New Year’s resolutions for healthcare
Five resolutions from a physician who doesn’t believe in them
By Dr. Joshua Landy
New Year’s resolutions don’t work. The evidence on that is clear, and in healthcare, everything we do should ideally be based on evidence. Generally, I believe in constant improvement — so I try not to wait until New Year’s to make resolutions. I think the act of setting (and achieving) goals should be an ongoing process, especially in healthcare where everything takes so agonizingly long to do. But if I were to identify goals I’d like to focus on — and that I might humbly prescribe to my fellow healthcare professionals — in the new year, these would be my top five:
Resolution #1: Promote self-care and prevent burnout
The type of people who pursue a career in medicine are typically the same type of people who feel obliged to stay at the office after hours. There’s a social expectation that physicians need to be available and devoted to their work at all times. Of course, when you’re on duty, that’s true. But many healthcare professionals have not learned the skill of making time for self-care, and we see it in constant reports of burnout, depression, and general unhappiness.
Nearly half of the physicians, residents, and nursing professionals we surveyed on the Figure 1 app reported feeling very or extremely burned out — and these are the healthcare professionals engaged enough in their professions to contribute to a global professional network. There’s no easy solution, as few of us can resolve to allocate more money to hiring. What I can do is recognize the life-saving work my colleagues are doing each day, and be more present in life outside the hospital. I believe this can only improve the quality of my work. Remember: You can tell someone they made your day every day, and in doing so you’ll likely make their day.
Resolution #2: Help reduce unnecessary treatments and tests
Choice overload is familiar to anyone who’s gone grocery shopping, and it’s time to realize we have the same problem in healthcare. And if we’re not sure which tests to order, it’s too easy to just blanket-order them all. Think of the broad-spectrum antibiotics that are routinely over prescribed, leading to the very worrisome increase in drug-resistant bacteria.
Let’s promote a culture where there are no defaults. Patients are unique individuals whose situations often demand customized solutions. Yes, it’s comforting for a worried but otherwise healthy patient to walk out of a doctor’s office with a prescription or a referral, but I’ll remember that such comfort comes at a cost.
Resolution #3: Help others learn something new
This year, I will focus on becoming a better teacher and student. I’ve been inspired by some amazing teachers, some I know and some I’ve never met.
For instance, a cardiologist who put pencil to paper to teach a nurse practitioner on Figure 1. “I need help developing a mental picture of this child’s heart,” the nurse practitioner had written. While our platform is intended for photographs, some of the most interesting cases we’ve seen use the technology in ways we never would have predicted. From the nurse’s description and a few followup questions, the pediatric cardiologist was able to put pencil to graph paper to create a detailed illustration. It was truly amazing to watch as the cardiologist answered questions from healthcare professionals and posed some of her own. “Does everyone understand the blood flow?” she asked. “For example, can anyone tell me some complications of this type of circulation and why it happens?” Though my medical illustrations are merely so-so, I hope to go above and beyond when I see a teaching opportunity like this in 2017.
Resolution #4: Practice what we prescribe
Healthcare professionals know what we should do to stay healthy. Unfortunately, that doesn’t mean we always do it. The holidays can present special challenges. When we asked practitioners on Figure 1 how they keep from gaining weight during the holidays, 30% of them said they’d worry about it in the New Year instead of taking preventative steps now.
This year, let’s resolve to practice what we prescribe. With more than two-thirds of Americans now classified as obese, it’s more important than ever for healthcare professionals to be role models for healthy choices.
Resolution #5: Quit smoking
We’ve come a long way from the days when a doctor would suggest a cigarette for digestion, so far that it’s easy to think we’ve all but won the war on tobacco. But then you hear the Surgeon General sounding the alarm on e-cigarettes, the not-so-safe alternative that is worryingly popular with teenagers and young adults. Formal guidelines and public health campaigns have not kept pace with this reality. I’ll do what I can in my practice to make clear that the science hasn’t changed: Nicotine is still harmful. And what’s more, I’ve seen cases of exploding e-cigarettes that doctors and nurses have shared on Figure 1. The safest alternative to smoking will always be not smoking. Or as I tell patients, it’s better to be stabbed with a clean knife than a dirty knife, but it’s far preferable not to be stabbed at all.
In healthcare, we describe our profession as more than just a job — it’s a way of life. For our patients, our colleagues and ourselves, let’s resolve to ensure it’s a healthy way of life.
While any healthcare professional would be glad to hear that a smoker is trying to quit, not all methods carry the same risks. E-cigarettes have become increasingly popular as a cessation aid, but the U.S. Surgeon General warns they have “major risks”. Healthcare professionals agree. A Figure 1 survey asked 3,614 healthcare professionals what they do in their practices, and the response was clear: 71% of doctors and nurses said they never recommend vaping. In addition to concerns about nicotine and a lack of regulation, they raised concerns about malfunctioning devices and negative side effects.
In 2017, let’s resolve to help our patients make informed choices about how to quit smoking.
Dr. Joshua Landy is the co-founder of Figure 1, a global case-sharing app for healthcare professionals, and a practicing critical care specialist.
