Simple Reminders for Calming Physician Overwhelm

In our current healthcare system, feeling overwhelmed is common among physicians and a huge contributing factor to burnout. One of the main reasons physicians feel overwhelmed is that they have been trained to shoulder the majority of the responsibility, even in areas that are unrelated to patient care. During these times there are simple, positive ways to calm the overwhelm. In this article, we are going to offer up three helpful reminders all physicians can use when feeling overwhelmed.

 
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Expect the Unexpected

Despite your best efforts, unexpected challenges are sure to crop up during the course of your day. Training yourself to expect the unexpected, and accept the unexpected, will help you better prepare for difficult situations when they arise.

Prioritize Your Time & Efforts

There is always more to be done! Our first one or two priorities usually get done but we cannot do it all! Keep doing a great job of managing the urgent and important tasks.  However, moving down the list, how do you address non-urgent tasks? These usually create the most angst when neglected for too long, because they are often on our mind but frequently incomplete. 

Which takes us to our third reminder.

Delegate & Rely on Staff

As physicians, many of us were taught to pick up the slack and do things ourselves. But this is a great way to welcome feelings of overwhelm, especially when we often don’t account for our lives outside of medicine. What tasks can YOU delegate and empower your staff with? That’s why they’re there, after all! 

Calming the feeling of overwhelm by having simple strategies to process important tasks are both helpful. 

What common circumstances are present when you start to feel overwhelmed? 

What strategies have you used to gain control of the situation?

SurgeonMasters provides a supportive, nonjudgmental, and enriching environment for self-development. Here, practicing surgeons can evaluate their current practices, create short- and long-term goals, refine their focus and self-inquiry, manage stress and frustration, and develop strong relationships with their peers. Check out our vast array of wellness and burnout prevention resources.

Reach out to Team@SurgeonMasters.com to learn more.

Moving Away from Second Victim Syndrome

A recent article published on kevinmd.com titled “Second victim syndrome: a doctor’s hidden struggle” outlined the concept of second victim syndrome and its impact on physicians experiencing burnout. In this article, I’d like to offer my perspective on this concept and how we can better approach it to prevent burnout and promote well-being.

 
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What is “Second Victim Syndrome?”

Second victim syndrome is a term coined in 2000 by Dr. Andrew Wu that refers to the psychological trauma that a physician may experience in cases of medical error. In a case of medical error, the patient is the first victim and the physician or healthcare professional is the second victim.

Severe cases of harm can lead to severe feelings and thoughts. Mild and moderate cases of harm still stir these feelings and are generally under appreciated for long-term effects. In these cases, the hospital performs root cause analyses and tries to determine ways to prevent errors in the future, while the physician is left alone to deal with the psychological trauma.

These analyses are appropriate if there are lessons learned. Often the system wants or insists that a new lesson is learned. Most frequently the root cause is not new to the system, though it may be new to that physician. To many physicians, the root cause analysis prioritizes the process and even the analysis rather than the humans involved. When lessons are learned, this is a great thing. When NOT, they may not realize the additional harm that is caused to the humans in overanalyzing the medical error. Whether an error actually occurred is not as simple as you might think. Similarly, who made the error makes it even more confusing. Internally, human minds are processing this information very rapidly, while the system processes at a different pace. The humans are further isolated and the feelings are can be GREATLY exacerbated.

So what can we do to help physicians deal with second victim syndrome?

Changing the Language from “Second Victim Syndrome”

First, what if we change the language of "Second Victim Syndrome?"

Many physicians don't want to be considered a victim (nor should we be). Healing, recovery, and learning is strengthened by the concept of moving out of the victim mindset. What if we just call these “adverse outcomes?” What if we appreciated that all involved in the adverse outcome have needs to heal, recover, and learn?

Emotional First Aid & Employee Assistance

Second, the best programs are not in place for surgeons and physicians to leverage when they need assistance. We need to get past “solutions” that are essentially just lipstick on a pig, and invest in real education and resources. For instance, we don't teach healthy empathy and very little attention is placed on emotional intelligence or skills in our training.

