P E R S O N A L & P R O F E S S I O N A L D E V E LO P M E N T
PUT YOUR OWN OXYGEN MASK ON FIRST by Helane Fronek, MD, FACP, FACPh
IN HIS COURAGEOUS ARTICLE in The New England Journal of Medicine, “Breaking the Stigma: A Physician’s Perspective on Self-care and Recovery,” Adam B. Hill, MD, explains his road to recovery after suffering from alcoholism, depression, and suicidal ideation. He describes a period in his career when he felt “abused, overworked, neglected, and underappreciated.” Dr. Hill states, “I felt I had lost my identity.” As a physician coach, I speak with many physicians who feel this way. Physicians are often not given the same sense of respect as in the past. We are no longer “doctors” but “providers” — as if our years of study and training aren’t considered important or meaningful. We worry about making the correct diagnosis and implementing the best treatment, and now also worry how our patients will rate us. When a patient or staff member complains, it is often the doctor who is asked to adjust his behavior to accommodate the other party.
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I rearranged the hierarchy of my needs to reflect the fact that I am a human being, a husband, a father, and then a physician. I learned that I must take care of myself before I can care for anyone else.
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And finally, we now devote unpaid hours to entering data, satisfying regulations or insurance requirements. This leaves less time for meaningful patient interactions or a life that can balance the stress at work. Dr. Hill found that taking charge of his own life was the key. “I rearranged the hierarchy of my needs to reflect the fact that I am a human being, a husband, a father, and then a physician. I learned that I must take care of myself before I can care for anyone else.” As we hear on every flight, “Put your own oxygen mask on first.” And yet, many of us put ourselves, and our own mental health, last. What might it look like if you put yourself first? What priorities would you establish? What boundaries would you create? What would you say “no” to? Dr. Hill then discusses the tragedy of stereotyping physicians who are struggling and the stigma that comes with acknowledging a mental health issue. Studies show depression affects 27% of medical students; unfortunately, only 15.7% seek treatment. It takes courage to admit we have a problem, and yet we brand anyone with a problem as damaged, weak, or incapable. So we quietly keep our imperfect thoughts and feelings to ourselves. We compare our internal insecurities with the seemingly perfect external composure of others. Being brave enough to show our vulnerabilities to our colleagues can let them know they are not alone and can establish a therapeutic, supportive relationship for us all. If we could change this perspective, perhaps we wouldn’t lose 300–400 physicians to suicide each year. The conclusion to Dr. Hill’s article focuses on building supportive networks, the “bedrock” of his recovery. From reminding you of your strength and resilience to holding you accountable to your commitment to your own wellbeing, family, friends, colleagues, counselors, and coaches can be invaluable in your pursuit of a more balanced life and healthier life. Let’s all take a stand for our own health and our own lives. A healthy doctor is the best kind of doctor for any patient to have. Dr. Fronek, SDCMS-CMA member since 2010, is assistant clinical professor of medicine at UC San Diego School of Medicine and a certified physician development coach who works with physicians to gain more power in their lives and create lives of greater joy. Read her blog at helanefronekmd.com.