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 a survey 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?
MY OWN STUBBORNNESS ABOUT ASKING FOR HELP
This post has explored my own struggles with burnout, depression, and hopelessness that were the result of my ex-husband’s addiction while I was a practicing addiction psychiatrist in a major healthcare system (for example, see “Dangerous Hope vs. Daring Hope”). Fortunately for me and my patients, I did not make clinical mistakes during this hard time in my life: I did not incur disciplinary action nor was I put on leave. However, I did suffer a lot through this hardship and that suffering did rattle my belief in the healthcare system and in my own confidence about and commitment to my career path.
Believe me when I admit that I would have agonized a lot less if I had had the courage to say “I need help” a lot earlier than I did. Speaking those three words to some trusted colleagues did change my life in positive ways I could have never imagined! I got connected with a mental health counselor, with an Al-Anon support group for family members of persons with addiction, and with the Gestalt training program in Cleveland. Through these therapeutic and non-therapeutic supportive experiences, I stopped hoping my ex-husband would change and started to look at how I might, instead, make some hard changes for and about myself.
A GREAT LESSON LEARNED
Three months ago, I had a planned surgery followed by complications, which resulted in an additional emergency surgery and an extra eight weeks in recovery. As an otherwise healthy 50-year-old, I was devastated by my body’s betrayal. I had always trusted my body’s ability to stay well, heal, and work in all the right ways. I certainly did not expect a near-death experience that required three blood transfusions, more days in the hospital, and a prolonged outpatient recovery process. My internal outrage sounded like this:
Doctors are not supposed to get sick!
I am not supposed to get sick!
I don’t have time for this.
I am getting ready to start a new job.
This is not the way I had planned my life to go.
Though it was difficult for me to ask for help, this time I did it immediately, and I am convinced that the assistance I received advanced my recovery. As I was healing, I was unable to do many things that I take for granted, like driving, walking two flights of stairs, participating in yoga, lifting heavy objects, and running simple errands. In my head I felt fine and ready to tackle the world, but my body needed to pause and rest.
Almost overnight, I became dependent on other people. My doctor advised that I spend most of my time sitting down or lying down and doing very little physical activity. I had to ask my 70-plus-year-old parents or my 18-year-old daughter to pick me up, drive me around, and drop me off like a 12-year-old. I even had to use a stepstool to get in and out of my car. Imagine the horror! I had to ask my sister to do the grocery shopping. I had to ask my daughter to take the dog on my share of the walks every day, to pick up my share of the chores around the house, and to take out the trash each week. Other family members and friends brought me food, flowers, and offered to help around the house. Thankfully, I accepted.
In addition, because of this intense and prolonged recovery, my new job at OhioPHP got delayed by almost two months. This was extremely difficult. I hated asking my new boss for extra time off before starting the job: she was so kind and gracious about the whole thing that for some twisted workaholic reason it made me feel even worse. I realized how much I need to be working and doing in order to feel worthy and useful. I was angry at myself, at my doctors, and at the world. It had been a long time since I felt this upset. In short, I was afraid. If I could not do my job, then who was I as a person? What good was I? How was I contributing to society?
WE CAN CHANGE THE WAY WE TREAT OURSELVES
My new job at OhioPHP involves helping healthcare professionals in Ohio who are struggling with burnout, addiction, emotional suffering, mental illness, and other behavioral conditions. I realize that my difficulties with asking for help are not unique. I hope that my experiences with managing feelings of denial, shame, and unworthiness related to asking for help will be beneficial to other healthcare professionals who may be in a similar and very vulnerable space.
WAYS TO ASK FOR HELP
Ohio Professionals Health Program
If you are a healthcare professional who needs help, the Ohio Professionals Health Program (Ohio PHP) provides a compassionate, supportive, and safe environment for you to receive confidential services to improve your health and well-being. For more information, contact us today:
Caring for your physical and mental health can help you stay at the top of your game as a healthcare provider. But often, the demands of practicing medicine and life in general can get in the way.
The Well-Being Checkup And Referral Engagement Service is a simple, free, and anonymous checkup of your mental and emotional health.
National Institute of Health (National Library of Medicine) - Dehumanization in Medicine
National Institute of Health (National Library of Medicine) - Stress and Dehumanizing Behaviors of Medical Staff Towards Patients
Originally posted on Club Hope.