Fried at Forty: 20 Ways to Connect, Manage, and Relax

MDNG Endocrinology, January 2007, Volume 9, Issue 3

We offer the following 20 suggestions on ways to relax, unwind, and put a little distance between yourself and the cares and concerns of practice. Links included to make your life, well, easier...

It’s 9:30pm. Today, Dr. Smith saw 31 scheduled patients, managed to squeeze in six work-ins, spent about an hour on the phone with various pharmacies and insurance companies, spent another 90 minutes doing paperwork and updating charts, and he somehow even spared a few minutes to speak with a pharma rep. To find the time to do all this, he skipped lunch for the third day in a row, hasn’t been to the gym in days, decided that the “check engine” light flashing on his dashboard could be ignored for one more day, and had to miss his son’s soccer game. Dr. Smith has more than 75 e-mails and phone messages from patients, colleagues, and friends he hasn’t had the time to answer; his PDA just reminded him that he has to be at the hospital at 7:00am tomorrow to follow-up with a patient; not one but two staff members have handed in their notices in the past 36 hours; and he just realized that his professional society’s meeting is less than 10 days away and he hasn’t even begun to make plans for it. Oh, and the lawsuit in which he was named as a defendant, the one that his attorney assured him he didn’t have to worry about—“it’s ridiculous, a joke; it’ll get laughed right out of court”—has not only not been dismissed, it has recently begun producing additional allegations, complaints, summons, and paperwork at an alarming rate. It’s 9:30pm. And it’s only Tuesday.

The sad truth is that the scene described above is not a misrepresentation of a healthcare provider’s typical day. For physicians in just about every specialty, their

time is an increasingly precious commodity as more and more demands are placed on them by patients, insurance companies and other payers, and the government. Physicians nowadays are providing more (and better) care for less money in an increasingly compressed amount of time, with more groups than ever complaining about how physicians deliver that care. It’s no wonder that physicians’ dissatisfaction with their profession is at an all-time high (see our November 2005 article for more on this ). Physician burnout is a very real possibility under such stressful conditions and poses a danger not just to the physician’s mental and physical health, but also to his or her ability to provide the best care for his or her patients.

Anderson Spickard, Jr., MD, Professor of Medicine and Psychiatry at the Vanderbilt University Medical Center and Medical Director of The Center for Professional Health (CPH) has extensive experience in treating physicians affected by the stresses and pressures unique to their profession. In September 2002, he and several colleagues published an article in JAMA titled “Mid-Career Burnout in Generalist and Specialist Physicians” We spoke to him in preparation for this article and he was resolute in his belief that not only is the danger of physician burnout as great as it was four years ago when the article was published, but also that the pressures that contribute to physicians’ career dissatisfaction and burnout are intensifying, making it more important than ever to face the issue.

“Physicians face more demands on their time and energies from more sources than ever before,” says Dr. Spickard. These stresses, in the absence of effective outlets, can lead to “emotional and physical exhaustion, cynicism, real or perceived clinical ineff ectiveness, and depersonalized relationships with colleagues and patients.” Dr. Spickard points to overwork as the catalyst, noting that physicians overwhelmed with work who also feel they have little or no control over their own work schedule face increased risk of burnout. “That’s when work becomes unrewarding, people begin to feel they aren’t being treated fairly, and the sense of community begins to break down.” In their JAMA article, Dr. Spickard and his coauthors recommend that “the best prevention for physician burnout is to promote personal and professional well-being on all levels: physical, emotional, psychological, and spiritual.”

To help support these four pillars of burnout prevention, we offer the following 20 suggestions on ways to relax, unwind, and put a little distance between yourself

and the cares and concerns of practice. Many of these were suggested, in whole or in part, by our readers, so you might say that they’re “doctor recommended.” We’ve also provided some additional links and information to help you get started.

1. All in the Family

After spending all day providing support and care to your patients, don’t forget about the people waiting for you at home. One of our readers’ favorite ways to relax is to spend time with family: helping out with Girl Scouts, coaching a Little League team, taking the grandkids to the park, sharing quiet time with a spouse or partner, playing with pets (they’re family, too)—anything to take their minds off work and reconnect with loved ones.

