Most Important Thing to Take Care of is You

Every day driving home from work, I reflect on my day. As a full-time hospitalist in a large community hospital, my day is often filled with a lot of stressors. From the demands of patients and family members, holding multiple family meetings, meeting expectations of hospital administration and staff, and completing my progress notes at the end I wonder "What did I accomplish today?" or is this why I spent 10 years of my life becoming a physician to just feel frustrated at the end of the day.

I wonder on certain days when I have a migraine, backache, neck problems, carpal tunnel, or the occasional chest pain, am I giving time to my own personal health? Or am I fulfilling my physician responsibilities of taking care of everyone but at the cost of my own health? Spending all day making life-and-death decisions, deciding for patients while skipping lunch, or having an extra cup of coffee to get through your afternoon are not exactly healthy habits. Unhealthy eating habits of energy drinks, highly saturated fatty food from the cafeteria, and salty chip snacks are quite a risk of developing premature cardiovascular disease.

I was talking about heart disease with a colleague who is an interventional cardiologist and he joked "I just hope my heart attack isn’t on the day I am on call". We spoke about healthy eating, exercise, and cholesterol medications but that’s easy to say. A study on physicians in Canada found that Ontario physicians have better cardiovascular outcomes than the general population, and the difference in outcomes between physicians and nonphysicians was not fully explained by traditional cardiac risk factors, (1) A cross-sectional study done in India found physicians and nurses to have higher-than-average cardiovascular risk factors (2) There is no good data available on physician heart conditions despite physicians being at the center of taking care of everyone else.

I also believe physicians are the worst patients. Being sick leads you to self-diagnose yourself - a know-it-all approach. I often hear my colleagues or even myself saying "I don’t have to see the doctor for a checkup or don't believe anything will happen to us". This is exactly what leads to a tragic event in your life to happen. When it does, you realize you are just another human being. Mental health is another rapidly progressing health condition among physicians.

An estimated 498 physicians committed suicide from 2012-2016 with the study reporting male to female physicians suicide ratio of 2:1. (3) A Medscape report from 2017 showed 51 percent or half of the physicians reporting burnout (4). Depressed mood, mental health problems poor general medical health, and work-related stressors were more frequently associated with physicians than with non-physician suicides (3). When it comes to mental health time and again physicians are the worst patients to seek out for help.

I believe it’s not hard to make a small change. I think we all have 30 minutes to exercise daily even if it’s walking the dog or running with your kids in the park. I believe we have 5 minutes to grab a healthy lunch from the cafeteria and sit down and take a break. Finding time in your day to connect with patients and changing your mindset to treat their diseases will make you happier. Seeing your primary care one or two times a year and doing a yearly physical is a small task. I believe in this because I started doing it. It seems impossible at first but you realize you have the time to make these changes you just don’t want to admit it. Getting ahead of your ego is the first hurdle to cross. The rest is all easy.

References

3. Gordon Y. Ye, Judy E. Davidson, Kristen Kim, Sidney Zisook, Physician death by suicide in the United States: 2012–2016, Journal of Psychiatric Research, Volume 134,2021, Pages 158-165, ISSN 0022-3956,
4. Medscape Lifestyle Report 2017: Race and Ethnicity, Bias and Burnout Carol Peckham | January 11, 2017 Ko DT, Chu A, Austin PC, et al. Comparison of Cardiovascular Risk Factors and Outcomes Among Practicing Physicians vs the General Population in Ontario, Canada. JAMA Netw Open. 2019;2(11):e1915983. doi:10.1001/jamanetworkopen.2019.15983 Hegde SK, Vijayakrishnan G, Sasankh AK, Venkateswaran S, Parasuraman G. Lifestyle-associated risk for cardiovascular diseases among doctors and nurses working in a medical college hospital in Tamil Nadu, India. J Family Med Prim Care. 2016 Apr-Jun;5(2):281-285. doi:10.4103/2249-4863.192355. PMID: 27843828; PMCID: PMC5084548.