Episode 057: Mental Health for Health Experts

Speaker 1: You're listening to Your Practice Made Perfect. Support, protection, and advice for practicing medical professionals brought to you by SVMIC.

Brian: Hello. Welcome to this week's episode of our podcast. My name is Brian Fortenberry. On this episode we're going to continue our conversation with Dr. Rebekah Bernard, focusing on physician burnout and discussing her most recent book, The Rock Star Doctors Guide: Change Your Thinking, Improve Your Life.

Initially we were talking about how to be a rock star doctor from the patient perspective. You had written a new book, The Rock Star Doctors Guide, and it kind of talks about how the doctor takes care of themselves more. Is that correct?

Dr. Bernard: That's right. It's all talking about how physicians can learn to change the way that we think about things so that we can improve our lives and take back control for ourselves. So much of what we're trying to do with physician wellness involves trying to change our system, trying to change our organizations, and those are good things. Those are good goals, but they're also things that take a lot of time and a lot of investment from many, many different stakeholders. With this book, I'm trying to give physicians specific tools that they can use as individuals to help themselves think about things differently and take back control. I wrote the book with a psychologist, he's excellent. He does work with several physician wellness programs in my community and we set up this physician wellness program through our county medical societies because we had a high rate of burnout. We had several physician suicides. I work in an office that straddles two different counties here in Florida, and we had two suicides right around the same time in both counties. And it really highlighted the struggle that doctors are facing.

Both medical societies decided at that time that we wanted to invest in our doctors and we created a physician wellness program where we were able to match physicians with a psychologist anonymously, confidentially. And the medical society also paid for a certain number of visits. And we did this as a motivation for doctors so that they didn't have to worry about the stigma of seeking help. And one of the psychologists in this program, Dr. Cohen and I, we collaborated to write this book to talk about different strategies that doctors could use. Of course we recommend doctors seek help and work with a psychologist, but there are things that we can do to get started that are self directed.

Brian: Absolutely. And you know, there is unfortunately a stigma at times about seeking help, seeking advice. Certainly when you're a professional, like a practicing physician, it is hard to kind of say, "Hey, I can't handle this myself." Is that part of the reason that you were driven to write this book?

Dr. Bernard: Yes, it's a huge part of it. Partially it comes from physicians having often a perfectionistic mindset where we feel like if we acknowledge that we need help, that it means that we're not perfect and that means that we're a failure. It also comes from the culture of medical training where we develop this kind of superhero persona where we're expected and we expect ourselves to work unreasonable hours without eating, without drinking, without sleeping. It's totally unrealistic, but yet we start to see it as something that we should be able to do even though we can't. And so when we realize that we can't do that, then we feel a sense of failure. Then of course in medical school, one of the things that you often hear in training, if you complain about something or you seem to be weak, you're told suck it up, and that is something that you hear a lot. Even if you express emotions. If you express sadness, if you express grief, so doctors do suck it up. We learn to just suppress our emotions. We start to compartmentalize and we put away our feelings in a little box somewhere. But if we never open up that box and start to process those feelings, they're basically there waiting for us and eventually they're going to cause problems if we don't deal with them properly.

Brian: You can only quote unquote suck it up for so long.

Dr. Bernard: Right.

Brian: In my mind it's kind of like a balloon and there's only so much air you can put into it before at some point it's going to rupture. It's going to burst and that's going to be catastrophic. What are some things that doctors can do? I know in your book, you probably go into great detail about this, but what are some things that they can do to kind of help them get through this? Is it a process of thinking? Is it a process of actual physical things they can do? Kind of take me through that.

Dr. Bernard: There's a number of things. I mean the first thing we need to do is we need to identify the emotions that we're feeling, acknowledge that we have them and we need to talk about them and share them. And that can be as simple as just simply talking with a colleague or a friend or a family member about the way that we feel. A lot of times we don't even give it a name. So just simply saying, "You know, I feel really sad about something that happened. I feel guilty about something that happened." That can make a big difference. The Mayo Clinic did a pretty big study where they showed that simply letting doctors spend time with their colleagues. In other words, they funded a program where the doctors would go and have dinner or lunch with their colleagues, I think it was once or twice a month, those doctors had lower burnout than those that did not. Just simply getting together with others and sharing our experiences is a very simple thing that we can do to help us improve our wellness.

Brian: It sounds like part of it is just being conscious about it and just being self aware. Correct?

Dr. Bernard: Yes. And that's when they talk about mindfulness, sometimes people will say, "Oh, mindfulness. That sounds so kind of new agey." But mindfulness is really simply, like you said, it's consciousness. It's being aware of how you feel about things. It's being in the moment and not just kind of suppressing your feelings and pushing them to the side and just trudging on.

