Physicians: Practice What You Preach

Hilary McClaffertyIt’s often said that doctors make the worst patients. One would suppose that, given their training and knowledge, physicians would be well inclined to take appropriate steps to keep themselves healthy whether they are patients or not. But research detailing high rates of physician burnout suggests that this is hardly the case. Dr. Hilary McClafferty, an Associate Professor in the Department of Medicine at the University of Arizona and an American Board of Physician Specialties® (ABPS) Diplomate in Integrative Medicine, writes extensively about the link between physician health and wellness and patient outcomes. She calls for a distinct shift in how the medical community views this topic.

While all doctors would certainly benefit from taking better care of themselves, says Dr. McClafferty, young physicians entering a medical culture that pays scant attention to physician self-care are the ones who stand to gain the most. After all, studies show that symptoms of burnout and depression start as early as medical school. It makes sense, therefore, that for lasting self-care improvements among individual physicians to occur, cultural and institutional changes should happen simultaneously.

If we assume that leaders of medical organizations expect doctors on their staff to provide the best health care possible, it follows that fostering workplace values that promote physician well-being should be a top priority. Dr. McClafferty points to an article by Maslach and Leiter as an excellent guide on how to embark on a program of improvements. In summary, low rates of physician burnout are associated with favorable organizational factors such as a sense of personal control, absence of role conflict, fair treatment, social support, the alignment of workplace and individual values, and appropriate rewards.

In terms of cultural progress, Dr. McClafferty, formerly a practicing pediatrician in emergency medicine, cites the Pediatric Burnout-Resilience Study Consortium as an exemplary initiative, with more than 30 pediatric residency programs committed to their trainees’ well-being. She says that further progress can be made if young doctors were introduced to evidence-based coping skills – mindfulness practice, for instance – which can help them effectively manage the challenges of a medical career. Over time, as more doctors attend to their own health, the medical community may grow to view self-care care as a normal practice.

Of course, lifestyle choices also play a significant role in physician well-being, as they can help or hinder how doctors deal with the stress that can lead to burnout. Since doctors are experts on their own lives, Dr. McClafferty says, they will be able to discern whether any behaviors need to be changed to attain a more balanced life. Areas to focus on in a self-case assessment should include fundamental concerns like nutrition, sleep, physical activity, social connections, and recreational activities. Dr. McClafferty also encourages physicians to schedule time for self-reflection, a moment to breathe and relax, to prepare oneself mentally for the challenges ahead. The calm and resiliency engendered by self-reflection can then benefit the entire workplace when doctors become models of positive change.

“We need to look out for each other as physicians,” Dr. McClafferty says. “An integrative medicine approach provides an effective template to do this.”

Integrative medicine, according to the American Board of Integrative Medicine (ABOIM), makes use of all evidence-based therapeutic approaches, healthcare professionals, and disciplines to achieve optimal health and well-being. The ABPS offers integrative medicine certification through the ABOIM. To learn more about the ABOIM, contact the ABPS today.

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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.

Chris Kunis MD
Internal Medicine
When I think historically, advancement in medicine and patient safety and care has been driven by the diversity of people and scientific thought. That’s what I found at the ABPS and more. For over 60 years that is just who we are. I found a physician certifying body that provides a choice and voice to all physicians ensuring that patients are always placed first.

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.

Richard Paula, MD
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.

Loren Jay Chassels, DO
Internal Medicine