Urgent message: The life of an urgent care physician entails having compassion for patients, but to prevent the very real phenomenon of physician burnout, compassion should start with yourself.
Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine.
We’ve all heard the announcement on the airline, “Before assisting other passengers, please secure your own oxygen first.” Yet, physicians and other urgent care providers, who frequently pursue medical careers to “help people,” often focus so much on patients, the needs of the business, family, and other priorities…that they neglect themselves.
The life of an urgent care provider is a stressful one. Highly competitive markets have raised patient expectations to be seen in 30 minutes or less, and many patients show little empathy for the provider who may have treated anything from a simple cold to a complex laceration to an asthma attack or cardio incident. Urgent care is a high-stress environment in which mistakes can put a patient’s entire wellbeing—and the provider’s career—on the line. Urgent care service will always require energy, and expending energy when each day is rough can wear you down.
Burnout is commonly described as “batteries being run down.” However, this description is inaccurate. A battery will shut off, but physicians keep working. You may feel exhausted, cynical about your job, and like your work doesn’t mean anything. When you come into your center with this mindset it can affect your performance and the engagement of your staff. Doctors are taught to sacrifice for their patients. Many work tirelessly, even bringing their work home and continuing their day.
For a lot of people, this isn’t a sustainable work ethic.
The last several years have seen this trend of physician burnout increase (https://www.amjmed.com/article/S0002-9343(18)30286-9/fulltext). So, how does a provider address this problem? You take care of yourself! Keeping a positive mindset, taking time for personal wellness, and reducing stress factors will lead to a healthier life in mind and body. Self-compassion is a skill that can be learned and cultivated.
Over a 3-year period, the percentage of physicians describing themselves as having a “healthy work─life balance” dropped from 48.5% to 40.9%. Patients are the same, doctors are the same, so the most prevalent cause cited was the rise of the insurer─employer─provider relationships and the fall of doctor─patient relationships. This new insurer─employer─provider triumvirate creates a focus on electronic health records, documentation, protocols, and patient-per-hour productivity. In fact, studies show that doctors spend more “face” time with their computer than with patients. (https://www.healthcareitnews.com/news/ehrs-steal-primary-care-doctors-face-time-patients-study-finds)
So when a physician spends “pajama time” documenting charts, suffers the slam-down of an angry patient, or over-exerts himself from the pace of a busy flu season, how does this manifest? They could lash out and blame others, become defensive, or criticize themselves. None are healthy options in the long run.
What if instead you treated yourself as you would a loved one? Start to direct your compassion—those kind, understanding, and encouraging feelings, toward yourself. A recent feature in the Harvard Business Review describes how self-compassion manifests in greater understanding and authenticity (https://hbr.org/2018/09/give-yourself-a-break-the-power-of-self-compassion):
First, people who possess self-compassion recognize failures are a shared human experience, and they take a balanced approach towards shortcomings. While you may feel badly about your shortcomings, you shouldn’t let your feelings consume you. Being able to reflect on mistakes is a powerful tool. When individuals possess the maturity to take a step back and examine themselves, they are able to arrive at more realistic goals. This strikes the balance between having too much self-confidence and being complacent, as thinking too little of ourselves can lead to defeatism. You excelled in your undergraduate studies, got accepted into medical school, and passed the licensing exams—there is no doubt you are qualified and capable. Realizing this doesn’t just make you feel better, it also makes you want to be better and put it into action.
Second, self-compassion is correlated with authenticity. Authenticity is defined as “being true to one’s own personality, spirit, or character.” When you don’t worry about societal norms you can focus more on yourself. This authenticity leads to empathy for other people, as well. If someone can reflect on their own behavior without bias, they possess the ability to put themselves in someone else’s shoes and give them genuine feedback. When the attention is on growth, leaders are more likely to notice changes in subordinates’ performance and give sincere advice on how to improve.
Being an urgent care provider is not for the faint of heart, and provider burnout is real. But if you show compassion for yourself, taking time to recharge yourself, putting your negative feelings in perspective, and extending understanding and authenticity, you will see improved interactions with patients and staff and greater professional and personal satisfaction. Because when the doctor feels better, certainly patients will feel better as well!