Heavy workloads, demanding standards of training and practice, complex practice environments―these are just some of the factors that put physicians at high risk for burnout. Can coaching or training help? We asked “the Doctor’s Doctor.”
On this episode of Boldly, we speak with Dr. Mamta Gautam, a psychiatrist who specializes in physician health and wellness. She is the founding director of the University of Ottawa Faculty of Medicine Wellness program. And, she coaches physicians on how to stay one step ahead of burnout.
Dr. Gautam shares how she became interested in physician health and wellness, how coaching can support physicians through burnout as well as powerful stories sure to change your perception of mental health.
tweetable: “I realized that even though I can help physicians get better in my office, one to one, that they're often returning back into a very difficult workplace environment and that was part of why they became unhealthy.”
What drew Dr. Gautam’s interest to physician health and wellness?
- She made a career change when a colleague asked her to present at a medical conference and got to speak about depression with hundreds of doctors.
- Following the presentation, two physicians approached Dr. Gautam and asked her to take them on as patients. From there, it was word of mouth and her practice grew.
- About 15 years ago, while still supporting physicians in her clinical practice, Dr. Gautam realized she could have more influence at a systematic level by educating leaders within the health care system.
tweetable: “We should watch out for times where there is an increased level of stress, perhaps increased workload, or if we’re coming up to a period where it’s more intense.”
Are there any times a physician or medical learner may be more prone to burnout?
- Burnout means chronic over-stress over a long period of time, and it’s more likely to happen with professions that take care of others.
- Physicians have a higher risk of burnout due to high workload, high pressure and doing more with fewer resources.
- Physicians should pay attention to times when there are increased levels of stress, perhaps a more intense period (for example: when a colleague is away and you need to pick up their workload).
- Physicians and medical learners should also pay attention to themselves and each other throughout periods of transition (for example: from medical school to residency, from residency to practice, etc.)
- Even positive stressors can impact our mental health.
tweetable: “There are different transition periods throughout our training, but not just within our training, and they continue throughout our practice.”
What is something physicians or their peers can do to help prevent burnout?
- Medical students and trainees are taught to care for others, yet not for themselves.
- They should focus on resilience and burnout prevention throughout their career—the earlier they start, the better the outcome.
- We are starting to talk a lot more about self-care, but we also need to think more about how we manage stress.
- She believes there should be more education and normalization of stressors within the workplace.
- Leadership should also proactively and consciously model healthy behaviours.
tweetable: “We don't really talk as much as we could about how prevalent depression and burnout is. And, I don't think we tell medical students that they are at more risk of being depressed than people in other professions.”
What are the tools and resources available to physicians and medical learners today?
- We have a long way to go to change the culture of medicine for the betterment of physician health and wellness, but Dr. Gautam feels we’ve come a long way the last few decades (for example: through normalization and increasing awareness).
- There are now Facebook groups to support colleagues and each other.
- There are also wellness programs starting up at medical organizations and hospitals.
tweetable: “I think that there's a wonderful opportunity at a very early level, starting in medical school, to change the perception of this toughness that we all have to have and really enhance it with compassion.”
Why is coaching so valuable when tackling burnout?
- Coaching is focused on moving forward.
- It can help enhance self-awareness by drawing on personal strengths as well as combat self-defeating thoughts and beliefs.
- Physicians don’t have to go through this by themselves, and coaching is a way to proactively address burnout in a positive way.
tweetable: “The leadership [has] to consciously and actively model these healthy behaviors, to have open conversations about burnout and really cultivate a sense of community in the workplace so the trainees know they are supported.”
How can individual physicians better support each other?
- Stay connected.
- Consider what’s in your “personal bank account”―sometimes working with certain people can feel like making deposits so you have a rich bank account, while others it might be more challenging and you need to take a withdrawal―you must find a way to maintain a healthy balance.
- Recognize others and be sincere when reaching out.
- Be compassionate and flexible with others.
tweetable: “I think the biggest thing is for us to support each other is to stay connected.”
How does the stigma around mental health impact physicians?
- Nowhere is the stigma around mental health greater than within medicine.
- Generally, physical health is better understood than mental health.
- Colleagues are treated differently when they are suffering from a mental illness vs. a physical illness.
- It is hard for colleagues to reach out when they’re struggling as they’re not sure of what to say around this stigma.
- Stigma arises from preconceptions, assumptions and lack of knowledge―the more we learn about burnout and depression the better―especially within the health care system.
- Diagnosis is not the same as impairment.
tweetable: “Nowhere is the stigma of mental health greater than within medicine.”
The Tarzan Rule: Tips for a Healthy Life in Medicine, a book by Dr. Mamta Gautam
From one doctor to another: here’s what you can do about burnout, a Boldly article by Dr. Duncan Rozario
How to tell if your doctor is burned out, a White Coat Black Art podcast by CBC featuring Dr. Mamta Gautam
Why this doctor went public with her story of burnout, a White Coat Black Art podcast by CBC
Four burning questions with Dr. Mamta Gautam, an interview with Dr. Gautam by Med e-News
Physician Health and Wellness in Canada: Connecting behaviours and occupational stressors to psychological outcomes, a report by the Canadian Medical Association
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The opinions stated by podcast participants are made in a personal capacity and do not reflect those of the Canadian Medical Association and its subsidiaries, including Joule. Joule does not endorse any views, product, service, association, company or industry mentioned in this podcast.
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