Thursday, November 11, 2010

Chairing a physician well-being task force

Patricia Lindholm, MD,
2010-2011 MMA President
Over the course of the last six months or so, I have been chairing the MMA Physician Well-Being Task Force.   While I was President-Elect I knew that this would be the emphasis of my presidential year and wanted to get an early start on the project.  We have a multidisciplinary group including physicians, chaplains, an attorney and a physician’s spouse.  We are in the process of generating a report and recommendations to the MMA board on how to address physician well-being. 
If you follow the MMA web site you will soon see a section on physician well being.  We have generated an extensive bibliography of articles and resources as well as web links.  We will identify opportunities such as retreats, workshops and educational sessions.  I also hope to provide information to you about how to start a physician peer support group in your local medical community.  We hope to produce some video material that can be accessed on-line. 
A great resource in Minnesota is the University of Minnesota’s Center for Spirituality and Healing.  We will soon have a link to this site.  The Center has many offerings that are valuable regarding self-care including Mindfulness Based Stress Reduction (MBSR) courses.  These are based on the pioneering work of Jon Kabat-Zinn at the University of Massachusetts.  I can enthusiastically recommend this program.  In my personal journey I have practiced MBSR for about two years.  When anxious or stressed the mindfulness meditation exercises have a wonderful calming effect on the mind and bIody. 
Another mindfulness exercise that many of us are practicing is yoga.  When we are practicing yoga asanas or another form of exercise we get out of the brain chatter that is constantly happening in our minds.  We are able to attend to what is real.  We realize where we are and are able to live in the moment.  I have not yet arrived at a continuous state of mindfulness (and likely never will) but even brief mindfulness of my breathing, emotions or bodily sensations during a stressful day can be very healing.
There are several books by Jon Kabat-Zinn that I would recommend if you would like to learn more about mindfulness.  Full Catastrophe Living, Coming to Our Senses and The Mindful Way through Depression have been very valuable resources for me.  Do you have other recommendations to share with your MMA Colleagues?  We would love to hear from you.

Thursday, November 4, 2010

Take your own advice and stay home

Patricia Lindholm, MD,
2010-2011 MMA President
A topic of interest to me is “presenteeism” among medical students, residents and physicians.  Yes, this is the opposite of “absenteeism.”  Both conditions may be problematic.  Have you ever presented for work when you were ill?  I confess that I have committed the act of presenteeism on more than a few occasions over the course of my training and career.
Most of us have received the subtle message that illness is a sign of weakness.  Doctors cannot afford to be ill, and especially cannot afford to be absent from work.  When we are absent, our colleagues usually have to pick up our workload and may let us know that they resent it.  Some patients even try to “guilt trip” us after an absence.  Most of us realize that returning to work after any type of absence means facing a mountain of charts, mail and messages that need addressing. 
Is it good practice to work when we have an infectious illness?  Of course not.  Would we advise our patients to stay home when ill?  Of course.  However, the misguided “macho” ethic of our profession has bullied us into doing the wrong thing for ourselves, our coworkers, and especially our patients. 
Is it good practice to work when we are sleep deprived, suicidal, manic, intoxicated?  Is it heroic to work immediately postoperatively or postpartum contrary to the advice of our physicians? 
Friends, let us permit ourselves to heal when sick, recover from surgery and tend to our mental health—if not for ourselves, then for our patients.   Let us also have mercy on our students and colleagues and give them the space to care for themselves.  It is odd that we even need this type of advice, isn’t it?
“Physician heal thyself” indeed!