Physicians, nurses, and other healthcare professionals are experts in helping others. However, they seem to have an aversion to asking for help themselves, especially when it comes to their own health and wellness. As an addiction psychiatrist with over 25 years of practice experience, I have gone through this struggle myself and have watched numerous colleagues engage in the same battle.
It’s as if having specialized knowledge and training in a niche of medical practice should somehow be a protective factor against our own illness and injury. Or perhaps many of us feel extra embarrassed about being perceived as someone who does not practice successfully what we preach to others. Think of a florist whose plants are wilting or a mechanic whose car is rarely working properly. A certain pride comes with calling oneself an expert, especially when you earn certifications, licenses, and advanced degrees to do the work.
I have noticed that the three hardest words for healthcare professionals to say are "I need help." It is my goal to change that.
MEDICAL TRAINING IS DEHUMANIZING
I often wonder how this habit of mind gets formed and perpetuated. Honestly, I think we medical professionals are conditioned by our training in medical school and by the daily experience of being a support to others. For instance, physician training encourages us to detach from our emotions as they arise in our encounters with patients. Our mentors teach us to rely on logical thinking and data from published research to make the best possible assessments and diagnoses. We are taught to be confident about medical knowledge and treatment protocols that are tested and proven effective by research.
Let me be clear. We are not intentionally trained to be inhuman robots. In fact, we do take courses in effective communication skills. However, until very recently, we did not take classes that teach us self-awareness, mindfulness, wellness, and how to achieve and maintain an effective work-life balance. In fact, in medical school, we are pushed to work long hours even though research continues to show that lack of sleep contributes significantly to clinical errors. In addition, we are encouraged to put our needs behind the needs of patients.
I encourage each of us to start taking care of ourselves first, so we may do a better job of taking care of others—with more energy, enthusiasm, and love for the work. Healthcare systems will not make these changes for us. We must take the initial first steps.
MEDICAL PRACTICE IS DEHUMANIZING
Another factor which conditions us not to ask for help comes from the work environment. Almost all healthcare institutions and systems are demanding that we work faster and faster to see more and more patients each day to increase "billable units" and, thus, revenue. These days, many institutions expect physicians to spend ten (10) minutes or fewer with each patient. This kind of throughput essentially transforms human beings into objects, as if patients were cars on a factory assembly line and physicians were machines attending to them. Doctors have less time to develop relationships with patients and get to know them and their life circumstances, which often contribute to acute and chronic illnesses such as obesity, lung disease, and heart disease, among others. The demands upon medical professionals and patients alike create a dehumanizing effect, which has a negative emotional impact.
Because we medical professionals are taught to detach from our emotions to succeed at work, we often lose—or do not develop a habit of—mindfulness and self-awareness about the impact of stress and burnout upon ourselves and, ultimately, upon others.
THE IMPACT OF BURNOUT ON HEALTHCARE PROFESSIONALS
In my role as Associate Medical Director at the Ohio Professionals Health Program (OhioPHP), I oversee the design and delivery of educational and well-being programs for physicians and other healthcare professionals who are experiencing health concerns, emotional conditions, and substance use disorders. OhioPHP is a nonprofit organization that provides a compassionate, supportive, and safe environment for healthcare professionals to receive confidential services to improve their health and well-being. Its goal is to inspire physicians and other healthcare professionals to seek treatment and monitoring for their illnesses to ensure quality patient care and safety.
OhioPHP recently conducted surveys of approximately 1,600 Ohio physicians and resident-physicians (a.k.a, residents) to measure their self-reports of burnout and well-being. The surveys were conducted before the COVID pandemic and during COVID. When compared to pre-COVID surveys, responses during COVID revealed that physicians and residents experienced a 200-percent increase in feeling emotionally drained from work on a daily basis and a 324-percent increase in feeling down, depressed, or hopeless nearly every day. In fact, there were statistically significant differences between median scores for all measures of burnout and mental health. Additionally, residents were more likely to report concerns than physicians.
My biggest concern is this. If medical professionals have a hard time saying "I need help" with burnout, depression, hopelessness, and addictive impulses and behavior under so-called "normal" non-pandemic conditions, what has been and will be the impact as the pandemic continues? How many medical professionals will continue to suffer? How many clinical errors will be made as a result? How many patients will suffer as a result?