by F. Brent Keeler, MD, CMS Past President
Featured in the July-August 2019 Colorado Medicine Colorado Medicine.
Physician wellness and its inverse, burnout, is about the culture! The word “culture” is overused – and yet, it applies here. Hopefully, we are evolving from a destructive and negative “culture.” Where have we been – and, where will (or should) this evolution take us? Here are a few thoughts about the “then” and the “now.”
From our earliest experiences in a “learning environment” we future physicians are rewarded for certain behaviors and attitudes. The incentives all seem to line up to reward and value resilient, rugged individualism. Our early credentials – GPA, scores – are strictly individualized. We begin to adopt an isolated – and solo – sense of our own successes – and failures. As our career unfolds, we are then asked to become collaborative and team-oriented. Most of us actually make this transition with minimal disruption. Some of us? Not so much.
“Asking for help is a sign of weakness.” This is the “resilience” piece. It’s part of the life of a physician. Our patients have a right to expect some resilience from us. Yet, we cannot possibly be “resilient” against all of the stressors that impact us. A little help along the way might do wonders. It is here that the “culture” blocks the road. We are reticent to ask for help and reluctant to offer it.
Collegiality and friendship? I submit that these often mean essentially the same thing. They are intertwined and interdependent. If we open our hearts, minds and eyes, a “troubled colleague” may just be in need of a friend. A few moments of empathetic listening, a.k.a. a “cup of coffee conversation,” may help your colleague begin to turn that proverbial “corner.”
We physicians are “fixers” – we want to fix what’s wrong! Beyond listening, this probably won’t work out in the case of a troubled colleague. We sense that this is true and thus arises the reluctance to “offer help.” Few of us have the training and experience necessary to really help our colleague. Let us instead be “connectors,” helping that colleague engage with the right resources. It might be as simple as mentioning a forum at your hospital (and maybe accompanying your colleague to the forum) or encouragement to self-refer to a state physician health program.
Your colleague is not radioactive – or infectious. The culture says to keep your distance. But wait! Doesn’t that then leave your colleague with a sense of abandonment? Maybe this is the time to be a friend?
The era of denial is over. The culture that says “resilience” is the key to everything offers a false and empty promise. We need a new culture and a new sense of professionalism where friendship and collegiality are merged.
Reach out to your fellow physicians.