Thursday, October 28, 2010

Wellsprings of resilience

Patricia Lindholm, MD,
2010-2011 MMA President
As physicians, we confront a host of stressful conditions and adversities, related to patient care, practice management, and just life. The challenge of a long-career in medicine is to learn how to bounce-back from these ups and downs, while still maintaining our equilibrium, openness, and wholeness. This is called resiliency by  physician-wellness experts.

I recently listened to a podcast about physician resiliency by pediatric radiologist Richard Gunderman, M.D., of Indiana University. It was part of series of podcasts I highly recommend called “Healthy Practices,” which are moderated by Dr. Mamta Gautam, who is known as “The Doctor’s Doctor.”

One of Dr. Gunderman’s thoughts is that aspiring to significance in our practices and our lives - leading lives that matter - can serve as a wellspring of resilience in ways that striving for success and prestige cannot do. In my view, medicine is a calling, not just a career or a job. I believe that burnout is more likely if we feel like cogs in a big machine, cranking out patient encounters, and racking up RVUs. If we realize that we are actually servants touching the lives of people when they are vulnerable, our work has great significance indeed.  

I would love to hear your stories of resiliency.  How have you recovered from adversity in your professional or personal life?  Can your life lessons inspire one of your colleagues? Leave a comment here or email me. 

Thursday, October 21, 2010

Patients may ask about “Dollars for Docs”

Patricia Lindholm, MD,
2010-2011 MMA President
This week I was interviewed for a story by KARE 11 TV about a recent public listing of physicians who have received payments from pharmaceutical companies. We commonly get reporter requests requiring a quick turnaround, and this was one of them. In the middle of a clinic day, I had less than two hours to respond – fortunately, I was able to do the interview on the telephone.

As part of the federal health care reform legislation there will be a requirement for all pharmaceutical companies to report payments to physicians (speaker’s fees or consultant fees) by 2013. This year a few companies published their information and it was noted that over $3 million has been paid to Minnesota physicians from these companies., NPR, and other media have made the information searchable by physician and call the project "Dollars for Docs."

KARE11 Reporter Kyle Porter was concerned about how patients should react to the issue of physicians being paid by pharmaceutical companies to promote their drugs. He was concerned that doctors may have a conflict of interest in prescribing drugs they have promoted rather than prescribing alternatives that would be more appropriate for the patient based on cost or other factors.

Earlier this year the MMA issued a policy statement regarding the relationship of physicians and industry that essentially says we disapprove of physicians accepting gifts from pharmaceutical and medical supply companies. Furthermore, the MMA supports making industry payments to doctors for services such as speaking, consulting, or doing research public and transparent. 

You may get questions from patients who have seen this story in various media outlets. If they ask about whether you are prescribing a drug due to relationships with industry, do not be surprised. If your name is on the list of physicians who have received payment from industry I encourage you to be transparent about that arrangement with the patients who ask. 

Personally, I am glad the days are in the past when we were offered free ski vacations, luxury accommodations, expensive meals, etc in the guise of “consulting.” Such offers were tempting, but ethically compromising. Yes, I suppose a pen or pad of paper is a minor trinket, but apparently research has shown that even small tokens subliminally affect prescribing habits.  I guess we are as human as “the next guy.”

Tuesday, October 12, 2010

Useful Canadian Physician Wellness Websites

Patricia Lindholm, MD,
2010-2011 MMA President
As I mentioned in my last post, the Canadians are doing something special when it comes to physician well-being.  I would like to share some of their resources with you since they are freely available to all of us, and it is not necessary to reinvent the wheel.

One resource that I have been following for over a year is the CMA web site  The content is excellent and includes wellness topics such as nutrition and fitness and resiliency.  There are also modules on anxiety, depression, burnout, substance abuse, disruptive behavior and so forth.  The content is updated periodically.  I was told by some Canadian physicians in Chicago that the site has drawn visitors from numerous countries around the world, with the most frequent use by Russian physicians.  Check it out!

Connected to the site is a related site called  This has good information on how to make our teams and workplaces healthier for ourselves and our coworkers.

Stay tuned for another gem from Canada!

Monday, October 4, 2010

Physician Wellness is an International Concern

Patricia Lindholm, MD,
2010-2011 MMA President

Originally Posted: October 4, 2010

This week I am attending the International Conference on Physician Health in Chicago.  It is jointly sponsored by the AMA, British Medical Association and Canadian Medical Association.  There are physicians here from other countries such as Spain, Australia and Saudi Arabia.  It is clear that we in Minnesota are not alone in our concern for the well-being of physicians.  
It is interesting to see research data that shows that a physician’s self care practices are directly related to the advice that they give patients about self care.  For example, a physician who has had colorectal cancer screening is more likely to advise it for their patients.  If we have adequate exercise and a healthy diet we are more comfortable advising our patients in these areas.
There is an entire “track” at this meeting studying the correlation of physician well being and quality of patient care.  People are also starting to ask how to make the lives of medical students, residents and practicing physicians better.  This is foreign territory for a profession that feels its members should care for others at the expense of ourselves.  There was also a very powerful talk by Dr. Michael F. Meyers on the subject of physician suicide and resilience.  The abstracts for most of the presentations are available on the AMA web site. 
I also notice that the British and the Canadians are way ahead of us in the study of the prevention and treatment of distress in physicians.  However, this month the AMA has released its new toolkit:  AMA Healthier Life Steps-A Physician’s Guide to Personal Health.  It is a good start, but there is much more that we must do for our colleagues.  I am looking forward to advancing this work in Minnesota together with the MMA.