Self-care is not selfish: It’s imperative to save the practice of medicine

The necessity of putting on our own oxygen mask first has never been more clear.

Bringing wellness into the mainstream culture of medicine and empowering and healing the healers so they can heal others has been the focus of my leadership work my entire career in medicine.

It took a pandemic to bring widespread national focus to this issue.  The cultural shift is finally beginning.  For the sustainability of the practice of medicine and for the health of all of us, it is time.  We must continue to keep the spotlight on the importance of optimally caring for our healers even after this pandemic has passed.

If doctors are not well, they cannot heal others to the best of their abilities. They must care for themselves so they can best care for others. The culture of self-sacrifice in medicine is outdated.  Professional athletes optimize their own health and wellness so they can perform optimally.  Physicians are asked to perform at an equally high, if not higher level, for longer careers.  Human lives are at stake in medicine.

We must start to create a culture within medicine where physician self-care is nurtured and valued.  Self-care is not selfish.  It is needed and important.  Through modeling self-care and allowing and encouraging others to do the same, we will save the most lives and the practice of medicine as a sustainable career.

I hope you will all start by starting.  Make a commitment to prioritize your sleep, to eat healthy food, to get exercise and fresh air, and to make time for connections with others as well as for recovery. If it seems hard, it is likely because judgmental thoughts about scarcity and value are getting in the way.

Breathing is another simple and accessible tool for self-care.  Many physicians hold their breath throughout the day.  Your breath is always available.  Deep breaths are healing and change the reactivity of your nervous system.  Paying attention to the breath and using it to nourish yourself and create space can make a huge difference.

Mindfulness is also an evidence-based self-care tool that impacts health and performance that can easily fit into the life of a physician. You can do it anywhere anytime. Just pause and be present.  Notice and allow.  Don’t make it complicated.  It is a practice and is not about perfection.  Use mindfulness to create space and compassion for yourself and others.  Use mindfulness as a form of preventive care or PPE for your emotional health.

Intentionally choosing your thoughts is a form of directed mindfulness.  Not letting our minds go unmanaged and causing unnecessary struggle is powerful self-care.  This is why coaching has become a lifeline for so many physicians.  Medicine and life itself are already challenging enough without adding in unintentional thoughts that make it harder.

Mindful coaching teaches you to notice and be aware of your naturally occurring thoughts.  You can’t change what you do not see. Start by noticing negative thoughts.  As physicians, we are trained to spot problems and plan for the worst.  Negativity bias causes us to feel more anxiety, fear, and scarcity.  Allow compassion for your highly-trained brain.  Opting out of self-judgment is part of self-care.

Once you notice and accept the cornucopia of negative thoughts in your head, you can intentionally shift your focus to more helpful, equally true thoughts.  This is not to minimize the challenges, stresses, or tragedy at hand.  It is to allow you to change your experience of it.   When you focus your mind on more positive thoughts, you struggle less and experience less stress, emotional exhaustion, and vicarious trauma. Choosing thoughts that highlight what is abundant rather than scarce and what is in your control rather than what is happening “to you” is like turning on the oxygen flowing through your mask.

Self-care is a gift for ourselves and for those to whom we provide care.  With our physician oxygen masks firmly on, medicine will be a more healing and healthy space for all.

May you all be well. May we all be well.

Jessie Mahoney is a pediatrician and can be reached at Pause & Presence Coaching.

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