Practicing medicine with all of its responsibilities often reminds me of a black hole. It seems each time something new is added it gets pushed into the vast vortex of the black hole, hidden from those around you and jumbled with everything you are expected to do.
People around you see the world as you present it. They rarely get a glimpse through the pinhole to the expansiveness that is beyond the surface. Seeing the black hole that is medicine as infinite, you hold much more than the weight of the world on your shoulders. At times, it may feel impossible to know where one task or obligation starts and another one ends.
As a physician’s career charges ahead, it can feel like you’ve left reality with no way of getting back. Physicians, you are expected to juggle too many things, and often your job is a scenario similar to this: It demands that as a physician, you fit more patients into a day than seems humanly possible while ensuring appropriate medical decision making has been made. You are expected to form meaningful relationships with patients, practice cost-effective medicine and fight insurance companies to get the appropriate treatment or therapy for your patient. Sometimes you have to stop in the middle of everything when a patient is acutely ill or dying and then continue with unchanged responsibilities or attitude the rest of the day. You have to ensure you are meeting targeted goals set forth by insurance companies, run to mandatory meetings and chart on systems that seem to slow you down. The endless tasks mentioned above feel overwhelming. And yet, they are only a small fraction of the many things in medicine expected of each physician. And this doesn’t include any of the personal responsibilities outside of work.
Most physicians are trained in an environment that prides itself on physicians representing themselves as never being overwhelmed, even when expectations of them seem impossible. As the black hole becomes more expansive, the weight of it all can be pervasive throughout your life. You start to feel tired and burned out which contributes to having less compassion and makes you more prone to mistakes. Your personal relationships may suffer, and you may even be questioning why you choose medicine at all. However, it does not have to be like this. Stop now, and reclaim those passions that first drew you to medicine! Here are five ways to get back to reality and leave the black hole behind.
1. Find a mentor (or a few). In medicine, you are not alone. Your colleagues can be a valuable and often a vital asset for improving your medical practice. Finding someone or more than one person you trust is crucial to pulling yourself out of the black hole. Given that physicians have many similar experiences, your colleagues can often offer a tip or trick of how they have successfully addressed the same problem. They can be one of the most valuable resources when you are upset or frustrated as it’s likely they’ve been in the same position before. Once you find someone you trust, be open and honest with him or her to allow yourself the greatest opportunity for growth. Utilize your mentors around problems they have faced before to help you target difficulties and brainstorm solutions that work for you.
2. Take a seat at the table. All aspects of medicine are in motion, and change is inevitable. As a physician, you have a voice that needs to be heard. Often changes in medicine impact you directly. Ensure you are present at group meetings, join a committee you feel can influence your practice or if desired become a leader within your group or organization. However, as you take on new commitments ensure they are in an area you are passionate about. Make room for them in your career from a time and energy perspective to prevent yourself from mindlessly adding another responsibility. Take a seat at the most meaningful table to you to become a part of the change conversation.
3. Remove a task or current responsibility. As your practice of medicine blossoms over the years, it is natural to slowly take on more responsibilities. It’s almost expected that most physicians will say yes when asked to help with a task or project. Physicians are groomed to be of service. However, at times you need to take a step back and evaluate everything you’re involved with, what’s become your own black hole vortex. Reflect on the parts of your practice you truly enjoy, as well as the areas that are not adding value. Choose one or two things that are not enhancing your life to remove from your obligations. And each time something new is requested of you take a moment to evaluate how it will impact your life before saying yes.
4. Work with a physician coach. At times, the shift back to reality may feel like too large of a step to take alone. Or maybe you need help achieving smaller goals to create the life you want to live. Working with a coach can provide you the opportunity to envision your best life in medicine and help you take steps towards it. Coaching is a safe (and confidential) space in which you work together to reflect on how to best reposition yourself towards happiness. It gives you the opportunity to sort through the many aspects of your life that have contributed to the black hole you’re floating through. Coaching is a valuable resource to individually move you away from the black hole, reframe the reality you are looking to create and help you take the steps needed to get there.
5. See a counselor. Practicing medicine can create an enormous list of emotions each day: fear, happiness, frustration, anxiety, guilt, joy and anger to list a few. If the more negative emotions go on unaddressed, they can become detrimental behaviors or patterns in thinking. Seeing a counselor when these emotions become overwhelming can help target specific areas to work through and restructure a healthier and happier focus. Counseling offers support in an array of mental health issues including depression, anxiety, grief, and fear. Although these may not be a clinical diagnosis for you, all physicians experience these emotions throughout their career. Counseling is a confidential space to ensure a healthy recovery as these emotions emerge.
Kathryn Schneider is a hospitalist and can be reached at the Whole Clinician.
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