My practice had become a burden. My patients seemed annoying and overly demanding. I was living alone in a small duplex, feeling isolated. I was sleeping more than usual, yet fatigued most of the time. Any resiliency had been stretched and tested and was wearing thin.
My usual optimism was gone. I did not become overtly suicidal, but I began to have thoughts about what it would be like if I was no longer “around.”
After wallowing around in that state for a while, I took some steps to extricate myself…
- Engaged a psychotherapist and began weekly counselling;
- Started a regular practice of mindfulness;
- Spent more time with some of my closest friends, parents and siblings;
- Began exercising regularly;
- Took up some new hobbies: rock climbing, downhill skiing, and scuba diving.
Gradually, I was able to claw my way back to a life with passion, energy and hope.
I was reminded of those times during a conversation about resiliency at the recent American Association for Physician Leadership Spring Institute in New York City.
Welcome Back
It has been about four years since I last attended a formal AAPL conference. Hence, I was really looking forward to this one.
Being in Manhattan with my wife, just a short walk from Times Square, was a great start. We enjoy being in a diverse, exciting city that never sleeps, even though my wife and I were back to our room by 9:00 PM most nights.
Since we were staying at the Sheraton Times Square, it was a short walk to Ellen's Stardust Diner, where your servers and the entertainment are one and the same. There was some great talent there!
Pursuing Resilient Physician Leadership
The conference started April 19 with an all day workshop on Resilient Physician Leadership. This workshop was led by Rebeka Apple and Mamta Gautam.
This seems to be a very popular general business topic. Resilience has been taken up by the AAPL as an important subject for physician leaders themselves and for the physicians in their organizations.
This may be in response to the apparent increase in physician burnout. Burnout is an issue that threatens many health systems and, while not a disease per se, has been associated with depression and suicide.
All of the registrants for the course completed the CPI 260 prior to arriving. This tool is one of several California Psychological Inventory™ instruments that can “help people gain a clearer picture of their personal and work-related characteristics, motivations, and thinking styles.”
Dr. Apple brought the Client Feedback Reports for each of us to review. So we spent time talking about the sections of the report that related to resiliency.
And we discussed useful skills needed to maintain resiliency:
- coping strategies for stress;
- the ability to maintain focus, optimism and composure; and,
- strategies for recovery when excess stress or burnout occur.
Enhancing Resilience
The second part of the workshop was led by Dr. Gautam. She started with a story.
As a young psychiatrist, she was asked to assist a few struggling physicians early in her career. This rapidly became a large part of her practice as she assisted professionals distressed by the circumstances of their challenging lives.
She came to devote much of her time to improving physician wellness. She spent years increasing awareness of physician health issues, treating colleagues, and creating a network of resources for physicians in distress. Now she devotes time to coaching physicians to learn strategies to keep well. Many can be used to enhance resilient physician leadership.
Here are the danger signs of increasing stress that she described:
- More frequent physical ailments and illness
- More problems in relationships
- Increasing frequency of negative thoughts
- Accumulation of bad habits
- Exhaustion
Additional Skills
She presented her approach to enhancing personal and professional resilience and described the FIVE C’s of RESILIENCE:
- Control – not of our circumstances, but of our perceptions about our circumstances
- Commitment – remembering our values and prioritizing them
- Connections – using our personal and workplace support systems
- Calmness – self-regulation, meditation, and mindfulness
- Care for Self – through exercise, nutrition, sleep and time alone
I found the workshop to be quite interesting and applicable to my life. Fortunately, I had already implemented many of the suggestions, but there are several that I don't use as much as I should:
- I spend less time with my parents and extended family than I would like.
- Time with close friends is very limited. For example, I recently wrote about a friend that passed away, and my regret for not having spent more time with him.
Finally, in addition to time for learning, there was plenty of time to network and meet new colleagues. I was impressed again by the breadth of backgrounds of the participants. Hearing about their varied experiences was very inspiring.
My Conclusions
I have been severely stressed at certain times in my life. And I wish that I had a better mastery of the skills presented in this workshop earlier in my career.
Resiliency is a leadership topic that will be increasingly important, and one that should be taught to our physician colleagues.
Next Steps
- Read more about resilient leadership. You can start by reviewing Harvard Business Review the article mentioned above, and this interview with Eric Greitans.
- Join the AAPL if you're not already a member and attend a live course or access one of its online courses.
- Subscribe here.
- Take a short survey: Survey Page
Recent Interview by Future Proof MD
FPMD was kind enough to post a written interview with me at Future Proof Docs – The Vital Physician Executive. Check it out and look around his site for useful financial information.
Feel free to email me directly at john.jurica.md@gmail.com
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