Doctors and Stress: How Common Is It?

Stress is commonly known as America’s leading health problem. It begins in the mind, impacts your emotions, and produces a physical or behavioral response. In other words, stress is your body’s response to situations under pressure. In most instances, individuals experience the psychological effects of stress, such as from being diagnosed with a severe illness, getting fired, losing a loved one, or even dealing with relationship issues. However, even happy life changes or events, such as getting married, having a baby, or winning the lottery, can cause unexpected stress. All of these events, both the positive and the negative, are normal parts of an individual’s course of life. Therefore, stress will always play a role, although some events may be easier to manage than others. For instance, planning and preparing for a wedding ceremony may be stressful, but the excitement of the joyful event may help alleviate the physical and mental aspects of the stress experienced.

While stress is an individual’s response to threatening or challenging situations, “stressor” is a term used to describe a stimulus that causes stress. There are two common types of stressors: external and internal stressors. External stressors depict stress derived from social interactions (rudeness, bullying), major life events (marriage, childbirth, death of a loved one), daily hassles (commuting, mechanical breakdowns), organizational factors (deadlines, rules and regulations), and the physical environment (noise, bright lights). Internal stressors, on the other hand, depict stress derived from lifestyle choices (jam-packed work schedule, lack of sleep), personality traits (workaholic, perfectionist), and negative thoughts (self-doubt, pessimistic thinking).

Every individual in every profession has to cope with stress. However, in the medical world, such stress, if ignored or poorly managed, may lead to symptoms of physician burnout. From getting into and graduating from medical school, performing clinical training in a hospital, and establishing doctor-patient relationships, to battling wrongful lawsuits and dealing with work overload, stress is likely to catch up with you. When outside forces are in question, it can cause feelings you are unable to control, such as emotional exhaustion and cynicism. In fact, conducted studies have linked high levels of physician stress to insomnia, changes in mental health, headaches, upset stomach, chest pain, anxiety, and depression. Therefore, it is important to find the right ways to cope.

Keeping physician burnout at a distance involves knowing to recognize and identify the signs that something is in fact wrong. Consider the following:

• Do you work in a high-stress environment? Is your practice especially chaotic?
• Do you act as an emotional buffer most of the time?
• Do you ever feel as if your colleagues do not share your values and opinions?
• Do you have an extremely high level of tolerance to stress?
• Do you dread going to work? Do you feel stressed when you arrive at work?
• Does your job constantly interfere with family get-togethers?
• Does your job constantly interfere with your personal life? 
• Are you spending more time at work than at home? Do you have any free time?
• Is your stress affecting the way you provide care to patients on a daily basis?
• Are you taking good care of yourself?

Most individuals deny being stressed throughout their lives, but for many, stress is ongoing. As a physician, you deal with countless patient cases on a daily basis. Each case requires you to make important decisions and, at times, life and death hang in the balance. The impact of physician stress is far-reaching—it is not only damaging to you and your family, but also to your patients, your staff, and the healthcare organization in general. While you may not be able to relieve current problems in the workplace, you can learn to manage and alleviate stress. A good place to start is by:

• Identifying if you are stressed
• Identifying the stressor (external or internal)
• Identifying the underlying cause of the stressor
• Selecting an appropriate stress-management approach
• Evaluating the situation

Research shows five of the most common aspects of physician stress include:

1. Working long hours
2. Dealing with difficult patients
3. Making quick, life-changing medical decisions
4. Feeling psychological pressure from family members and loved ones
5. Being surrounded in a negative environment

You have one of the most stressful jobs in the world and you hold patients’ lives in your hands on a day-to-day basis. For this reason, it is important to take crucial steps towards managing and alleviating physician stress. After all, if you can’t take care of yourself, how will you take care of your patients?

• Eat plenty of healthy foods
• Eat at least one meal a day with family members or friends
• Make time to exercise a few times a week
• Practice breathing and meditation techniques on a regular basis
• Incorporate mindfulness
• Make more time for your hobbies/interests
• Get enough sleep
• Plan your day and set achievable goals
• Avoid cynicism and self-doubt
• Keep a stress journal
• Strengthen your communication skills
• Avoid being too efficient
• Seek insight and wisdom from elderly patients on how they have dealt with difficulties and challenging situations
• Give yourself adequate breaks whenever necessary
• Try expressing stress through activities such as painting, cooking, or writing
• Learn to accept there are some things you cannot control
• Develop a support system
• Read magazines, books, or articles unrelated to medicine when you are at home
• Take a different route/change of scenery when commuting to work
• Share your problems and concerns with family, friends, or even colleagues
• Establish a flexible work schedule or reasonable work hours
• Hand over time-demanding tasks to other members of your organization
• Have regular team meetings or group huddles
• Invest in modern, up-to-date technology
• Start a fun project and get in touch with your creative side
• Do not waste your time making excuses
• Find value in what you do 
• Treat yourself to the occasional sweet treat
• Take some unscheduled time off
• Take some time away from your computer/phone during the day
• Set boundaries and learn to say NO
• Give back to your community by volunteering
• Talk about other matters unrelated to medicine when you are out with family, friends, or colleagues
• Learn to multitask and focus on the tasks that deserve your undivided attention
• Take a much-needed vacation
• Join a support group
• Seek alternative therapies, such as hypnotherapy, acupuncture, aromatherapy, and more
• Maintain a positive attitude
• Prioritize job duties and objectives
• Prioritize self-care

Recognizing the need to lead an overall healthy lifestyle, including your emotional health, is the first step to evolving in your profession. A simple form of exercise, such as a brisk walk or bike ride, can help you channel your emotions and eliminate ongoing stress. Exercise is an essential element in any stress-reduction program. It can help lower your blood pressure, clear your mind of negative thoughts, and improve your self-image. Furthermore, practice ways in which you can cope with difficult situations. Relaxation and meditation techniques are proven stress-relievers designed to relax your muscles. After a long day, a state of deep relaxation may be just what you need to bring down your body’s stress level and maintain a calming effect.

