CHAPTER ONE
PHYSICIAN WELLNESS—WHAT MAKES THIS BOOK DIFFERENT?
If you’ve picked up this book, there is a reason. It means that you have the courage to take steps to improve your life and your career.
It’s a tough time to be a physician. With the steadily growing demands and ever-waning rewards of our current health care system, doctors have become increasingly miserable, burned out, and depressed. And many physicians have simply had enough. In fact, nearly half of all doctors report that they are actively making plans to leave the clinical practice of medicine.i While attention is beginning to be paid to the increasing strain on physicians, most expert recommendations for improving wellness rely heavily on organizational change. Unfortunately, individual doctors have little to no control over how their organizations function. And, when physician-specific advice is given, it tends to be well-meaning but vague—like recommending that doctors prioritize self-care and find work-life balance, without elaborating on how to achieve such a feat.
That’s where this book is different.
Physician Wellness: The Rock Star Doctor’s Guide will start you on a journey of using the science of psychology to overcome the challenges that each of us face as practicing physicians. By learning to think differently, you will acquire the tools that can help you to take back control of your personal life and your medical practice.
What you will not find in this book: Generic, one-size-fits-all recommendations intended just to get you through another day.
Instead, the physician will discover specific, practical, data-driven advice that you can apply to improve your everyday life and to help you make changes that deliver long term benefits.
Be warned: this book will not be easy. It’s going to force you to develop a sense of self-awareness that can sometimes be uncomfortable. We will ask you to explore inner aspects of yourself as well as emotions that we often avoid acknowledging. That includes our own weaknesses and insecurities.
But we believe that the trade-off is well worth it because this book will help you to gain the insight and confidence to take charge of your life.
Each section also includes cognitive exercises (ROCK STAR ACTIVITIES) designed to reinforce your new skills and improve your results.
HOW TO USE THIS BOOK
Don’t be daunted!
It’s not necessary to read this book cover-to-cover or do every single exercise to be successful.
This book is meant to be a guide and a tool for your personal growth.
You can choose to read the entire book, or you can pick and choose the chapters that you feel will be most beneficial for your needs. Or, you can read it systematically, chapter by chapter, and take the time to process and practice each new skill before you move on to the next.
Again, you don’t have to do it all! Even if you take away one or two new strategies, this book will change your life.
Why psychology?
The bottom line is that psychology works—numerous studies have shown that by learning to think differently, you can change not only how you feel, but also how you behave.ii iii iv And, by changing how you behave, you may positively influence the behavior of those around you.v So, while some of the challenges in medicine may seem insurmountable, the simple act of thinking differently can improve how you cope with the problems in our health care system. Or, by thinking about your situation differently, you may find yourself empowered to make a bigger life change, such as switching jobs or even “opting out” of the traditional health care system and into an alternate medical practice.
How can this book help me?
One of the best ways to change your thinking is through cognitive behavioral therapy, or psychotherapy, usually with an experienced psychologist. But for many doctors, working with a psychologist isn’t an option—we may not be ready or able to start our own individual psychotherapy at this stage in our lives. Consider this book as the next best option: A preliminary step toward using the techniques of psychology to ease the stressors that you face as a physician.
While we encourage every physician confronting emotional challenges to seek professional psychological counseling, we hope that this book will help you to begin healing and will motivate you to encourage others to get the help that they need. We also hope to inspire an ongoing discussion about how psychology can help with mental strain while removing the stigma of seeking treatment, something that comes too late for some physicians.
WHY IS THIS BOOK SO IMPORTANT? A PERSONAL MESSAGE
This book was inspired by the sudden death of a beloved community physician, someone that Dr. Rebekah Bernard, one of the authors of this book, had known and worked with for fifteen years. Here are her words:
When I first learned of this physician’s death, I was shocked and deeply saddened—after all, he was only in his early 50s. But my shock turned to horror when murmurings from colleagues reached me—while his family had listed “natural causes” as the cause of death to avoid negative publicity, the physician had actually died of suicide.
How could this have happened? I reflected on my many years of friendship with this physician. I remembered how I often ran into him at doctor events and he always seemed so happy-go-lucky. I recalled the way I used to joke with him about how he seemed to be able to “do it all,” working in the hospital and office, while giving lectures and participating in many committees and groups.
My heart broke to think that this physician, who gave so much to his patients, the community, and his colleagues, was silently suffering to the point where he felt that the best solution was to take his own life. And this physician was not alone. Around the same time that our county lost a beloved doctor, the county just north of us also lost a physician to suicide. And across our country, other physicians are suffering, with an estimated 400 doctors dying by suicide each year.vi Physicians are experiencing increased emotional strain, often due to the burdens associated with the practice of modern medicine.vii I realized that something had to change. While we may not be able to change our system, we can change ourselves and our thinking using psychology. Fortunately, I happened to know just the right psychologist, Dr. Steven Cohen, to get this message out. Together, we collaborated to write this book to explain how you can use psychological techniques to improve your thinking and your life. His advice throughout this book will serve as a guide and a starting point to the healing process that many physicians so desperately need.
As a physician, I have personally benefited from the use of psychology—unfortunately, it took me ten years in practice to realize that I could (and should) get help. Only when I faced an existential crisis of burnout in my own life did I begin to apply psychology to take control of my own personal and professional life. In fact, some of the clinical vignettes you will read in this book (every one of them true stories) are from my own painful experiences as a physician.
Once I began to use psychology techniques in my day-to-day interactions with patients and with those around me, I saw tremendous results that inspired me to learn more. And the light at the end of the tunnel is real—after fourteen years of being owned by various corporate entities I finally had to courage to open my own practice. Within a year, the practice was full, and by two years, I was able to add a physician partner.
Despite all the positive changes in my life, I still use psychological techniques to stay at my best. After all, there will always be difficult patients and life will continue to throw curve balls. Even Rock Star Doctors can benefit from psychology!
SO, WHAT IS A ROCK STAR DOCTOR, ANYWAY?
So, when my colleagues asked me for tips on how to see more patients while maintaining high patient satisfaction, I began sharing the handouts and forms and workarounds I had created to optimize my efficiency—and from that, How to Be a Rock Star Doctor was born.
A Rock Star Doctor is a physician who is beloved by patients, has a busy and thriving practice, and manages the office with the...