Brian: And in this world, I know in my particular work, there's a side of me whenever I think, "Well, I need a vacation. I need a break. I need to get away from this." But there's part of me that goes, "Well, how will the business world continue to revolve if I'm not here to handle it?" And I'm always amazed when I come back. You know what? The world did not come off of its axis and things went okay. I imagine for doctors, that's pretty hard as well.

Dr. Bernard: That is so funny that you say that because I think one of the most important lessons that I learned as a young doctor was the realization that I'm not indispensable. I always had that feeling like, "Oh, I better come to work even if I'm sick" and, "What will they do without me?" And then you're right. All of a sudden you realize, "Wow, the world can go on." The sooner we realize that and acknowledge that, I think the better off we will be. Yes, we're important to the people that we serve, but we're not indispensable, so we have to take care of ourselves. We have to prioritize our self care.

Brian: I totally agree with you. And part of me, every time I come back is like slightly disappointed that everybody functions so well without me. But when I come back from a vacation, I always have a little extra spark, a little extra energy, a little more in me to maybe tackle and be more efficient at those issues. And I assume for physicians it's the same thing.

Dr. Bernard: I think a little bit of that for us can be ego because we get our needs met in different ways and we do all have the needs to be needed and feel important, and many physicians get that through work. It's important to also fill that in other ways, which is to nurture family relationships, to nurture friendships. And that way when you're getting your needs met through other ways than just work, then it's a little easier to step away from the job. The job is not offering you everything you need to have balance, so you need to have different elements of your life. Work should not be everything.

Brian: I have some very close friends that are physicians and I am always amazed they are such achievers, and if they're not at work, they come home and they find other things to work on. And I will tell them take a break, take it easy and they like this is taking a break for me. So it is a different mindset but it is finding that that works for you. Correct?

Dr. Bernard: Absolutely. And we talk a lot about finding hobbies and maybe it seems like work to you and me, but if it's something that puts them into what we call flow. Have you ever done something like a jigsaw puzzle or put together a model airplane or something and then all of a sudden hours have gone by and you just didn't even realize it because you were in flow, and that is what hobbies give us. Hobbies or things that we do because we enjoy it so much that just time can pass like nothing or reading a great book. Those are the things that we need to spend some time doing. Finding those hobbies are those activities that put us into that flow mindset is that those are really good for our brain.

Brian: As we get ready to wrap up here, Dr. Bernard, there's going to be a physician, at least one if not several statistically speaking, as we talked about early on, doctors that are at that point, they are at burnout. They are at, I am fed up, I can't keep this pace up, I can't do this. They're at that point break. How can these physicians get help? Where would you direct them?

Dr. Bernard: The first thing I would say to them is, number one, it's really important to remember that you always have options as a physician. We are all extremely educated, intelligent, and resilient people because we didn't get to where we are without being that way. We have options. We just may not be able to see them clearly. We can get help to be able to look at those options and explore them, so a good psychologist is often a person that can help you with that. Your County Medical Society may have a physician wellness program, like the ones that I've discussed. You can also just find someone through a recommendation from a friend or from your primary care doctor and you don't have to use your insurance if you don't want to. Although because of the mental health parity act, mental health coverage is available through most all insurances, but you can always just pay cash and just see a psychologist sort of quote off the books if you want to, that's something that many physicians do.

But don't let that stop you from the fear of getting help or that somehow it will come back to hurt you. Don't let that stop you from getting help because one thing that I always say when people say, "Oh, do you see a psychologist?" I say, "Of course I do. Do you realize what I do all day? I deal with people that have a lot of problems and a lot of mental health problems. I see a psychologist so that I can learn how to deal with them and how to help them." It's a matter of a lot of times of spinning it in the right way, so we get helps and that we can help others. You just have to look at it that way and realize that we're doing this so that we can help other people.

Brian: That is so great. And I would also direct people to your books that you have written.

Dr. Bernard: Oh, thank you. Yes.

Brian: Tell us the names of those books again for our listeners that might want to go get a copy.

Dr. Bernard: The new book is called Physician Wellness: The Rock Star Doctors Guide: Change Your Thinking, Improve Your Life, and the other book is called How To Be a Rock Star Doctor and you can also find information about both of those on my website, which is rebekahbernard.com.

Brian: Fantastic. And what we will do is we'll put that information as well in our show notes of our podcast episode.

Dr. Bernard: Great.

Brian: Dr. Bernard, I can't thank you enough for being here. This has been incredible information. We thank you for taking the time, not only to write the books and to realize the issues that a lot of medical professionals are facing out there. Not only doing that, but taking the time to come spend with us and talk about it.

Dr. Bernard: Thank you so much for inviting me.

Speaker 1: Thank you for listening to this episode of Your Practice Made Perfect with your host Bryan Fortenberry. Listen to more episodes, subscribe to the podcast and find show notes at svmic.com/podcast.

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