How to Beat Stress With Balance

Face it, a physician’s life can be very stressful. Caring for your family, caring for your patients, caring for your staff, and caring for your business leaves precious little time to care for yourself.

The key to relieving that stress is to find the proper balance in your life, said Lee Lipsenthal, MD, during his presentation “Living and Dying With Life Balance” at the 2010 AAFP Scientific Assembly in Denver. “Life balance is a sense of mental, physical, emotional and spiritual wellbeing,” he says. “Most of us have lives that are not in balance.”

Lipsenthal, a board-certified internist and author of "Finding Balance in a Medical Life," said the need to find proper balance in his life became clear after he was diagnosed with terminal metastatic cancer last year. The diagnosis, and his family’s loving, supportive response, taught him how to appreciate life as it comes. “If at some point you realize that you’ve lived fully, you’ve had love, you’ve enjoyed life, then you can say to yourself today is a good day to die,” he says.

For physicians, finding a proper sense of balance is difficult because practicing medicine is extremely stressful in itself, Lipsenthal says. “Doctors are more likely to die from heart disease, accidents and suicide than the general population,” he says. “Forty-five percent of primary care doctors report they feel some kind of burnout, 28 percent say they feel under a significant amount of stress.” More than a third report feelings of depression and a general sense of dissatisfaction, he added.

How Did We Get So Screwed Up?

Dissatisfaction with work and home is a leading cause of physician burnout. Lipsenthal says some of the determinants of physician dissatisfaction are:

• Lack of control in the workplace, specifically the long and often unpredictable work hours.

• Workplace stress, and the anxiety that comes with running a business.

• Home stress -- when things are bad at home physicians tend to work more.

• Lack of a religious or spiritual life.

Even the number of children you have can be a stressor -- but not for the reasons you’d expect. Lipsenthal says physicians with fewer kids are actually more dissatisfied than those with a lot of children. “The more kids you have, the less control you have, kids are a great teacher for letting go of control,” he says. “Docs with lots of kids are also more efficient. They have to be.”

It’s easy to blame stress on worries at home or in the office, but in fact an individual’s personality is to blame in most cases of physician burnout, Lipsenthal says. “Look at who goes into medicine, the basic personality is intelligent, caring, sensitive and inquisitive, right?” he says, “The other side of who we are is the Type A personality: We’re competitive, perfectionists, multitaskers, compulsive to the point of obsessive-compulsive and not trusting of others to do the job.”

The irony, Lipsenthal says, is this drive and desire for perfection on the job doesn’t lead to increased satisfaction. “Who gets more work done, a Type A or Type B personality?” he asks. “Neither. They both get the same amount of work done, only Type As do it with more anxiety.”

Four Keys to Finding Balance

So how do you find balance in your life? Lipsenthal says you need to focus on the four key areas of wellbeing:

Physical: Exercise is a great stress reliever. Lipsenthal suggests meditation, yoga, and prayer -- even for just a few minutes each day. “Sitting on the couch at night and ruminating on the day is not stress management,” he says.

Mental: Life gets boring, you need to learn and create at work and at home to keep your mind stimulated.

Emotional: “Ask yourself, ‘Are you getting enough love and are you giving enough love?’” Lipsenthal says.

Spiritual: A sense of connection to something bigger than yourself. It could be religion, or it could be communing with nature. “Volunteering can be very enriching,” he says.

If your life has these four things, you’re doing OK, Lipsenthal says. If not, you have work to do. “Each day, ask yourself what of these three things need attending today?” he says. “Don’t try to do everything at once, focus on just one area that’s lacking each day and your life will slowly come into balance.”