Homeostasis is a biologic process that is self-regulated. It is a key concept in physiology that helps our bodies adjust to conditions in order to maintain survival. It is the human body’s way to remain in balance amidst change. However, unlike a scale, of which the destination is stillness, homeostasis is a dynamic equilibrium. There is fluidity and continuous change in order to adapt and evolve with feedback and integration. It is an amazing natural engineering of our human bodies. But when it comes to the art of living, why is homeostasis and balance so hard to realize and achieve?
Wanting It All
My friend Cathy has always told me: “You can have it all, just not all at once.” I understand that – to a degree. When I first embarked on a career as a medical doctor, I knew sacrifices would have to be made. Working part time was never a thought on my mind. Medicine is life’s work. But after being in practice for just over five years, I wonder, is all life meant to be work? Or should doctors really maintain more of a work-life balance?
Burnout is characterized as a syndrome of symptoms such as fatigue, decreased enthusiasm, and increased cynicism with waning job satisfaction. It is not an uncommon phenomenon. This is especially true in medicine. Recent Medscape surveys note ranges of burnout amongst physicians to be ranging from 30% – 65%, depending on specialties. Most vulnerable populations include critical care, emergency medicine, and primary care. This response is unfortunately not unique but a serious upward trend over the last decade. This not only leads to an increase in job turnover, which can cost healthcare systems millions, but if left unrecognized and untreated, can lead to a decrease in the quality of care for our patients.
Beyond the Bottom Line
Recognizing burnout early to prevent further physical and mental sequelae is important for rehabilitation. Moreover, it is important to consider breeding a culture that is able to focus on balancing dedication and self-preservation to provide excellent care to patients, as well as providing impeccable care to ourselves. It is hard to educate, counsel, empower and engage patients about their health when many physicians are nearing if not at burnout or compassion fatigue. How can we help achieve greater balance when the demands of healthcare continues to rise?
Here are three tips to consider to improve balance while preventing burnout:
- Reflect on what is important in your life daily. What relationships, hobbies, experiences matter to you outside of your work? Write these things down. Keep them handy. Let these things help root you in times of stress. Next time it is a busy day, consider this: two feet, one breath. Read your list. Feel your feet on the ground. Take a breath. Reset and go.
- Set your priorities. Being a physician means you are going to have to have to have flexibility to adapt to the unpredictable demands of our patients. It is important to note that some days are going to demand you work outside your requested schedules in order to provide the best care possible to our patients. However, it is critical to also respect the same dedication to your other priorities. So mark those family events on those calendars. Take that trip with you have always wanted. You are more than your job.
- Saying “no” is not a bad thing. You have to consider saying “yes” to your life. Helping and serving is the essence of why many choose a path of medicine. However, your value is not enhanced by being a martyr and constant sacrificing. It is important to help out when you can and able, but consider saying “no” with a smile. Resentment from always stepping up and stepping in can creep before you know it.
Patient Centered Care
The art, science and career of medicine has always encouraged the patient to be put first. And this is demonstrated through value based care models that emphasize decreased cost of care while improving outcomes and patient satisfaction. It is important not to forget the importance of physician health and satisfaction in that equation. It is known that job satisfaction improves employee engagement while decreasing costly turnover. However, what directly impacts patients more is the fact that decrease in satisfaction of physicians may ultimately lead to less medical errors. It is reported by Andel et al in 2012, medical errors cost the US healthcare system approximately $19.5 billion. This amount is not trivial when considering the out of pocket costs continue to soar in the US. Despite many proposed models of cost containment have been developed, the concept of work life balance, improved physician engagement, and avoid burnout has not been largely recognized as an opportunity to not only improve quality of care but improving value to the healthcare system. It is in my hope as the population continues to grow, we all demand the wave of the future to embrace this challenge and find dynamic balance amidst the struggles in order to teach the importance of thrive and resilience.
Dr. Joanne Wu is a board certified physician in Physical Medicine and Rehabilitation and Integrative and Holistic Medicine. Her background extends beyond traditional medicine to encompass training as a medical acupuncturist, an experienced yoga and fitness teacher, and holistic health coach. She has passion in integrated wellness and value based medicine for both patients and practitioners.