A physician’s job requires lots of time, energy, and dedication. Yet, you can’t expect to be able to do everything yourself. Whenever possible, hand over tasks to other staff members so you are better focused and able to spend your time in a more valuable way. Moreover, while you may not be able to cut back on your hours at work, you can learn to schedule your time in a more effective way. The best strategies to cope with doctor stress are used outside of work, and they entail spending time with family and friends, enjoying personal hobbies or activities, getting plenty of rest, and talking freely with loved ones about fears and concerns. Such strategies lower emotional exhaustion and alleviate the pressures and stress in the workplace.

The ABC strategy is a popular method of stress control used in several different situations by many individuals—even by healthcare professionals such as you.

• A stands for awareness, and it brings forth the question: what causes you stress?
• B stands for balance, and it represents the fine line between positive and negative stress. It begs the question: how much stress can you tolerate before the positive turns to negative?
• C stands for control, and it raises the question: what can you do to defend yourself from the negative consequences of stress?

The ABC strategy represents changing your thinking, behavior, and overall lifestyle. It is a way to redirect your mental map to focus on positive thinking. It does not change the reality of the things around you, but rather how you perceive them. Changing your behavior means extending your range of communication skills, getting organized, and being assertive. It can help you cope with difficult situations by minimizing their frequency and thus raising your self-confidence. Being assertive means having the right to express your feelings, to say yes or no, to set your own priorities, and to express your opinions and beliefs. Lastly, changing your overall lifestyle precludes changing your diet, eating habits, sleeping habits, and leisure. By doing so, you can increase your focus and productivity, all the while decreasing mental worries.

The fact remains the surroundings within a healthcare environment cannot be predicted. While some diagnoses or surgical procedures are unavoidable, improving the physician-patient relationship can help ease some of the pressure. You may not be able to control physician stress, but you can manage it. A few stress-management tips within the workplace that can help you feel better on a daily basis include:

• Implementing efficient practice management software
• Hiring competent office management
• Setting up a kiosk to maintain a positive reputation online

Automation is everywhere. With innovative practice management software, you can save time and money, all the while addressing patient needs and concerns. The use of medical practice management software can help streamline efficiency and patient flow management. This, in turn, means improved patient care, an increase in staff productivity, a rise in revenue, and overall management of the practice. With immediate access to such software, you will be able to create medical reports more easily and avoid unnecessary paperwork that would normally take up much of your valuable time.

There are several programs available to meet your EMR solutions. One increasingly popular tool used nowadays is the review kiosk, also known as a patient-enabling review platform. The patient kiosk is a self-service workstation designed to help your patients check in and provide feedback following a positive appointment. Patient kiosks improve practice efficiency and allow a patient’s in-office experience to become available at the click of a button. By setting up a kiosk, a medical practice can encourage recurring patients to write a positive review on a physician's listing. This is a great opportunity for you to maximize your visibility and maintain a positive reputation online.

Training staff, implementing practice management software, and setting up a kiosk are not only designed to reduce patient wait time and ease payment methods; by filing patients’ medical data, the likeliness of errors is reduced. This makes way for physicians, such as you, to verify patient information and provide the best treatment available. Such solutions can help ease the pressure of your workload, thus alleviating your concerns. The less you have on your plate, the better. You will spend less time dealing with stressful administrative duties and more time providing quality care for your patients.

In a world that constantly asks physicians to be more aware, more informative, and more invested, it is only natural the stress would get to you. It affects your mind, body, and emotions. Sometimes, you may encounter a stressful situation you cannot change. Such situations may entail work overload, change in working patterns, uncertainty, or conflict. For this reason, you need to explore ways to refocus your energy elsewhere. When you are experiencing stress in the workplace, go out and get some fresh air. Take a short walk and clear your mind. If you are feeling discouraged, perhaps consider a change of specialty or hospital. Whatever you decide to do, try to avoid physician burnout by taking the time to understand your emotions and learn from them. The less anxious you are and the higher your self-esteem, the more likely you will be able to manage stress successfully.

Remember, you are a role model in the eyes of your patients and you make a huge difference in their lives. However, you are also only human and you can’t expect to be unbreakable. At times, keeping up with medicine, ongoing diagnoses, and surgical procedures may be too much for some. To get back your identity as a healthcare professional, you need to be able to recognize stress and seek help when symptoms of physician burnout present themselves. Take steps towards recognizing the problems, acknowledging them, and confronting them. Most of the stress we experience throughout our lives is self-generated. It is not always the events that are stressful, but how we perceive them—or, rather, how we perceive life around us. Some events make us feel anxious and frightened, while others make us feel happy and content. At the end of the day, achieving and maintaining a work-life balance is crucial. Organize and prioritize your tasks and time. This balance between your personal and professional life is yours to change as you see fit. Doctor stress may be common and inevitable, but it is not unbeatable.