Blog | Monday, September 29, 2014

Do we model good lifestyle choices for our students and residents?


The Wall Street Journal has a very interesting Expert Panel comment on What Is the Most Common Piece of Advice Doctors Give—But Don’t Take?. Their opinions are worthy of a quick read, but I would like to challenge us in a different way.

Charles Barkley famously once said, “I am not a role model”. In our position (clinical educators), we are role models. Our students and residents aspire to become like us. Do we role model good health behaviors?

We do better than average. I almost never see physicians who smoke in 2014. We have accepted this advice in far greater numbers than the average person.

What about exercise and weight control? I do not have data, but truly obese physicians seem less common that truly obese people at the mall. Many physicians do exercise regularly.

We tend to work too hard and accept too much stress. Our learners see that, and often consider “lifestyle” fields.

When we embrace a healthy lifestyle, our learners take notice. As I have lost weight and taken up running, so have many residents.

Burnout remains our biggest risk. We must improve how we approach our profession to decrease burnout. My friend and colleague, Mark Linzer who works at Hennepin County Hospital in Minneapolis, has carefully researched this problem. Too few of us in academics have embraced his work, Doctor burnout: Nearly half of physicians report symptoms.

The burnout rate is nearly twice as high as in an earlier report by physician Mark Linzer, director of the Hennepin Healthcare System in Minneapolis. He is not associated with the Mayo study. He found 26.5% of doctors complain of burnout.

The doctors in the Linzer survey typically reported more than one symptom, but, if left untended, the doctors surveyed in the Mayo study could reach that point, too, he says.

“Control is the biggest predictor of burnout across the board,” Linzer says.

Among control issues that add to stress:
How many patients you see.
How much time you have with them.
How many different types of patients you might see in a short period.
When you might have to release someone from the hospital.

He adds team-oriented approaches could help ease the pressure: “It used to be all about the clinician caring for the patient. Now it needs to be the clinician, nurse, care coordinator and others. When you start expanding the numbers of types of people who are caring for a patient, that helps a doctor and patient a lot.”

As academicians we should embrace this research, and change how we teach and role model. We need help from administrators and physician leaders. We need to focus on teamwork. We need to focus on the person not the numbers.

We can help our learners the most when we address this issue strongly.

db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Regional Associate Dean for the Huntsville Regional Medical Campus of UASOM. He still makes inpatient rounds over 100 days each year. This post originally appeared at his blog, db's Medical Rants.