Physician Thriving: Meaning and Purpose – Burnout and Resilience

By Hilary McClafferty, MD, FAAP

Like many of you, my work life has changed significantly over the years. These transitions have reinforced my conviction that a strong sense of meaning and purpose are integral to a sustainable career in medicine.

Take a moment to consider your current feeling of meaning and purpose at work. Where would you fall on an informal scale of 1 -10, with 10 being a high sense of meaning and purpose on most days?

If you fall in the upper range, say 7-10, that is a tremendous accomplishment and a powerful buffer against burnout. What are those things that are bringing you meaning and joy, providing you energy to meet the challenges of the day? Write them down. These are your guideposts.

If you are on the lower end of the scale, say less than 5, when was the last time you did have a strong sense of meaning and purpose at work? What work were you doing? What elements of work resonated with you? What fueled your sense of purpose? Write it down- these are your bread crumbs.

When you think about your prior sense of purpose and direction, what is different now? Changes might include your job, the setting, the people, your support system, technology, time constraints, call schedule, sleep schedule and so on.

Once you have identified some of the differences between then and now, write them down. There are clues here. Can you identify the potential obstacles, speed bumps, or closed doors blocking your way to regaining meaning and purpose in your work life?

The next important question to ask when considering your perceived obstacles is this: Which elements of the situation are actually in your control, and which are not?

Research shows that a strong sense of ‘locus of control’, i.e., an inner ‘can-do’ perspective, is a recognized trait of highly resilient people. (1) It is not that these resilient people don’t recognize the obstacle, it is that they do several things simultaneously including recognizing challenges, maintaining an attitude of realistic optimism and problem solving without fear of failure.

One of the things I’ve observed when talking with some colleagues about burnout is a profound sense of loss of control, a feeling that medicine has changed for the worse and there is little they can do about it. This concerns me because I have seen many colleagues make deep and significant shifts in their outlook, turn events in their favor, seek out new opportunities, connect with broader networks and open doors to solutions not previously considered.

If you need to refuel your sense of meaning in medicine, it may be worthwhile examining an area where you feel stymied, stuck, or stagnant. Take some time to consider these questions:

  • Can you clearly bring to mind a time you felt a strong sense of meaning and purpose at work?
  • Which elements resonated with you then?
  • If you’ve lost your sense of purpose, what is different now?
  • Does the change involve elements that are, in fact, in your control?
  • If so, focus on one small area where you can realistically make a change.
  • Then make it.

Each time you follow the breadcrumbs and act, whether it’s a step towards physical self-care or in seeking out a new job opportunity, you enhance your inner locus of control. Taking that first step, no matter how small, will provide a sense of welcome relief from feeling burned out, off course, and out of control. This allows you to make the next decision from a place of greater strength and can catalyze a positive and healthy cycle of change.

Reference

  1. Stress in America: Paying with Our Health. American Psychological Association, 2015

 

Hilary McClafferty, MD, FAAP, is board certified in pediatrics, pediatric emergency medicine, and integrative medicine. She writes and speaks nationally on physician wellbeing, resiliency, and whole physician wellness. She is a certified physician coach and author of two books: Mind-Body Medicine in Clinical Practice and Integrative Pediatrics: Art, Science, and Clinical Application, and editor of two Special Editions on the use of integrative medicine in practice. She is Founding Director of the Pediatric Integrative Medicine in Residency program, University of Arizona, and Medical Director, Pediatric Emergency Medicine at Tucson Medical Center, Tucson, AZ. Email: mcclaffertyh@gmail.com  Website: www.drmcclafferty.com  Twitter: @drmcclafferty

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Patient Care Is Our Priority

Medical organizations throughout North America understand that our rigorous certification standards prove that ABPS Diplomates are capable of delivering the best patient care possible.

Far too often, medicine is led by less than 5% of non-practicing physicians taking away and replacing the voice of the 95% of physicians practicing and placing patient safety and care first on the front lines every day. The American Board of Physician Specialties has raised the standards in physician board certification not only in the quality of their boards of certification, but in hearing and allowing for the voice of those active physicians caring directly for patients. Having been a part of the ABPS over the last 28 years has allowed me to grow as a woman leader in a field often wrought with challenges. It helped me and others raise the bar of the standards of care in my specialty, Emergency Medicine, through their Board Certification in Emergency Medicine (BCEM). ABPS also helped raise the standards of care for 21st century medicine through their certifications in other specialties, particularly in Integrative Medicine & Disaster Medicine. Having physician voices heard matters to medicine and is essential in the betterment of patient safety and care.

Sarah E. Gilbert, MD, FAAEP
Sarah E. Gilbert, MD, FAAEP
Emergency Medicine
On October 18, 2007, President George W. Bush released Homeland Security Presidential Directive 21 (HSPD-21), calling on our nation, among other initiatives, to “collectively support and facilitate the establishment of a discipline of disaster health”. It is a great testament to the wisdom and foresight of the American Board of Physician Specialties that it immediately set to work and created, within the short span of only one year, an educational blueprint and set of certification examinations, both written and oral, for a new subspecialty of disaster medicine—and it is why I chose to be part this vital initiative and this wonderful organization. This is but one of the many innovative programs initiated by the American Board of Physician Specialties over the years, and why I am proud to support its work on behalf of our nation’s public health.

Art Cooper, MD
Disaster Medicine
When the American Board of Physician Specialties offered to host the American Board of Integrative Medicine, ABPS became a landmark organization working to move medicine into the twenty first century. Certifying physicians who have completed rigorous academic training in Integrative Medicine ensures that the field of Integrative Medicine will continue to develop academically, clinically, and professionally. The leadership of ABPS continues to impress me - they are diligent in constantly innovating to provide certifications for physicians who want to advance their careers and their areas of expertise. I am honored to be a part of this organization.

Ann Marie Chiasson, MD
Integrative Medicine
There are many ways board certification advances a physician career. ABPS Board examination verifies your accuracy, precision, and reflects your mastery of your residency training verifying your expertise. ABPS Board certification demonstrates your level of expertise beyond your practice experience, primary education degrees, and training which are necessary for insurance reimbursement and practice privilege requirements. Attaining your ABPS Board Certification will clarify your purpose, secure your practice growth, and expand into leadership positions. Board certification can serve as an indication of a physician’s commitment to medicine, beyond the minimal standards and competency of training, their measurement to quality of care, and attaining an award for excellence.

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Internal Medicine
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Jerry Allison, MD
Emergency Medicine
When I decided to pursue a full time role as a physician executive it was important to me to obtain additional professional training, education and work experience. Board certification through the ABPS in Administrative Medicine is validation of my efforts and a demonstration of dedication to professional development. We need more physicians to become full time health care executives, knowing there is a board certification option in Administrative Medicine encourages physicians to take the leap from full time clinical practice to healthcare organizational leadership.

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Administrative Medicine
The American Board of Physician Specialties has provided me with the opportunity to demonstrate mastery of internal medicine through board certification. As a hospitalist, board certification is an expected credential, and hospitals recognize the American Board of Physician Specialties (ABPS) as one of the three standard credentialling bodies for Internal Medicine. Additionally, the ABPS has helped me develop leadership skills as a Board member and Committee Chairperson. ABPS has also helped me sharpen critical thinking skills as a test question developer and reviewer. The Allopathic (MD) and Osteopathic (DO) physicians in the ABPS are lifelong learners and frequently pursue multiple board certifications. I enjoy the camaraderie of my peers in ABPS.

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Internal Medicine