It’s 10 p.m. on Wednesday night, and I’m finishing up my notes for my patient visits from this morning while I do my bowel prep for my colonoscopy tomorrow.
Now, I know we can argue the biomechanical challenges of doing both of these tasks at the same time, and this certainly may be TMI, but it struck me as I was sitting there trying to do both of these things how important our own health and well-being is to our ability to create a truly patient-centered medical model of care for our patients and our country.
We are all trying to do two things at once — and often, more than two things — and we’ve seen lots of writing by providers and articles in the medical literature about increasing burnout and worsening health indicators for practitioners trying to survive in the medical world today.
And multiple newspaper stories, journal articles, and even memoirs have been written about the health challenges that providers have had to face, oftentimes as we’ve neglected our own health at the expense of all the other things we need to do.
We’ve been ignoring that lingering cough, or attributing worsening fatigue to our busy lives. But I would argue that we need to take care of ourselves in order to take care of others.
We all know that doctors are the worst patients, and when you combine that with the old adage, “Physician, heal thyself” and William Osler’s quote, “The doctor who treats himself has a fool for a patient,” you probably have a recipe for disaster, or at least poor care.
I can imagine that as each of us sits with our patients and struggles with them to get their health care maintenance items “up-to-date”, while we are simultaneously managing their acute and chronic medical conditions, trying to deal with our daily administrative and regulatory requirements, and navigating the lumbering electronic health record, we oftentimes look at some action that we’re ordering for them and say, “Hey, don’t I need to do that?”
When was the last time that you, a health care provider who knows best, saw your own primary care provider? Are you prescribing medicines for yourself, or having one of your partners send in prescriptions for you? Ordering your own labs, and reviewing them yourself?
I guess all I really want to say is, to take care of everyone else we do need to take care of ourselves, especially as we try to double down and reinvigorate our efforts to fix this broken health care system.
I would like to take advantage of having this soapbox, this place where I get to talk, to make sure we all get the health care we need so that we can be here tomorrow to take care of our patients and transform this country’s messed up health care system.
Do something for yourself. Please.
Schedule an appointment to see your primary care provider. (If you don’t have one, get one. If you don’t know anyone, let me know, and I can help you find someone good!)
Get your mammogram done.
Have your cholesterol checked.
Have your PSA checked, if you think that’s right for you.
Get your colonoscopy done.
Get your diabetes under better control, quit smoking, eat healthy, get some exercise, get some sleep.
Overweight, snoring, waking up exhausted? Get a sleep study.
Tired? Maybe you really are hypothyroid or anemic or something else (although we often just chalk this up to life).
We all know all the things we need to do; we do them all day long for all of our patients. All I’m asking is for us to imagine our own charts, and all the unclicked boxes we have, and now, as we head into the holiday season, to take a moment to make sure you’ve done all you can for yourself, so you can continue to do so for others.
Please, do me a favor, look to yourself and what you need, and get some of this done.
If you don’t mind, reply to this column with a comment, and let me know that your health care maintenance is up-to-date, that you set up a colonoscopy, that you had your pneumonia vaccine, that you saw your gynecologist, and that you went and saw your primary care provider and let them be your doctor, instead of you having to do it for yourself. Maybe you won’t get yourself all up-to-date right away, but each step is a start.
This will make the discomfort of prepping for my own colonoscopy seem worthwhile.
Fred N. Pelzman is an associate professor of medicine, New York Presbyterian Hospital and associate director, Weill Cornell Internal Medicine Associates, New York City, NY. He blogs at MedPage Today’s Building the Patient-Centered Medical Home.
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