the demands of a surgeon’s professional responsibilities, the balance may seem particularly difficult to achieve. Even more important may be the realization that there is no formula for work-life balance.
Everyone has various work-load thresholds and priorities used to decide work-life responsibilities. No one person can say what is the best proportion of time to spend at work, home or on other priorities that provide personal rewards. Work-life balance requires a personal effort to understand what makes you happy, which allows one to be successful at home and work. There is never enough time to accomplish all that appears necessary to achieve goals. Therefore, the starting point should be self-awareness of what is truly important to you.
Define priorities
During this holiday season, spend some time defining priorities. Begin with yourself by focusing on your health. Assess your approach to nutrition, exercise and sleep. A healthy body will support and nourish a healthy mind. This is your life and no one else can create these priorities and commit to them. Schedule activities, such as exercise, just like you would schedule a surgical procedure.
With a foundation that supports a healthy mind and body, assess your relationships, especially your family relationships. Most people crave companionship and they thrive when it is a routine part of life. Work on your relationship with your spouse or significant other. Spend as much time with your children as possible. The time is not only critical to a child’s growth and development, but also to yours. As life goes on, one regret that is difficult to avoid is the many activities and accomplishments we miss due to work responsibilities. Every effort should be made to identify and attend the most important events. The important people in your life will always remember you were there.
Finally, while developing a strong support system at home, it is time to reassess work responsibilities and environment. Define short-, mid- and long-term goals. Schedule your life at work, including a reasonable assessment of start and finish times, and stick to the schedule. Do not be embarrassed or ashamed of leaving early to attend important family events. Make sure you support this behavior for those who work with you. Avoid the idea that one more patient, surgery or project at work is insignificant. The time commitment adds up to more time away and may hinder the proper balance you designed to achieve your greatest overall potential as a person.
After many years of formal education, we embark on a career that often spans more than 30 years. No matter what stage you are in the process, take time to work on the foundations of life that allow for gratitude and make life worthwhile.
- Reference:
- Shanafelt TD, et al. Arch Intern Med. 2012;doi:10.1001/archinternmed.2012.3199.
- For more information:
- Anthony A. Romeo, MD, is the Chief Medical Editor of Orthopedics Today. He can be reached at Orthopedics Today, 6900 Grove Rd., Thorofare, NJ 08086; email: orthopedics@healio.com.
Disclosure: Romeo reports he receives royalties, is on the speaker’s bureau and a consultant for Arthrex; does contracted research for Arthrex and DJO Surgical; receives institutional grants from AANA and MLB; and receives institutional research support from Arthrex, Ossur, Smith & Nephew, ConMed Linvatec, Athletico and Miomed.