• Rosalind Kaplan, M.D.

Self-Care 101

We all say it. Many of us believe it. 'Doctors make the worst patients.'

Is it true? I don't really know. Some of us are probably hyperaware of everything that might happen to us. Others are deniers. We do some foolish things, like work when we're sick, but probably not because we want to. More because we feel like we have to because we have full schedules every day and there's no contingency plan. But in truth, doctors, as a group, are physically healthier than the general population.

Here's some US statistics:

- 22% of the population as a whole exercises 30 minutes or more at least 3 times weekly, but 58% of doctors do.

-in the general population, 40% of men are overweight, and 32% are obese, but while 37% of male doctors are overweight, only 5.3% are obese

-in the general population, 28.6% of women are overweight, and 35% are obese, but only 26% of female doctors are overweight and only 6.2% are obese.

-in the general population, 18% of people smoke, but less than 2% of doctors do.

-doctors overall drink less alcohol than the general population

-doctors have less diabetes and less hypertension than the general population. Rates of hyperlipidemia, MI, cancer and asthma are about the same.

-doctors have longer life expectancies than other professionals!!!!

While that's all good, here's where we fall down on the job of taking care of ourselves:

-2/3 of attending physicians say they are sleep deprived at least 3 days weekly

-Multiple studies show that doctors are less likely than other people of similar socioeconomic status to see a doctor when they're sick.

-1/3-1/2 of US doctors do not have a source of regular healthcare

-92% of physicians admit to prescribing for themselves at some point

And then, of course, there's our mental health issues, but let's stay out of that, just for one post...

or not, because anything we do to help our physical health is a boost for our mental health, too. We can't separate our minds from our bodies- something we try not to forget with our patients, and something we shouldn't forget with ourselves.

What are the biggest barriers to being healthier? What are the barriers to allowing ourselves the care that we would expect our patients to get? Well, surveys of physicians tell us the a big one is embarrassment. Over 70% of doctors worry about being seen as weak or about over-reacting if they reach out for help when they are not feeling well. We feel like we have to be REALLY sick to deserve attention. Another reason is denial. ME? I CAN'T BE SICK! THAT ONLY HAPPENS TO PATIENTS!

Strangely, medical knowledge stops us from getting help. We think we know what's going on. Or we don't and we realize that probably nobody else is going to either, or even if they do, they might not be able to make it better. Then there's that big one, the one we all use as a reason, but it's really an excuse. I DON'T HAVE TIME. Really? You can't move your arm, but you don't have time to see a doctor because you have to keep seeing patients? That's what I did for many, many months. The pain after surgery was nothing compared to the pain I'd had for all those months. I felt pretty foolish for waiting that long. Nobody is indispensable. Besides, you're likely to end up disabled for longer if you don't attend to the problem appropriately.

Finally, it's hard to be a physician-patient. It's not easy to find that person, the one with whom you feel safe, both medically and psychologically. The one who treats you like a patient, but doesn't talk down to you. The person who will understand your panic or your denial or whatever weird reaction you have to your symptoms that COMES from being a doctor and knowing just enough to be a danger to yourself.

So what's the bottom line?

We need to keep ourselves healthy. We need to treat ourselves the way we know we should treat our patients, the way we want our patients to treat themselves. If our jobs as physicians are making it difficult to do that, it's time to start advocating for a healthier work environment.

We need regular meals (I don't want to be told that I shouldn't need to eat lunch just because someone else can get by just fine without it), we need adequate sleep, and we need regular exercise, just at a baseline.

We shouldn't be treating ourselves or getting 'curbside' consults or treatment. If treat a colleague or a friend, we need to take their care as seriously as any patient's care and follow up the way we would for anyone. It's not a 'favor' to prescribe or otherwise treat someone without the evaluation and monitoring that you know is right.

Best case: have a personal physician. Work with that person. Get your screening tests and your vaccinations. Seek help when you are sick. Don't work when you are too sick to work. Your patients will likely understand. Doctors are people too.

#physiciandepression #patientcare #physician #medicine #physicianwellness #doctor #primarycare #physicianburnout #patientsafety #health #selfcare

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