Physician Wellness 101

 Is physician wellness about meditation and yoga? Do wellness classes benefit physicians if they are mandatory? What if they are scheduled at a time that conflicts with family obligations? Are today’s physicians simply entitled complainers? What about physicians being victims of an abusive system? An overview of physician wellness starts with a discussion at three levels: personal wellness, organization wellness and wellness within the culture of medicine.

Physician wellness at the personal level includes what we all know and preach: Get adequate sleep. Eat healthy foods, mostly vegetables. Lead an active lifestyle. Surround yourself with healthy people. Set healthy boundaries. Develop a support network. Establish care with a primary care physician. Manage your finances. Care for your spiritual needs. Maintain intellectual pursuits across your lifetime. Physician wellness at this level focuses on life skills and habits that support our resiliency and promote our overall well-being.

It is well known that greater than 50% of physicians report symptoms of professional burnout. (1)  When a group of highly resilient and dedicated physicians report that they are suffering, we must give pause. This level of burnout speaks to a systemic rather than individual etiology.

Physician wellness at the organizational level is gaining remarkable traction in the past few years.   Organizations recognize it is in their best interest to keep their physicians happy. The costs and consequences of physician turnover are substantial and may include financial consequences, patient satisfaction, and effects on the organization whole. (2)

Focus on the organizational level leads to many questions and potential solutions, all of which will vary with local circumstances. National physician organizations, international conferences, and smaller meetings with leaders across the country are focusing on physician wellness at the organizational level.

Wellness within the culture of medicine is the third level of physician wellness to examine. Western medicine has its own set of customs, traditions and values that are learned early in the course of medical training. The value of sound scientific methods, the importance placed on logic and reason, and the significance of professional integrity are examples. When examining physician wellness at the cultural level, we must also address discrimination in its many forms. For example, overt racism and misogyny are everyday occurrences for many physicians and surely affect everyone within the culture of medicine.

Yes, mindfulness in medicine is important. Very important. But physician wellness is more than practicing mindfulness. It is complex and changing. Some attempts at progress might prove to be a step-backward. Nevertheless, physician wellness is essential if we are to provide optimal care to our patients. Follow-up next week as we continue our series on a closer look at physician wellness.

1. Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. Shanafelt, Tait D. et al. Mayo Clinic Proceedings , Volume 90 , Issue 12 , 1600 – 1613.

2. A Review of Physician Turnover: Rates, Causes, and Consequences . Misra-Hebert, Anita D. et al. American Journal of Medical Quality, Vol 19, Issue 2, pp. 56 – 66.

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