Physician Thriving: Tools to Promote Thriving

By Hilary McClafferty, MD, FAAP

Much has been written about the complex challenges of modern medical practice and the prevalence of physician burnout. There is no simple answer. All of us, at every level of training, practice, and administration must step up and take responsibility for changing the current dynamic in medicine.

Mindfulness is one tool that has been explored as an evidence-based approach that can be used to buffer stress and gain perspective as one moves through daily practice challenges.

Other useful approaches are outlined in an important article by Zwack and Schweitzer (1) entitled “If every fifth physician is affected by burnout, what about the other four?  Resilience strategies of experienced physicians.” Their results are based on 200 physician interviews of physicians with an average of 14 years in practice. The takeaway message was that the valuable ability to invest personal resources in a way that initiates positive resource spirals, in spite of stressful working conditions, is highly protective against burnout over time.

Broken down, the characteristics identified to promote this creation of positive resource spirals include some intangible, yet very important personal characteristics, including:

  • Useful attitudes (realistic acceptance of challenges such as loss, flexibility, self-awareness)
  • Gratification (acknowledging and nurturing relationships with colleagues, patients, family, friends)
  • Resilience building (self-reflection, time for oneself, self-compassion, spirituality and a sense of something greater than oneself)

These themes can be further refined through the use of mindfulness to help focus attention on positive steps and by helping physicians maintain a healthy sense of perspective in the moment as skills are built and reinforced over time.

A second article examining thriving in medicine, ‘Thriving in scrubs: a qualitative study of resident resilience’ (2) comes from the OB/Gyn literature and involves qualitative data from 18 Ob/Gyn residents (PL 1-4) where the following themes emerged:

  • Resilience is rooted in a calling to medicine
  • Resilience is a developmental phenomenon
  • Adversity catalyzes acquisition of adaptive coping skills
  • Personal connections (peers, mentors, patients, family) offer significant buffer for stress

A striking graphic in this article helps to convey the sense that although medicine is a challenging calling, we are shaped and strengthened by the events we encounter, each on our own path of growth and maturity, and that even as difficulties occur, we have the inherent ability to become stronger over time and use the roots and anchors we have cultivated such as  healthy relationships, healthy lifestyle practices, sense of calling to a worthy profession, and belief in something greater than ourselves to allow us to weather the inevitable difficulties, emerge stronger, and teach this perspective and awareness to those following us in training.

Obviously, many changes are needed in our medical culture, and these will be driven by physicians who are insightful, strong, and dedicated to their profession. When you think about your individual strengths, are you able to identify one characteristic you might use as a foundation to create a positive resource spiral for yourself? Where might you start? And conversely, what behavior or attitude might you release that could be holding you back from thriving more fully? I encourage you to explore these articles and begin to identify key attitudes and actions that will help you become a powerful agent of change.

References

  1. Zwack, Schweitzer. If every fifth physician is affected by burnout, what about the other four? Resilience strategies of experienced physicians. Acad Med. 2013 Mar;88(3):382-9.
  2. Ford Winkel, et al. Thriving in scrubs: a qualitative study of resident resilience. Reprod Health. 2018;15:53.

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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Emergency Medicine
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Administrative Medicine
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