How doctors can cope with stress

by Walter van den Broek, MD, PhD

Often I ask my residents that if you can’t take care of yourself, how do you expect to take care of your patients?

Or in another way: the only difference between God and a doctor is that God knows he’s not a doctor. These sound like cliches but there is some truth in them. In short, doctors are just ordinary people with ordinary problems who can make mistakes and who should look after themselves.

But how to take good care of yourself in a job as a doctor or even a resident? Working as a doctor can be very stressful. To much of this stress can lead to problems such as burnout, depression, or alcohol misuse. Most doctors think they can cope with this stress but they need good coping strategies. Doctors normally just keep on working. Run from the first to the next problem without paying attention to their well-being.

This experience is recently supported by research. From this study it was evident that often workplace coping strategies of doctors were inefficient and increased the risk of emotional exhaustion. The most prevalent coping strategy was “just keep on going,” “soldier on” or “get the job done.”

… I don’t think I do much to deal with it at work. I just keep, keep, keep on going and I’m somewhat obsessive compulsive I think. I know I am and I think that most doctors are quite frankly. So part of what relieves my stress is getting everything done. And if I have a dictation that’s hanging over my head like I did today, that stresses me, so I try and get that kind of stuff done … I relieve stress by continuing to work. I mean, it’s kind of sick

This coping strategy is associated with higher frequency of emotional exhaustion. Other coping strategies with high risk on emotional exhaustion were: keep it to myself, go on as if nothing happened. It’s inefficient and can mainly be classified as denial responses to stress.

Better coping strategies were: talking to co-workers for emotional and informational support, using humor, joking with staff about stressing incidences. The best coping strategies were those used outside of work such as spending time with family, talking to one’s spouse and physical exercise were associated with lower frequency of emotional exhaustion, they were much healthier coping strategies. They improve mental health in stressful work, they’re better in coping with stress.

These differences between bad and good coping strategies were consistent with previously published work on this subject. Moreover, it has been shown that time away from work, switching off mentally and enjoying a psychological detachment from work during off-job time, and other leisure activities that allow recovery in between work periods result in positive benefits.

Walter van den Broek is a psychiatrist who blogs at Dr. Shock MD PhD.

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  • Pieter Kubben

    Mindfulness or other meditation may be better than currently considered. I am experimenting a little at the moment…

  • BobBapaso

    “Stress” is an engineering term and has no place in psychology. It has been misappropriated by weak minded foggy thinkers. Until you can say what you want to say without it, you don’t know what you are talking about—unless you are an engineer.

    Usually when people use the word about themselves they really mean, “I am feeling anxiety.” Anxiety is the normal emotional response when the idea, “I might possibly be in some kind of danger,” creeps into the mind. If you are in danger, get out. If you are really not in danger because you are behind in dictation, recognize that. Problem solved.

    Medical practice is largely a technical procedure, eg, removing a brain tumor, during which concentration on the task is required and emotion is not appropriate. Concentration is tiring. When you get tired, rest. Airline pilots and truck drivers are required by law to rest after a certain number of hours on the job. Doctors are supposed to be smart enough to decide for themselves when they need to rest.

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