• Rosalind Kaplan, M.D.

A Good Start to Fall

The first day of Fall is almost here. I'm still like a kid when it comes to the seasons. Fall is the beginning- the excitement of new beginnings, the first day of school (well, yeah, the first day is exciting and then it gets old pretty quickly, but still)... out with the heat and humidity and in with the cool, crisp air. The leaves will turn all those pretty colors and start twirling to the ground. My birthday and our anniversary come up soon...Yes, I think Autumn is my favorite season.

Through this hot, humid summer, with its gray, rainy weekends-at least here in Philly, it rained almost every weekend-I've written about a lot of heavy, negative stuff. Stress, burnout, bullying, depression, suicide. I'd like to start this Autumn with a little bit of positive thinking. How can each of us start this season with a little more energy, a little less pessimism in our roles as physicians?

For me, it's an easy answer. I'm starting completely fresh. I'm out of my old position. I'm not doing Primary Care. I'm not working for an academic institution. I'm 3/4 of the way into the first semester of my MFA program and I'm loving it. I've been in contact with lots of my medical friends and colleagues, and I still have the great privilege of working with some students. I added some medical writing and editing. Then I found that I really was missing clinical work, so...I'm going to do some Urgent Care shifts starting next month. I renewed my BLS and will be renewing ACLS. I'll also take a suturing course and a splinting course with the Urgent Care group I signed on with. I just did Suboxone training, because I had an opportunity last week. I feel like I'm learning new things and doing new things all the time. I'm doing it all on my own terms. And guess what? I'm even making a living!

I am sure that I will encounter obstacles, especially once clinical work starts again. But realizing I have choices is very helpful. There are lots of jobs out there- clinical jobs of all sorts, and non-clinical jobs doing obvious things and things that aren't so obvious. I looked at lots of them over the last few months and talked to lots of people. We are lucky as physicians- we have many more options than most of us know. I was amazed. I got offered quite a few opportunities before I found what I hope is going to be the right mix of things for me. It helped me regain my confidence and my energy to know that I have these options, and that are people out there who value my skills and my experience.

If you are working in a position where you don't feel particularly valued, it may help just to know that there are other things out there. It doesn't mean you have to go find a new job right now, nor do you have to threaten your employer that you're going to leave

. Just the knowledge might empower you a little. Think about what you need the most in your current position. Is it more support staff in your office? Do you really need to ask for a raise? Do you need your schedule adjusted to give you more control? Is it possible that you actually could ask for one important thing? Remember, you are more valuable than you think.

If the answer is no, it's not possible, think about what else might help your situation. Is there any wiggle room for you to shift anything? Can workflows be improved in your clinical office? Can you afford to drop one clinical session a week to give you better balance? From reading lots of the 'burn-out' literature, it appears that chaotic work environments, lack of control over schedules, and interpersonal stresses in the office are several of the most toxic factors for doctors. So if you are plagued by one of these three factors (or all of them), even making one small improvement might make your daily life better. If you don't have ideas, you might think about consulting your Employee Assistance Plan, your faculty Ombudsman, if you have one, or, perhaps, a trusted friend to get an opinion.

Ultimately, it's not your responsibility to fix everything, of course. I don't want to leave anybody feeling that I think it is. The huge systemic problems are not disappearing. I'm just suggesting taking any little bits of control you can.

Remember, back a bunch of posts ago, I quoted the ACP CEO saying 'we can't yoga our way out of this.'

I still fully believe that. But I also believe that we can each try to take care of ourselves, and each other. So that's another thing. If you've got a friend in your clinical office, make sure to look out for each other. Try to sneak out for lunch or coffee, or just have lunch in the office together, but shut the door and have a chat. Check in. Be there for each other. It makes a huge difference to know that there's a caring presence around each day. Reaffirm each other's value, because it's easy to forget!

#physiciandepression #patientcare #physiciansuicide #physicianburnout #primarycare #doctor #physicianwellness #writing #medicaladministration #medicine #physician #health #bullying #narrativemedicine

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