Eye on Wellness - Simple Burnout Prevention Steps

Are you overwhelmed at work to such an extent that you feel deflated, depleted, and emotionally drained? You may be experiencing burnout – and you’re not alone! Burnout can ruin careers and lives, but only if we let it. What many don’t realize is that burnout has a positive side. The key to managing burnout is to leverage the positive side over the negative. In this article, we are going to offer up a few tips that can help save your career from the perils of burnout.

Focus on Sleep

Many surgeons simply do not get enough sleep. Me included! I am very well trained in sleep deprivation. Until fairly recently, I was proud of this ability. One way to train FOR the worst case scenario is to train IN the worst case scenario. While I am still able to turn on my system in the middle of the night in ways others might not understand, I now see some changes in my ability to handle periods of frequent middle of the night call duties. I am continuing to address my performance and self-care. Start to recognize how much sleep you get every night, and see where you can add more if needed. Power naps and changes to improve quality of sleep are other ways to improve our sleep recovery.  It may seem like you need to burn the midnight oil to get your work done but being well-rested can improve your proficiency at work – allowing you to get more done in less time. Where is your threshold?

Strategically Disconnect

With social media, constant texting, and email updates continually ringing in our pockets, many people feel the need to respond immediately and always be available. It’s no wonder we feel drained! Do your best to strategically disconnect. Strategically is the keyword here. Obviously, you shouldn’t disconnect yourself from everything if you’re on call, but when you can – turn your phone off, don’t respond to emails, and schedule time for yourself to do leisure activities that give you pleasure and recharge your batteries.

Don’t Feel Defeated

Remember that you are not “giving up” in recognizing that you are feeling the effects of burnout. There is no defeat in recognizing that you need to make some changes to improve your wellness. It generally means that you have not allowed yourself enough physical, mental, and emotional rest and recovery in between the bursts of intense performance for our patients.

Connect with the SurgeonMasters Community

If you or a physician you know are experiencing warning signs of burnout, SurgeonMasters is here to help. We are a wellness and coaching organization focused on helping surgeons combat burnout and build sustainable practices. How do we do that? By providing a variety of educational materials, including podcasts, blogs, webinars, and meetups. Join a community of like-minded surgeons helping each other build lifestyle-friendly practices. Contact us today to learn more or join our mailing list to get the latest updates.

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Can We Prevent Career Ending Musculoskeletal Injuries in Surgeons?

A recent review published in JAMA found that surgeons are at a high risk of sustaining work-related musculoskeletal injuries. It is safe to say the orthopaedic surgeons in my circle and I are not good examples of applying the knowledge we have about acute and chronic overuse injuries to ourselves. I personally believe this is part of our extremely negative healthcare culture that leaves no room for self-care. What if we started encouraging best practices in musculoskeletal health and ergonomics for all surgeons? In this article, we are going to explore some of the findings of the JAMA review article and offer some tips for surgeons to reduce on-the-job musculoskeletal injuries.

 
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Musculoskeletal Injuries

Acute

Performing surgical procedures does not often result in acute injuries, mainly due to a more present focus on surgical safety. That being said, most surgeons I know are able to share many stories of acute injuries they have sustained. Even with these events, the pervasive opinion would be that these things are inevitable, and if there is no harm to the patient, then no big deal. Needlesticks and other “sharp” injuries don’t usually involve the musculoskeletal system. However, each tool we use in surgery carries a risk of harm. Every time we lift a patient, we place ourselves at risk of injuring our neck, back, or shoulders in particular.

Acute on Chronic

At this point in my career, these are the most common. Every time I am asked to assist in the transfer of a patient to the operating table, I comment that I will do my best and that it might impact my performance of the surgery when it really matters. Rarely does anyone understand and few even care. However, on occasion, these moves lead to an increase of my baseline back pain, and at a minimum, risk causing distraction and delay in performance of the procedure. I have also performed plenty of operations where I need to hold a steady, sometimes awkward position, and I can feel a worsening of baseline numbness or tingling in my hand/arm or my foot/leg. Believe me, I am not unique. I know many surgeons who have rotator cuff problems, “tennis” elbow, wrist or thumb arthritis, and so on, where almost every move they make causes pain. We “learn” to endure and sometimes modify, but what if we could learn to prevent, mend or perhaps recover from these injuries.

