“…the culture of medicine still entertains the view that persons who cannot cope, or err, or fail, or who are weak, have violated the traditional norms of the physician as a strong, independent, self sufficient perfectionist who does not and should not need help”. Dewitt C. Baldwin Jr., M.D.
Recently, I attended two medical conferences, one national and one regional and I was encouraged that the topic of physician burn-out and physician well being were presented at both venues. In the medical profession itself, we have known about this problem for quite some time but we really have not done too much about it and what has been done is not yet embedded in the psyche of the culture of medicine.
Annually about 300–400 physicians complete suicide every year. The suicide rate for male physicians compared with age matched controls in the general population: 1.41 higher. The suicide rate for female physicians compared with age matched controls in the general population: 2.27 times higher. [Schernhammer E, Colditz G. Am J Psych 2004]This is a big and growing problem, tragic and sad because how, you might ask, in a field where service and helping people is at the core, can this continue to be true?
I love being a healthcare professional, coming to my career in medicine later in life after a successful career as a dance educator, choreographer and performer, I really do see the ’arts’ in medicine and the potential for this field to be transformative for both the physician and the patient alike. However, as a profession we must do everything that we can to let go of this highly regarded culture of medicine value that the physician is a ‘self sufficient perfectionist who does not and should not need help’. It is killing us; and before it kills many of my colleagues travel a long road of depression and/or substance abuse.
We do know that medical students matriculate with better well being than their age group peers and then sometime early in medical school this reverses. Poor well being then persists through medical school and residency into practice. [West CP et al, JAMA 2006; Desai et al, JAMA 2013; Sen S, JAMA Intern Med 2013] This suggests that the place to begin prevent physician suicide, depression, and substance abuse is on the first day of medical school where at the very least courses in mindfulness can be woven into the curriculum with additional mind body medicine modalities that would required for each year of medical school and graduate medical education. This would serve to not only teach self care to our medical students and Residents across all medical specialties but it would also give the physician a very useful skill set that he or she could then pass on to their patients. This ‘self care’ model as pioneered by Dr. James S. Gordon and The Center for Mind Body Medicine, www.cmbm.org has been successfully implemented into a few medical school curriculums and steps are being made to incorporate this model of self care into a hospital system that would like to become a healthcare system that reflects self care for it entire community of employees and patients.
For me personally, coming into my medical training with an established yoga and meditation practice helped me to deepen my desire to help both my colleagues and my patients learn mind body medicine modalities as real alternatives to pharmaceuticals for pain relief, anxiety, and depression. Now as we take stock as a profession, it’s time for already established medical professionals, physicians who are trained to care for others to create a wellness model where physician and patient are part of an equation that calls for well being and balance on both sides of the equation. We already have a well entrenched system of CME’s or Continuing Medical Education requirements in place. The next time I go to a conference I would like to see an entire day devoted to a physician well being tract, complete with CME’s being awarded to participants attending sessions on mindfulness, meditation, spirituality, yoga, Qigong and guided imagery or teach a session or two myself.
I can only imagine the possibilities for what health care could be, if we the Healers truly become healthy ourselves — to be continued…