Few physicians are even aware if an employee assistance program exists or they might not have access if they are not employed by a hospital or system. Even when available, surgeons are internally and culturally least likely to reach out for support or "feel" that the support "doesn’t get us." Physicians and surgeons are not trusting of confidentiality and safety, as often these have been violated by the system. Lastly, physicians might accept support, but only after repeated offers. We have much more training in giving versus receiving care and support.

We need to offer peer-support that is built around the individual. Each situation is unique, and right now our healthcare system isn’t offering the support physicians need. Too often the support is lacking adequate funding, scheduling conflicts with clinical or personal time, and clarity of physician purpose and goals. There are best practices for peer-support, and we all have to be willing to embrace them.

We all know there’s a long way to go in creating the change our system requires. When medical errors do happen, what if we started with a truly confidential physician-to-physician conversation with someone who understands what we are going through?

With a vast array of resources, including physician coaching, advocacy blogs and podcasts, health and exercise guidance, and resilience training, SurgeonMasters provides a supportive, nonjudgmental, and enriching environment for self-development. Coaching is one avenue that provides an environment for confidential peer-to-peer connections.

Reach out to Team@SurgeonMasters.com to learn more.


How to Ensure Physician Wellness Programs are NOT Like Lipstick on a Pig

In her KevinMD.com article entitled “Physician wellness programs are lipstick on a pig” Linda Drozdowicz, MD argues that physician wellness programs are essentially lipstick on a pig, and do not address the underlying issues that lead to burnout. She goes on to state that these programs can act as a form of unintended victim blaming - giving the impression that doctors just need to take better care of themselves to not feel burnout. In this article, we are going to discuss how physician wellness programs are NOT like lipstick on a pig when the right conditions and commitments from stakeholders are met.

 
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Physician Wellness Requires the Right Tools

Dr. Drozdowicz brings up some salient points about the state of the healthcare system and how it is set up to lead doctors down the path to burnout. However, I would like for her and others to consider that physician wellness programs can be effective when deployed correctly and when victim blaming is avoided.

Physician wellness efforts are not inherently bad. They tend to be ineffective when they don’t have adequate funding or are seemingly intended to just check a box. They work best if certain conditions are in place. These include:

  • Education and Resources - Education designed to raise awareness and offer next steps is a great start. No program provides a magic elixir. Let’s offer helpful resources without shame and blame. Since we all view wellness a little differently, we can expect that a successful wellness program will have a menu of items from which to select.

  • Leadership AND Grassroots Support and Input - It is critical to have leadership active in the conversation, AND active input from the players most directly impacted. Dialogue isn’t nearly enough - those directly involved in patient care need to feel like their voices are being heard in the actions taken by the leadership.

  • Financial and Administrative Investment - Healthcare is not free, and neither is the care of healthcare professionals. What is invested upfront in our well-being will be paid back in multiple ways, including improved patient safety, outcomes, and satisfaction, as well as lower litigation risk, physician turnover, and dissatisfaction.

  • Effort to Control the Causes of Stress and Frustration - There’s no doubt about what is frustrating physicians most - everything in the system that isn’t directly about patient care! Let’s make REAL efforts to minimize the impact of these causes - like EHR and paperwork - and we’ll start to see our environment improve.

With these conditions in place, wellness programs can go a long way to preventing burnout and encouraging healthy lives for physicians both at work and at home.

Awareness Resources

If you are interested in more physician wellness resources, SurgeonMasters has you covered. We regularly post blogs, podcasts, and webinars with helpful tips on how to prevent burnout and sustain a thriving surgical career. Interested in 1-on-1 coaching, or coach training?

Reach out to Team@SurgeonMasters.com to learn more.


Make Time for Wellness During Conference Season

If you are like me and many of the physicians I know, you’re often attending conferences in spring and fall. Travel can be stressful and often we would rather be home with family, but there are still ways to create opportunities to recharge and improve our wellbeing while we’re away. In this article, I would like to offer a few simple things we can do to improve our mental health and wellness as we go through another conference season.

 
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Set Personal Learning Objectives and Goals

We all attend meetings with program learning objectives telling us what we will learn and how we will improve our practice. I find that conference objectives don’t always align with my greatest needs. Before you go, I encourage you to reflect on YOUR greatest needs and write them down as personal learning objectives and goals. It can be as simple as a list of things you would like to accomplish by the end of the meeting. Be sure to check them off as you go and include the next steps as to how these will be transitioned into practice back home.

