Q. Can you please give us an overview on your experience working with health practitioners requiring rehabilitation?
A. For several years I worked at a rehab program that specialised in treating doctors with addiction and mental health issues. We also had a nurses and pharmacists program. Having treated hundreds of healthcare professionals who weren’t able to cope I can provide some unique observations on the topic.
Q. What are the common stresses for health professionals?
A. The stresses for the field span a wide range. Some end up in the profession without fully thinking through what they want. They may do so because their family expects them to be a doctor but their heart isn’t in it.
Some I have seen really underestimate the amount of commitment needed in certain specialities for example. It may be very prestigious to be a brain surgeon. However, there is the consideration that you are often on call & need to be ready to do a difficult & lengthy surgery at any moment. This may not be at all compatible of your other goals in life like being an involved parent and coaching your children’s sports teams etc.
Others cave to the pressures of making a small practice profitable. For some running a solo or small practice may be a very lonely existence that isn’t suited to their personality etc. For folks to survive let alone thrive they should consider making time to accommodate their needs both personal and professional so that they can live a life that is in balance. Unfortunately if they don’t they may resort to drugs or become depressed.
Q. In your experience, are there certain areas of practice in health where you have seen more practitioners requiring rehabilitation?
A. In my personal experience I have seen more clients present with stress, anxiety, depression or substance abuse issues from the areas of surgery, emergency medicine and anaesthesiology. I have seen far fewer doctors who practice in areas like dermatology, ear, nose & throat etc.
As with most things in life that could be attributed to multiple contributing factors.
However, taking into consideration the environment that these different specialties practice in would ultimately have a significant impact on the practitioners coping abilities.
There was a client I had several years ago who made the choice during medical school to specialise in dermatology so that she could have the ability to set her own office & surgery hours since having a family was another one of her priorities. Her husband who was also a physician had chosen another speciality with the understanding he wouldn’t be the primary carer for their kids. He later burned out and spiralled into depression and drug use which is what brought them into my office when they were then in their 40’s. I saw them as a family therapist at a drug treatment program specialising in addicted doctors.
With the emergency room doctors think for a minute about the pace and pressure that these folks deal with each shift. They are expected to deal with an ever increasing volume of patients in a short amount of time. To complicate matters they will be on multiple cases simultaneously and never know what is walking in the door next. They often need immediate responses to crises that need to be correct. In terms of work life balance consider also that the ER is 24 hour unlike the private dermatology office mentioned above. So they will be working hours that may not be compatible with hobbies, friends, family or other elements of their self-care that would help prevent burnout. Even if they are not the usual worker on the night shift they may be asked to do this on a rotation basis or be on call for weekends and holidays. Again making it difficult to maintain balance in their personal lives. This sort of impact isn’t something the public or for that matter doctors in training always fully appreciate.
Q. Can you comment on work life balance in preventing burnout?
A. Work life balance is at the heart of preventing burnout. The tricky part is that the research shows that what balance is varies based on a host of factors e.g. culture, personality, values etc. So even a supportive workplace has a hard time creating programs or benefits that best suit a range of different employee’s needs. Some of the more universal suggestions would be maintain a meaningful social support system, look after your health i.e. diet, exercise, sleep, make time for the activities that help you recharge be they travel, reading, even lazy days at the park with the family. In a way this whole concept goes back to the old saying are you the person who works to live or lives to work?
This leads into the importance of considering your motivations, values as well as interests when selecting a career. The area of vocational assessment has evolved over the years from looking at primarily skills or technical ability to also including more nuanced elements like personality traits, values etc.
Q. How do values play a role in burnout?
A. There is a good base of evidence that factors e.g. personality, values etc. are very good predictors of engagement, as well as longevity in a position. Career assessments have begun to focus more on these factors as well so that people as well as companies can make sure they are making the best choices possible to get a good fit.
Even if you aren’t planning on meeting with a career counsellor or coach to help you sort out your career choices it would be wise to spend a lot of time reflecting on what makes you happy, what drives you etc.
For example are you really motivated by power? This may seem like a dirty word but you could also think about this as someone who is driven to be a leader or manager.
Is money something that dictates your decisions? Yes, we all need a certain amount to get by but that standard of living that each of us define as comfortable varies. If you are the type that view your job just a source of money that is a very different person from one who must have a job that is intrinsically rewarding and is the primary source of satisfaction for them.
Think about how altruistic you are. Picture your favourite professor who would spend countless hours patiently helping along budding students. This person may have more skills and abilities than the person who makes on the upper end of 6 figures & just paid off their 3 holiday home. When you scratch your head & think about why equally skilled professionals choose the options that gets the biggest pay day or the academic who may not have near the income but gets great personal satisfaction from passing on their knowledge & helping others. Neither is good or bad but highlights how this one element may play out for instance.
Similar to power may be a high need for achievement. Think of the medical researcher who is driven to make the next best drug, prosthesis or surgical technique. Factors such as personality play a major role in not only the speciality one may choose but how well suited they are at it. The classic example is a client I once had who was painfully introverted who had chosen to go into radiography. He was well suited to this since it often involved working alone but used all of his knowledge & expertise. The sort of person who is drawn to radiography or decades of research on some little known virus for example would have a very different make up than one who used their technical knowledge in a bustling paediatric practice. Making sure you are selecting a speciality that is suited to your personality as well as values will help a lot with making sure you don’t burn out trying to be something you are not.
Q. Can you expand on how values are important in the workplace?
A. One of the dynamics to consider on this spectrum would be what sort of company represents the values that you can proudly support. If you are the type that believes strongly in using medical knowledge purely to help the most people and you enjoy the human interaction you may be best suited to being a front line clinician in the trenches of public health system helping for the greater good. These folks may have a really difficult time working at a large pharmaceutical company for example. Regardless of what you think of these companies personally you have to acknowledge there are certainly the critics that call them big pharma who would never associate themselves with the way they do business. They may say they are about profits over people etc. If you are one of those who think this way it wouldn’t make a bit of difference what the pay packet was they wouldn’t find you working there simply because you don’t see their values as a company as ones you share. If by some fluke you ended up in a mismatch like this one you would have a lot of difficulty reconciling these conflicts. A similar comparison may be if one of the things you feel very strongly about is animal rights you would find it quite hard working in roles that required animal testing or surgical procedure or medications. This would be a clash that would take a big toll if you found yourself in such a position.
A really good assessment that helps explore these factors is the motivations, values and interests by Hogan. http://www.drbobhurley.com/pdf/MVPI_Manual_for_Elec_Copy.pdf
Dan Martin MS Psych, Assoc MAPS has over 17 years experience providing psychological services. Visit his website to learn more about his practice at www.personalenrichmentservices.com.au
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