01 Feb The “Medicalization” of Physician Health and Wellness
Despite its rewards, medicine can be a demanding profession with tremendous responsibility. The issue of Physician Health and Wellness resonates across the continuum of physician’s career, from medical training through the spectrum of a full practice. Although important strides have been made to enhance the health and wellness of physicians, barriers remain. Evidence shows that physicians face a growing list of challenging issues, including increasing rates of burnout, depression, sleep deprivation, fatigue, substance abuse and suicide. These issues are linked to an array of contributing factors, such as difficult work environment, changing autonomy, heavy workload and calls, imbalance between work and private life, scarce financial resources, expectations of patients and colleagues, and an ever-evolving medical culture. With all these compounding factors, it is not surprising that there is a growing evidence of association between physician wellness, patient care and safety.
The vision of health and wellness over the last few years has evolved to include a multitude of interconnected physical, mental and social factors. The WHO’s Position Statement on Physicians Health and Wellness brings forward the concept of prevention and treatment of acute and chronic illnesses experienced by physicians resulting from occupational stresses, and optimization of multiple factors affecting health and wellness, such as being physically active, eating a healthy diet, reducing fatigue, and effectively managing daily schedules. Mental health relates to good psychological health, decreasing risk of medical error, improved productivity and a sustainable practice. Social health relates to maintaining personal and professional relationships that promote a balanced environment for private life, career development and job satisfaction.
Physician’s health and wellness is becoming an important international subject. National and International conferences are bringing together leading academic scientists, clinicians and educators to address physician health and wellness through sharing of experiences, presentation of recent innovations, and discussion of trends and practical challenges. Today’s physicians are exploring all aspects of burnout, sleep deprivation, depression, work overload, substance abuse, bringing forward creative innovations to promote wellness and strengthen resilience, developing coping mechanisms and promoting organizational support for physicians.
I have been a pediatric cardiovascular and thoracic surgeon for 35 years, with a previous 10 years of intensive training. I have had a very busy practice, clinically and administratively. I have been on-call every second week for 30 years and experienced sleep deprivation and heavy workload. It did translate in work and personal life imbalance, which I consider of my own making. Everybody reacts differently. I personally developed resilience to burnout and sleep deprivation by exercising, taking full advantage of my holidays and staying healthy, not completely by choice but also because of my cardiovascular risks. This experience has given me a good understanding of physician health and wellness. I welcome national and international awareness.
After being retired for six years, I started to realize that there is a missing link. I believe that we are narrowing the scope of Physician’s health and wellness by creating a “medicalization” of an issue pertinent not only to physicians but to most professions. We need to expand the scope not only from the arenas of medical school and active practice but also to preparing for and moving to a fulfilled and enjoyable retirement. I have personally found this process challenging, yet outside of my comfort zone I made decisions I did not know I could make and re-invented myself in a way that surprised me and could not imagine when I first planned to retire.
For several years now, I have discussed retirement with many anxious, uncomfortable, and fearful colleagues. I have heard a variety of positions, from physicians who believe they are prepared and organized to ones who do not really know to retire, or are afraid of how to approach it.
For me, I came to understand that retirement is about preparing for what I believe are three pillars of life after an active practice: relationship and family; financial preparedness; and re-inventing oneself. I did not know anything about retirement when I made my decision, and I had to work hard in realizing for me what was important. After reflecting on retirement, more than a few years into it now, I can say from experience that these three areas are constants in retirement.
From this realization, I realized that as physicians, our health and wellness in 30 to 35 years of active practice must include the management of our finances, of our lives and of retirement plans. With the current multiple stressors in physician’s clinical practice and environments, planning for retirement and retiring can easily become another stressor, that may create much unhappiness, health problems and ultimately patient care issues. For this reason, I am genuinely concerned about the “medicalization” of Physician health and wellness. It is not a medical problem. It is one of life balance.
Fortunately, there are many tools to help us. Nonetheless, planning for retirement is more than attending a financial retirement planning meeting organized by any big investment firms. It begins with making physician health and wellness integral to our careers, both in approaching and following retirement. The goal is one.