Create Opportunities for Self-Care

I think of opportunities for self-care very broadly. Basically it can include anything that impacts our physical or mental well-being. Here are three simple suggestions for self-care at conferences:

  • Disconnect - Strategically turn off email, phone, social media, and any other intrusion when you can. Even if it is for 5-10 minutes at a time, that’s 5-10 minutes of mental rest you didn’t have before.

  • Sleep - Sleep can be hard to come by in our busy lives and at conferences. We learned in Episode 35 of the MIni-Podcast Sleep Hygiene! that it is possible to catch-up on sleep, and improve our health in the long term. Take a nap, go to bed early, or sleep in later than usual. Find some way to manage your sleep hygiene.

  • Exercise - Inject physical activity into your conference experience. For me, it’s yoga. I love that conferences more and more are offering events like yoga and 5ks. Even if they aren’t, consider taking a few hours to go for a hike or play the golf course on the property. I will often find a local yoga studio to practice, if the conference isn’t offering it.

No matter how you choose to care for yourself don’t be afraid to think of it broadly. There are a million ways we can improve our wellness while at conferences.

Connect with Colleagues and Friends

One of the items on top of your list should be to connect with colleagues and friends. Take this time to reconnect with colleagues from medical school, residency, fellowship, and other points in your career. Peer support is a powerful tool for improving and maintaining our well-being. There’s no better time to connect with others who understand the challenges we face regularly than during conference season.

SurgeonMasters is building a community of surgeons and physicians offering peer support and camaraderie. Reach out to Team@SurgeonMasters.com to contribute.

How to Help Recognize the Signs of Burnout

It is well known these days that burnout is a widespread point of discussion in the medical community – especially among surgeons. As much as we talk about it, many physicians don’t even realize that they’re burned out. We talk a lot about how surgeons can prevent and treat symptoms of burnout when they arise, but an essential first step in that process is getting the burned out surgeon to realize that they are experiencing burnout. In this article, we are going to address this issue and offer some tips for helping surgeons recognize the signs and symptoms of burnout so they can take appropriate action.

 
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Demands of the Job

The system and culture expects a lot of our physicians – too much, in fact. Many of us were trained to power through adverse situations and solve problems on our own, without asking others for help. The strategy of working harder and longer does nothing to improve our situation. Rather, it leads to unprocessed anxiety, stress, and fatigue – classic symptoms of burnout.

Burnout is not typically caused by a single event. It usually builds slowly over the course of months or years, much like the frog in the boiling pot – making it even more difficult to recognize and address. When we do finally exhibit the signs, it is important to effectively identify them as such.

Recognizing the Signs

Keeping an eye out for red flags is an important first step. Even asking simple questions can bring heightened awareness to our current situation.


Here are three simple questions you can start with.

Do you find yourself or a colleague “checking out” or disengaging from patients?
Do you find yourself or a colleague overwhelmed and disengaging from family, friends, or colleagues?
Do you find yourself or a colleague losing the joy of your (their) career and accomplishments?

These signs can be hard to recognize in ourselves, so it’s also important to keep an eye on our friends and colleagues as well. If you notice any of these red flags in a friend or colleague, go beyond asking them how they’re doing and if they need any help. Most will say they are fine and “no thanks.” Come at it from the side of compassion. You could offer support in ways that you might want others to give it to you, or you could share with your colleague one of our resources, blogs, or podcasts that really resonated with you.

SurgeonMasters Wellness & Resilience Services

At SurgeonMasters we are focused entirely on the wellbeing of surgeons and physicians. We offer a variety of educational resources (educational programs, coaching, articles, podcasts, etc.) aimed at equipping physicians with tools and strategies to improve well-being and increase resilience. We are building a community of surgeons and physicians offering support and camaraderie. If you are not currently subscribed, add your name to the mailing list and send us a note to say hello or provide your thoughts.


Source - Helping Physicians Recognize They're Burned Out, Steph Weber, Physicians Practice, April 9, 2018