Family Fun

Want to Spend More Time With Your Family? Have You Considered Part-Time Practice?

2. Feel the Burn

Many, many studies have demonstrated the beneficial effects of regular exercise: improved cardiovascular health, increased strength, reduced stress. Another benefit of exercise is that practicing what you preach adds weight to your words when you are advising your patients regarding their diet and exercise habits.

American Heart Association Fitness Center

Exercise Counseling and Personal Exercise Habits of US Women Physicians

Mayo Clinic Fitness Center

Small Steps to Better Health

3. Video Games: Not Just for Kids Anymore

Game consoles (Playstation 2/3, Xbox360, Wii); PC games, portable gaming units, MMORPGs—you name it and some not-insignificant portion of our reading audience is probably a devoted enthusiast of it. The current generation of video games boasts eye-popping graphics, immersive game play andvirtual environments, and a wide range of titles to satisfy most anyone’s tastes or interests. Not only that but contrary to some folks’ perceptions, video games are an increasingly social phenomenon that, thanks to online play, can help form and enhance community and interaction.

Game Pro

Gaming the Way You Remember It

GameTap (subscription-based video game rental service)

Serious Games Initiative

4. Get Away From it All

“Traveling” was one of the more popular options for relaxing sent in by readers. No matter whether you take a cruise to an exotic locale, go for an extended stay in a far-off land, hop in the car for a marathon trip around this great land of ours, or just get out for a daytrip up the coast or out to the country or wherever, literally getting away from your current environment is one of the best ways we know to recharge your batteries.

Flickr: Travel Photos

Lonely Planet

Roadside America

Travel Blog

Weird US

5. The Great Outdoors

Camping, hiking, fishing, hunting, mountain biking, canoeing, kayaking, and such ranked right up there with “travel” in our survey results as a favorite pastime and

diversion. The Internet is an excellent resource for you outdoors types, replete with in-depth information on everything from where to find the best hiking trails

and where to buy the best gear (the gear that you really need, not that flashy L.L. Bean crap), to how to properly tie a fly and how to ward off bears.

FishingStories.net

GORP Camping Guide

HuntingNet.com

Outside Online

Tales of the Ultimate Sportsmen

Trails.com 6. Free Your Mind...

The various forms of yoga and meditation are proven stress reducers and count many physicians and other healthcare professionals among the ranks of their practitioners.

Wikipedia: Meditation

Yoga Alliance

Yoga.com 7…And Your Ass Will Follow

The therapeutic powers of dance are well established. It’s a great way to blow off some steam, it gets the heart (and other body parts) pumping, and it is literally impossible to refrain from smiling while you shake yo’ thang (this is especially true if you’re cuttin’ a rug with one or more partners whose skill and abilities pale in comparison to their enthusiasm). It matters not which form of dance your muse calls you to—salsa, tango, Israeli folk dancing, West African dance, ballet, the Argentine tango, aerobic dance, anaerobic dance, disrobic dance (hubba hubba!), ballroom dancing, swing dancing, line dancing, break dancing—the important thing is to get up and get moving.

Greatest Musical (Song and Dance) Movie Moments and Scenes

Learn to Dance With Napoleon Dynamite

Voice of Dance

8. Reading and Writing

Ah yes, two pastimes near and dear to our hearts. There’s nothing better than curling up for an hour or three with a good book. And to all you aspiring wordsmiths out there, we’re always looking for contributing writers. Drop us a line at tkunkler@mdng.com!

Bartleby.com

The Chumps of Choice (discussion spot for the new Pynchon tome)

The DNA of Literature (50 years of Paris Review interviews with authors)

9. Golf

All those jokes about doctors and golf? They’re funny because they’re true. A whopping 21% of our readers enjoy a day on the links. We want to hear more from you on why this is, so send us your best golf stories (heck, send us your worst golf stories, too).

