President’s letter: What about you? Physicians learning to care for themselves

Thursday, March 01, 2012 12:05 PM

F. Brent Keeler, President
Colorado Medical Society

Third place? The bronze medal? Which physician aims for that distinction? What if I told you that there is a syndrome that we recognize first in our patients, second in our colleagues, and only a distant third in ourselves? There is no vaccine or new-fangled drug to prevent or treat it. There is no high-tech scan to diagnose it. My goal in writing this column is to raise awareness about the importance of physician health and wellbeing. This syndrome has denial written all over it, and diagnosis requires those old-fashioned skills of listening, awareness and empathy.

A couple of years ago, I spent three hours on a Saturday afternoon listening to a distressed colleague share his story. His depression was readily evident and he was unfamiliar with the tools available to help him. I tried to assist by providing him with resources, including services available through the Colorado Physician Health Program (CPHP). I hope I made a friend in the process.

This was a real eye-opener for me and I began to take notice. I soon realized that this was not an isolated incident. The concept of physician wellness is gaining national attention. The need for physicians to care for themselves was a major element of our Colorado Medical Society Spring Conference in 2011 and physician wellbeing and success remains a major CMS strategic goal. A newly formed CMS expert panel on physician wellness will guide CMS leadership in promoting physician wellbeing throughout the state.

We are blessed to have a wealth of local expertise to bring to bear on this issue. Doris Gundersen, MD, medical director for CPHP, is a nationally known expert in this field. I want to personally thank Doris for her role in the planning and presentation of the 2011 Spring Conference. She also played an active part in the 2011 Annual Meeting last September, and she has generously agreed to chair our new expert panel on physician wellness.

Our goal is NOT limited to addressing physician addiction. While alcohol and drug dependence can contribute to the syndrome, other conditions including stress, anxiety, depression, burnout, difficulties maintaining a work-life balance and physical illness factor heavily into its development. We docs actually do a pretty good job recognizing this in our patients. (After all, we are trained to do this). We might also recognize it in our friends and colleagues. However, we seldom recognize the signs in ourselves.

Physicians are highly susceptible to self-care neglect. We experience more suicides, more depression and burnout and greater risk for certain types of physical illnesses than observed in the general population. We are reluctant to make time for ourselves. We are even more reluctant to seek help. Many of us do not have a personal physician. Some of us get little or no exercise. We can be so focused on being a doctor that we lose sight of other valuable aspects of life.

Information from COPIC tells us that physicians who put self-care on the back burner are susceptible to a variety of medical-legal issues, including State Medical Board complaints, poor patient communication, greater rates of actual patient problems and complications and even liability actions.

What action can we take at the individual physician level? An important first step is to develop a greater awareness of the problem. Is your friend, colleague or partner showing signs of depression, distraction or irritability? Sometimes simply inviting a colleague for a cup of coffee and casual conversation can help an otherwise bad day feel better. Other times, it may be necessary to give that doc a gentle push toward action. Suggest a medical check or share information about CPHP – it may be the nudge that a stressed doc needs to seek counseling or medical care.

Not all of us actually have a primary care physician or we may not have been to ours in years. Physicians have a degree of reluctance in assuming a “patient” role. Privacy is a concern. Embarrassment about having neglected one’s health may also create a barrier to seeking help. Some of us find it more comfortable to seek help outside of our own local medical community.

Take a friend for coffee. Have a quiet conversation. Raise awareness. Don’t be afraid to ask for help! Consider contacting CPHP. The majority of CPHP referrals are self-referrals. See your PCP. Don’t let life pass you by.

Special thanks to Dr. Doris Gundersen for her gracious assistance with editing this article.