Purpose: An Antidote to Burnout

This week, I had another one of those conversations where I can no longer remain silent. A friend began to criticize a doctor, selling me the popular line that all his doctor cares about is money. I never used to feel a need to speak up for my colleagues, but I do now. With all the challenges and obstacles we face in healthcare, somebody needs to speak up for us — so why not me!

I just read a terrific article addressing the epidemic (my term) of physician burnout and our need of resiliency training. As I read, I wondered, How many professions out there talk about needing to train in resiliency? Next time you see a doctor, try not to think about this: "One-third to one-half of physicians meet burnout criteria, leading to very real suffering among physicians and their families." That is a huge number of caregivers helping others while running on empty, discouraged and unfulfilled. To me, this is not only an epidemic — it reflects a crisis in our profession that's affecting society as a whole.

Our task as physicians is extremely difficult; sometimes it seems impossible. We must be caring, compassionate, efficient, thorough, patient, engaging, knowledgeable, up-to-date, skillful, and able to diagnose, encourage, empower, inspire, treat, keep good records, and more ... all in half the time the typical sitcom lasts. It's tiring just thinking about what we're expected to do each day, especially when you consider other factors that affect what we do, such as patient denial, fear, anger, distrust, substance abuse, and personality disorders. In some ways, it's surprising that the rate of burnout isn't even higher!

The authors speak of a resiliency triad that helps strengthen those in the caring fields. This triad involves developing greater insight and a commitment to one's values and to a healthy lifestyle (sleep, nutrition, activity level, among others). I agree that these are all essential and sometimes lacking among my peers but, very often, it's because of the challenges built into our personalities, our profession, and the culture in which we practice. In the culture of medicine, rest is equated with laziness and a commitment to balance is often looked down upon by the overachieving, perfectionist personality that prevails.

The gifts we bring to our profession often become our greatest liability.

Yet, I agree that there is much we can do to help ourselves and care for people with compassion. Although at times what we must do seems impossible, we really can do it, but we must also have the courage to change ourselves and our environment when needed.

The privilege to care for others must be balanced with our need to care for ourselves and our families. I have also found that, as I align my practice of medicine with my values and who I am, I have much more joy, I am much more effective, and those I care for leave encouraged, inspired, and even empowered to live according to their own. This return to congruence has had more impact on my satisfaction and joy as a doctor than anything else I've done. It's helped me grow as an individual, and it's made me more compassionate.

Aligning what we do and how we help others with our values means we have the courage to be ourselves: broken, human, and vulnerable. This inner change impacts not only ourselves but our staff and our patients. This commitment to stop pretending we're perfect, this paradigm shift to be fully ourselves while caring for others begins to transform the culture in which we practice.

I believe questions like, Who am I? and Why am I here? have the power to transform our day-to-day lives. In every profession, we must find that spark that helps us do what we must do with joy. Finding our purpose and living it out — becoming who we were created to be — is a source of contentment that also increases our effectiveness. It's a win-win!

So what can we start doing to achieve that today? And tomorrow. And the next day....

I invite you to have the courage to be yourself. 

Joyfully,
Dr Mari

Learn more about my journey to greater wholeness in my book, Walking with Jesus in Healthcare.

Quote from Physician Resilience and Burnout: Can You Make the Switch? Family Practice Management, Jan-Feb 2013.

More Ways to Unload Your Life (Part III)

Many of you enjoyed Overloaded Lives are Powerless Lives and Unloaded Lives are Powerful and asked for more. As we approach what to many of us is the busiest time of the year, why not resolve to have it be different this time around? We can manage our time proactively starting now. We can enjoy a true Advent - the time of preparation leading up to Christmas - by setting aside time to ready our hearts and nurture our spirits along the way. As you consider these steps we can all take to unload our lives, I invite you to put them into practice now to avoid another frazzled, hectic month that will leave you exhausted - just in time for Christmas!

So here are some more choices we can make to help us recover the precious gift of time. They are from Dr Richard Swenson's book, Margin: Restoring Emotional, Physical, Financial, and Time Reserves to Overloaded Lives.

