Stress: Preventing and Handling

It’s well known that occupations in medical professions, particularly physicians, are very stressful. Some key characteristics of physicians that increased stress and burnout, according to a study¹ published in Southern Medical Journal, include:

• Drive

• Competitiveness

• Compulsiveness (driven to solve problems)

• Need for individuality and high levels of autonomy

• Ambitiousness

What’s more, physicians die by their own hands at much higher rates than members of the general public do-40% higher in males and 130% higher in females²-so recognizing and responding to physician distress is crucial.

Recognizing Stress

Stress at appropriate levels can support optimal performance. “It can push us to try a little harder and stretch a little further,” says Judith S. Treharne, consulting executive, Halley Consulting Group, Rosemount, Minn. “However, when stress is too intense or becomes chronic at a low level, it can lead to burnout and negatively impact health.”

But it can be hard to recognize low level chronic stress. “We often brush symptoms aside in the busy activity of our typical work day,” Treharne says. Symptoms such as irritability, sense of being overwhelmed, procrastination, eating disorders, sleep issues, stomach problems, depressed immune system, and lack of concentration are just a few.

“We are so used to hearing others talk about these issues, and seeing them in ourselves, that we think it is just part of normal life,” Treharne continues. “This lack of early recognition or denial is often the reason physicians push themselves to burnout. After all, they have been taught that they are stronger and more resilient than the general population. To some degree this is true, as they are high achievers. But their strength can also become their downfall if lack of recognition and denial hold them back from taking some action to reduce the stress inherent to their roles.”

Managing Stress

Recognition is the first step in reducing stress. After an intensely stressful situation, e.g., a critical care case or difficult patient discussion, a physician should take a few deep breaths to get re-centered and mentally let go of the situation before running into the next patient’s room. “The simple act of creating a few seconds of space for letting go between situations can have a huge impact in one’s sense of well-being at the end of the day,” Treharne says.

Treharne goes on to say that physicians need to learn to take care of themselves, just as they teach their patients to do. That means finding stress management tools that work for them. For some it will be exercise, for others it may be yoga and meditation. “The important step is to find something that you can individually connect with and then commit to making it part of your life,” she says.

References:

1. Miller MN, Ramsey Mcgowen K. The painful truth: physicians are not invincible. South Med J. 2000;93(10):966-973.

2. Smith TM. New tool for recognizing physician distress, preventing suicide. AMA. September 28, 2016. Available at: https://wire.ama-assn.org/practice-management/new-tool-recognizing-physician-distress-preventing-suicide. Accessed November 18, 2016.