Find your grounding

Tuesday, July 01, 2014 12:26 PM

Kate Alfano, CMS contributing writer

CMS president-elect chooses future by reflecting on past

Tamaan Osbourne-Roberts, MD, CMS president-elect, chose his future by reflecting on his past. But even after years of hard work placed him in the seemingly perfect position, the young physician discovered that he had to find balance to ensure a long and happy professional and personal life. “Find your grounding” was his message as he opened the 2014 Spring Conference in Vail in May.

He set the scene by telling the story of his childhood and the cumulative experiences that would lead him to medicine. His parents, immigrants from Trinidad, met in Brooklyn. His mother wanted to become a doctor but instead became a teacher when she was told international students couldn’t pursue medicine. His father joined the U.S. Air Force and the couple moved to Guam where Osbourne-Roberts and his brother were born.

Moving to various locations around the world fueled his interests in nature, science and people. He eventually ended up in Colorado for middle school and high school, and went off to college wondering what to choose as a career.

Osbourne-Roberts looked to his parents’ example – a teacher and a soldier – and he knew he would have a service-oriented career. He also knew he loved bioscience and he was interested in serving people. “The obvious answer was medicine,” he said. “I veered off into education for a couple years, figuring I’d follow in my mother’s footsteps, but eventually I followed my mother’s dream to become a doctor.”

He met his wife during medical school, completed his family medicine residency, had two children, bought a house, entered practice where he wanted to work and seeing the patients he wanted to see. “As you can see, all of this looks like it’s going according to plan. It looks fairly ideal,” he said.

But starting practice is where things got difficult. He – like many other physicians – felt alone as he struggled with the issues of the times. For him in 2010 it was the economic meltdown, a boom of patients who desperately needed care but couldn’t pay, and the Affordable Care Act that brought a lot of instability and concern among physicians and patients. All of this weighed on him, he said. He also struggled to be present, wanting to give both his family and his patients 100 percent. “That just doesn’t work,” he said.

“You’ve all been in this place. It’s a hard spot to be in. It’s isolating, it’s cold, it’s difficult, it’s hard. So now that I’ve depressed you, let’s talk about answers. How do we get out of here?”

For him, many of the solutions were related to his practice. They restructured how they saw patients, how many they saw and how they handled their electronic medical record. “But the thing that brought me back to a much happier place where I find myself today is something a mentor of mine referred to as ‘grounding,’” he said. “A tree cannot stand if it has no roots.”

He encouraged the audience of physicians and physicians in training to reflect on their grounding, and remember why they decided to dedicate their lives to service through medicine. It’s difficult because of “all the challenges we have on a daily basis; the things that wear us down, make us question why we’re doing this, burn us out, keep us awake at night worrying about the people under our care, keep us away from our families, make us forget why we’re doing what we’re doing. These take away from that grounding.”

Osbourne-Roberts found grounding for his professional life in the Hippocratic oath, and one line in particular: “I will apply for the benefit of the sick all measures that are required.”

“All measures,” he repeated. “For me that one sentence was the grounding I needed to bring me back from this (dark) place in my professional life. We’re all very tied to what we do in our profession, but the reality is we have other things we need to keep in mind.” One part of this, he said, is summarized in the phrase, “physician, heal thyself,” asserting that physicians apply for others all measures that are required but don’t pay themselves the same service.

“Your compassion is incomplete if it does not include yourself, if you’re not working to heal yourself as a physician and to make sure you can be there in a full way for the people who need you. You work is going to be compromised, your home is going to be compromised and you won’t be able to do what you want to do to be happy in life.”

He found his grounding in hiking the Colorado 14ers, cooking for his family and exploring beautiful places with his family. “This is what keeps me able to do all of the other things I do. It’s not easy to find time to be a full-time physician, father, husband, son, brother, and still find time to get out and exercise. It’s not easy to find time to cook healthy meals or take vacations.”

“It’s hard to find the balance but I strive toward it,” Osbourne-Roberts said. “Why? The things that keep me able to do what I do are the things that keep me grounded. It’s about holding onto what’s important in your professional life – for me my oath – and in your personal life – for me my family. Whatever those things are for you, hold onto those things because those are the things that are going to keep you able to do what you do. They’re going to keep you grounded.”