Chronic

For surgeons, most musculoskeletal injuries are caused by standing in static (often uncomfortable) positions for long periods of time and performing repetitive motions during procedures. This, coupled with the fact that many surgeons wear heavy lead aprons, awkward headgear, and other equipment can lead to overuse injuries. Over time these factors can build and cause repetitive stress injuries like carpal tunnel syndrome, arthritis, and more. My goal is to raise awareness, so that most of our younger and future surgeons can either prevent or at least lessen the damage from our noble work. One effort to raise awareness was our web-conference, Ergonomics: Best Practices for Longevity. Thus far, personally, I have been successful in managing my chronic injuries with some physical therapy and a lot of yoga with core strengthening. My episodes of back pain are much less severe and much less frequent. What if you could avoid or stall musculoskeletal injuries significantly in your career?

Tips for Preventing Work Injuries

Here are a few simple tips to help prevent or delay these types of injuries at work:

  • Stay in Shape - The better shape you’re in, the better you’ll be able to handle the physical demands of being a surgeon.

  • Take Breaks - If you’ve got back to back procedures, try to take even a few minutes break to rest, take a walk or do a “mini” or 5-minute workout (cross-training) before heading back into the OR.

  • Stretch - Doing simple stretches before, during, and after a long procedure can significantly help avoid injury.

  • PRACTICE Improvement for Injury Management - We recommend taking on the complex problem of injury management in surgeons with our PRACTICE improvement methodology. Reflect on your injury situation with our 8 PRACTICEs checklist to either get back in the game sooner with the least harm or stay in the game longer. Make a plan with realistic goals. Intentionally adjust your surgical practice to recover well. Repeat until Well! Try the SurgeonMasters Performance Improvement Tool to assist your recovery. Check it out here.

SurgeonMasters

At SurgeonMasters, our goal is to provide surgeons with the tools they need to build sustainable practices. We offer a variety of educational materials including regular blog articles, podcasts, webinars, and in-person meetups. We also deliver surgeon and physician coaching to individuals and teams to power improved performance inside and outside the OR. Contact us today to learn more about our offerings, or join our mailing list to stay up to date with the latest from SurgeonMasters!


Source: Epstein S, Sparer EH, Tran BN, et al. Prevalence of Work-Related Musculoskeletal Disorders Among Surgeons and InterventionalistsA Systematic Review and Meta-analysis. JAMA Surg. 2018;153(2):e174947. doi:10.1001/jamasurg.2017.4947

I Can Fly And Miguel Is Teaching Me

Miguel was part of a team that broke the world record in skydiving sequential. 111 people, 3 points at skydive Chicago. Thank you Miguel for permission to use this photo.

Miguel was part of a team that broke the world record in skydiving sequential. 111 people, 3 points at skydive Chicago. Thank you Miguel for permission to use this photo.

How Does Peer Mentoring Work?

Peer Mentoring. We all do it. However, we don’t always notice that we’re doing it. That lack of awareness makes it less effective. When we’re aware of what we’re doing and how we’re doing it, we can be much more effective. I think I can explain this best by way of an example.

Taking Flight

I already know how to fly. For me, this involves buying a ticket, showing up, and having a highly trained individual (a pilot) do it for me. My goal is to get to my destination safely and efficiently.

As a kid, learning to fly didn’t work out so well. I had unrealistic expectations, no equipment, and inadequate training & practice. I would flap my arms as hard as I could and jump from a tree, but I always ended up crash landing.

However, I have a surgeon friend (Miguel) that knows several ways to fly. While he might describe it otherwise, from my perspective Miguel is an expert. Miguel has clocked over 800 hours as a private pilot. He’s also jumped out of an airplane over 2400 times.

You’re probably thinking he must be crazy. My thought was “How cool!” While one of those used to be on my bucket list, my maturity has allowed me to understand that my knees, back, and neck are in no condition to tolerate that experience. Rather, my “how cool” thought comes from how much I enjoy learning about other surgeons’ fitness, mindfulness, or recharge activities. Miguel has been able to create longevity in his career by maintaining and expanding his skills inside and outside of the operating room.

Peer Mentoring

So how does this apply to peer mentoring?

Peer mentoring involves helping your peers be more aware. After talking with Miguel just once at length, he responded in an email:

“I have to thank you for your encouragement and your website. If your goal is to change surgeons’ lives, man I tell you,.. you are doing it!!”