Free Golf Tips Online

Memorable Quotes from Caddyshack

WorldGolf.com

10. Sleeping

This was listed on a depressing number of survey responses. Only doctors would list as a leisure activity something which the rest of us regard as a necessity. Ya’ll work too hard.

The Big Sleep Script

Resources for Better Sleep

Sleepnet.com

11. Tonight, We Dine!

Now we’re talking! Everybody likes to eat out. Whether your tastes lean more toward humble taquerias or if you prefer top-of-the-line steakhouses, pick a night and meet your friends at your favorite local eatery for a guaranteed good time. As Tony Shaloub’s character says in Big Night (perhaps the best movie ever about restaurant dining), “To eat good food is to be close to God.”

The Essential Restaurant Guide

Roadfood.com

For Those Who Live to Eat

12. Spirituality and Religion

Many of our readers wrote to say they find solace in their faith and are involved in various groups and activities through their churches, synagogues, mosques, and other places of worship. Others among our readers told us they fi nd peace and refuge in a non-denominational expression of spirituality.

Beliefnet.com

Sacred Texts of Various Faiths

13. The Opiate of the Masses, 2.0

Tee-Vee. Television. Love it or hate it, there’s no denying it has become the go-to source of entertainment and diversion for many of us, whether we plan our nights around “must-see” TV or just turn the thing on when we get home and leave it playing in the background. Between digital high-def cable service, TiVo, and the apparent determination of the industry to release on DVD literally every TV series ever made, it seems there’s no escape. Even Jack Bauer can't get us out of this one.

Television Without Pity

TV Land

When TV Shows Go Downhill

14. Too Many Notes

Some iteration of “listening to” and/or “playing” music was probably the favorite form of relaxation and enjoyment most commonly cited by our survey respondents. Going to live concerts, fiddling with their mp3 players, home stereo geekery, playing in bands with friends and family—the ways in which our readers both partake of and make music is extensive and fascinating.

All things iPod

Mapping Connections Between Music and Artists

Pandora and the Music Genome Project

15. General Upkeep

Landscaping and gardening? Check. Woodworking, cabinetry, and other carpentry? Check. “Puttering around the house doing odd jobs and chores?” Check. Our readers are an industrious and (apparently) handy lot.

Do-It-Yourself Home Improvements

Garden Web

Joe Woodworker

16. Online Tomfoolery

The Internet is the last word in silly and mindless fun. Trust us; we’re experts on this.

All-Time Grand Champion Online Time Killer

The Bunny Suicides

How to Destroy the Earth

17. Arts and Crafts

Want to learn how to make the perfect sock monkey? Want to learn how to crochet? Want to learn how to sew a quilt? Visit these sites and some of the others they link to, and you’ll enter the newly chic world of crafting. It’s not about tea cozies anymore.

Craftster

Get Crafty

Handcraft in a Hectic World

18. Photography

Shutterbugs of all skill levels will be able to learn something from the camera and equipment reviews, online forums, how-to guides, and other information at these sites.

Digital Photography Review

Photo.net

Shutterfly

Snapfish

19. Save Us the Aisle Seats

No matter how many times you go to the movies, that moment when the lights fi rst go down and the music kicks in before the fi rst previews start is still exciting. Next time things get too hectic around the office, make some time to steal away for a couple hours in the middle of the afternoon, grab some popcorn, and lose yourself in a darkened theater.

Cinema.com

Fandango

The Greatest Films

The Internet Movie Database

Rotten Tomatoes (movie reviews)

20. Cooking

You know what? Forget what we said before; going out to eat is a hassle. Messed up reservations, bad service, small portions, sun-dried tomatoes in everything—I mean, who needs it? No, it’s better to stay in and cook something you know you’ll like. You’re almost guaranteed to get a table and you don’t have to tip the server. Check out the recipes at these sites, and let us know how they turn out (especially if you have the stomach for the concoctions at the third site listed).

David Rosengarten: Foodie Extraordinaire

Food Writing and Recipes

Recipes of the Damned

Top Secret Recipes