• Sabotage Your Fuse Box. The author shares, "Our family enjoys Wisconsin winters where a two-foot snowfall is a thrill, not a torment. When the world is snowed in, cars can't move, businesses can't open, and schools can't convene. A spirit of holiday reigns. Part of the reason for this is the unexpected gift of time margin." Make today a "snow day" and decide to enjoy the gift of time! Can you even remember what it is you love to do when you suddenly have a free day? Do it now! And build it into your schedule more often.
• Get Less Done But Do the Right Things. Some people lead such hectic lives that even hearing about their day is stressful. How they can continue to live with such daily chaos is beyond me! Even "good things" can become too much if they fill up our days to such an extent that we are no longer kind to ourselves or to others. "'For many people,' says pastor and author Rick Warren, 'the barrier to spiritual growth is not lack of commitment, but overcommitment to the wrong things.'" Remember, when you say yes to something, you have just said no to something else. Are your answers consistently in agreement with your values and goals? 
• Enjoy Anticipation, Relish the Memories. Is your schedule ever so busy that there's little time to anticipate a wonderful event, enjoy it when it arrives or reminisce about it afterwards because you've already moved on to the next thing? Consider saying no to a few invitations next month so you can fully enjoy the ones to which you say yes! Do you feel obligated to go? Perhaps this question can help you as you discern when to say no.
• Don't Rush Wisdom. Take your time when making decisions. "If life's pace pushes you, push back. Take as much time and prayer as you need for (clarity) to develop. And wait for your decision to be affirmed by peace."
• For Type A's Only. Dr Swenson shares this advice from Dr Meyer Friedman, who first described the type A personality. "Practice smiling. Purposely speak more slowly, stop in the middle of some sentences, hesitate for three seconds, then continue. Purposely say 'I'm wrong' at least twice today, even if you're not sure you're wrong. Listen to at least two persons today without interrupting even once... Seek out the longest line at the bank." Although the old me could be the poster child for the type A personality (and still, at times!), I have learned to receive such previously frustrating annoyances as long lines in the supermarket as gifts - opportunities to breathe, to pray, to rest. "In repentance and rest is your salvation," says the Lord in Isaiah 30:15, "in quietness and trust is your strength, but you would have none of it." These are sobering words if we haven't learned to desire inner quiet more than we want whatever it is we want right now. To those of us pursuing the abundant life each day, the need to wait for some things becomes a gift. Outer chaos in our lives often reflects or leads to inner chaos. Having to wait builds patient endurance and is often a path to greater wisdom and love. 
• Create Buffer Zones. Wouldn't it be nice if we all learned to create buffer zones around our daily lives? Whether at work or running errands, we can set aside even five minutes an hour to rest our minds and nurture our spirits. A song on iTunes. An inspiring poem. Enjoying photos of our children and spouse. Closing our eyes in prayer or reading a psalm or two. These short but powerful infusions of hope and joy in the middle of a busy day can make all the difference.
• Plan for Free Time. "Christ's teaching, His healing, His serving, and His loving were usually spontaneous. The person standing in front of Him was the opportunity He accepted. If He chose spontaneous living, isn't that a signal to us? Overloaded schedules are not the way to walk In His Steps." An inflexible, over-scheduled day lacks buffer zones and leaves little room for the Holy Spirit to move. If your day is packed, move some items to another day or delete them altogether.
• Be Available. "God... exalts faithfulness over productivity." Do we? Have we scheduled ourselves so full that we are unavailable to God? Can our agenda be interrupted to serve God and His people in need?

As we approach Advent and the celebration of Christ's birth, let us resolve to prepare our hearts, making room for God to use us like never before, giving Him our time and choosing to glorify Him in all we do.

Be free!
Dr Mari

* Photo by James Randkley, Stone/Getty Images. 

Visit Overloaded Lives are Powerless Lives for Part I and Unloaded Lives are Powerful for Part II of this series based on Dr Richard Swenson's book, Margin.

 

Unloaded Lives are Powerful: Restoring a Margin of Sanity (Part II)

Are you frazzled, going from one commitment to another, continually in a rush, never fully processing one important event before the next one comes? If so, it is time to build a margin of sanity around your life! Judging from how many of you read my post Overloaded Lives are Powerless Lives, this topic has struck a cord. Last week I shared about the syndrome of overload; today I share some of what we can do about it. This comes from Dr Richard Swenson's book, Margin: Restoring Emotional, Physical, Financial, and Time Reserves to Overloaded Lives.

Here are some practical things we can begin to do today to recover the gift of time.