Peer mentoring is not one-sided. Miguel is also mentoring me. His knowledge in areas that require hours and hours of training, significant planning, teamwork, checklists, and where the consequence of shortcuts can be catastrophic, is extremely valuable to me. It raises my awareness both inside and outside of the operating room.

SurgeonMasters

SurgeonMasters creates peer-mentoring opportunities through Meetups, Webinars, Web-Conferences and more. Contact us to see what opportunities best fit your time, energy and budget. SurgeonMasters is a continuing medical education company focused on delivering medical education, strategies and techniques overlooked or underemphasized in traditional medical training that improve practice performance, surgeon wellness and ultimately, patient outcomes.

 

The Jeff Smith Diet: How Surgeons Can Lose 30 Pounds in Less Than 12 Months

I’m going to begin this blog with a disclaimer: I am not a diet expert. I haven’t devoted my career to helping people take control of their weight, and I haven’t performed extensive research on the topic.

I am, however, a surgeon, and I know from experience what it takes to manage your weight while working in medicine. After being overweight for more than a decade, I lost thirty pounds in less than six months, and I’ve maintained that weight loss ever since. And while exercise played a pivotal role (more on that in a later blog), redesigning my diet was key.

Here’s how I did it:

#1. I Ate More Plant-Based Foods

My favorite foods used to be bacon, sausage, and cheese. I ate them constantly -- at home, while I traveled, at medical conferences, and during my shifts at the hospital. I ate these foods so frequently that my taste buds regularly requested them. Thus, when I changed my diet, I had to teach my brain to overpower my taste buds.

I did this by increasing my intake of plant-based foods. Every evening I ate a large salad topped with healthy fruits, vegetables, and nuts. I still added “less healthy” toppings such as chicken, steak, cheese, and pasta, but the vegetables balance them out.

#2. I Stopped Eating when I Felt Full

Eating when you’re already full isn’t something your body does naturally; it’s a habit you learned. For example, growing up my parents made a big deal about finishing everything on our plate. This lesson is ingrained in my brain, so to this day I have a tendency to continue eating until my plate is clean, even if my stomach is full.

If this is a problem for you, recognizing the issue is the first step. The next step is changing the habit. A great strategy is to pause halfway through your meal to check in with your level of fullness. Or, you can try only filling your plate halfway in the first place.

#3. I Reduced my Consumption of Sweets and Soda

I used to eat oatmeal raisin cookies all day long because they were always available in the surgeon’s lounge. Every time I passed through I grabbed one without even thinking about it. At home, I loved eating ice cream and chocolate. Our kids are rarely offered soda, and when they had it available, they had a one soda maximum per day rule. I was exempt. I was famous in our family for my Dr. Pepper addiction.

It was too overwhelming to stop eating these foods cold turkey, so instead I slowly reduced the amount I consumed. I started by cutting down from several cans of soda a day to one a day. A few months later I reduced to two cans a week, then to one a week, and so forth.

#4. I Drank Loads of Water

Not only do I drink water for the health benefits, I also use it to avoid overeating. For example, before dinner I fill my stomach partway with water first. That way when I eat, I reach a satisfied state sooner.

#5. I Made Unhealthy Snacks Less Available

You can keep your snacking habit and still lose weight by making unhealthy snacks less available. The best option is to avoid unhealthy snacks altogether, but if that’s not possible, pause before you indulge. Take 10-15 seconds to consciously make a healthier snack choice.

#6. I was More Careful when On-Call

Being on-call is challenging for a few reasons. First, it keeps you awake longer, so you’re exposed to hunger more often. Second, your surgical cases aren’t scheduled around mealtimes, so you’re forced to skip meals. And third, the desire for quick food when you’re finally able to eat exposes you to unhealthy choices, whether it’s at a restaurant or in the surgeon’s lounge. I addressed this challenge by planning out my meals in advance and being very aware of what I consumed during my on-call days. It required a bit more focus, but it was well worth it, especially when I hit my target weight.

There you have it -- the six strategies that helped me lose thirty pounds in less than a year. I share them not so you can follow them exactly, but to encourage you to design your own healthier way of eating. Start with your first step, then keep adding on and moving forward with YOUR goal in mind.

How many of these steps will you incorporate into your own new diet? What additional strategies can you think of to manage your weight while working in medicine?