• Expect the Unexpected. "Everything takes longer than it does," says a proverb in Ecuador. Build in some extra time each day to handle the unexpected.
• Learn to Say No. And I would add, and "to feel good about it," for this is frequently a step toward greater health. Say No and move on, feeling good about your choice. But, beware. "Saying No is not an excuse for selfishness, rudeness or insensitivity. Instead, it is an invitation to listen carefully to the Spirit's voice, adhering closely to a system of wise priorities that inform our Yes and our No."
• Turn off the TV! For the average adult, saying no to the TV will open up "twenty to thirty hours a week... Americans watch close to a billion hours of television every day. What did we do with this time before television was invented? Is it possible we lingered at the dinner table, helped the kids with homework, visited with the neighbors, dug in the garden, read great books, took long walks, and slept full nights?"
• Prune the Activity Branches. Less can be more when it comes to cluttered schedules! And beware of directing your kids into over-scheduled lives by signing them up for everything under the sun. Is there something you can cut out from your weekly schedule that will open up another night to get to know your family again?
• Practice Simplicity and Contentment. Less focus, energy, and time spent on things means more time for meaningful pursuits and relationships. Stop here a moment and reflect on what you're most focused on, what takes up your time and energy? There's much room for positive change here!
• Separate Time from Technology. "Time-saving technologies... consume compress, and devour time. All the countries with the most time-saving technologies are the most stressed-out... Try disconnecting from clocks, watches, alarms, beepers, telephones, and e-mail for a day, a weekend or a week... Don't answer the telephone. Stop giving people the number to your cell phone and instead use it to make calls rather than receive calls." Remember the man in Mali, West Africa who said to Dr Swenson, "You Americans have all the watches, but we have all the time."
• Short-Term Flurry Versus Long-Term Vision. What are we living for? Do we have a sense of direction and a vision for our lives? Have we sought God's vision for us? This is critical!
• Thank God. Perhaps God orchestrated two events for you in one night so that you can comfortably say No to the one you're not thrilled about. Rather than fretting over it, thank God!

Enjoy Nature today; it's free!

These are just a few things we can start doing to regain some sanity in our schedules. I will share a few more later this week. Until then, I hope you're becoming more committed to protecting the precious gift of time and using it wisely. You and your loved ones will be glad you did!

Be free!
Dr Mari

Visit Overloaded Lives are Powerless Lives: It's Time for a Change! for Part I and More Ways to Unload Your Life for Part III of this series based on Dr Richard Swenson's book, Margin.

Overloaded Lives are Powerless Lives: It's Time for a Change! (Part I)

This month I've been reading a book titled Margin: Restoring Emotional, Physical, Financial, and Time Reserves to Overloaded Lives. Written by Dr Richard Swenson, it addresses the many ways that modern progress has robbed us of our reserves and has contributed to a culture that drives us to hurried, frazzled living. Whereas much good has come out of the technological age, we are living  chronically overloaded lives as individuals and as a society. The author shares various manifestations of this overload syndrome; see if they sound familiar.

• Activity overload, which "takes away the pleasure of anticipation and the delight of reminiscence." 
• Change overload, with frequent moves, new jobs, new schools, new... everything, constantly!
• Choice overload: Just go to the supermarket or, better yet, visit one of the Superstores.
• Commitment overload: Have we learned to discern our commitments and feel good about saying "No" when we must?
• Debt overload. 
• Decision overload.
• Expectation overload. 
• Fatigue overload: In my practice of family medicine, at least half of the patients that come in with a chronic problem complain of fatigue. Most of them sleep less than 6 hours per night, drink too much coffee and consume alcohol in excess, all of which contribute to fatigue.
• Hurry overload.
• Information overload: "We are buried by data on a daily basis." 
• Media overload: In North America, the average TV set is turned on 55 hours a week!
• Noise overload: "True quiet is extremely rare."
• Possession overload: "Having first imprisoned us with debt, possessions then take over our houses and occupy our time... Everything I own owns me. Why would I want more?"
• Technology overload: "The average person must learn to operate 20,000 pieces of equipment."
• Traffic overload: "We now have more cars per family than drivers per family."
• Work overload: "Work is God-ordained. Work overload, however, was not part of the original plan. Yet every morning millions of Americans head drudgingly to an exhausting work schedule that leaves them stressed and worn out. The earlier predictions of shorter work-weeks and higher incomes have backfired. Instead we often find total family work schedules exceeding eighty hours a week - yet another family 'over-working and under-relating.'"

Such is life in our modern, advanced, developed world. The author relates meeting a man in Mali, West Africa, who said, "You Americans have all the watches; we have all the time."

Does any of this resonate with you today? If so, consider ways to help yourself on a daily basis beginning right now. You can redirect your life by making new choices and moving in the direction of greater sanity and true living. Overload syndrome is pervasive, but there's so much that we can do about it! The book speaks of the concept of "margin" as the opposite of overload. Margin builds our reserves, increasing the space between us and our limits. Margin = power - load. We can increase our power for abundant living by doing more of those things that increase our well-being, and we can decrease the load we carry through careful choices, too. This will bring back a margin of sanity, energy, peace, and contentment to our daily lives that will make all the difference.

One last thought. Are we measuring our progress by the world's definition of success, ours or God's? "What if... we were to begin measuring our progress not by our wealth but by our virtue; not by our education but by our humility; and not by our power but by our meekness?" What if?

Be free!
Dr Mari

For part II of this series, read Unloaded Lives are Powerful: Restoring a Margin of Sanity. For more on why the choices we make matter, read I Am Not My Own.

 Above excerpts are from Margin: Restoring Emotional, Physical, Financial, and Time Reserves to Overloaded Lives by Richard Swenson, MD.

*Photo by Manuel Díaz Photography. All Rights Reserved. *