How do doctors cope?

Often I will tell my residents that if you can’t take care of yourself how do you expect to take care of your patients. Or in another way: the only difference between God and a doctor is that God knows he’s not a doctor. These sound like cliches but there is some truth in them. In short doctors are just ordinary people with ordinary problems who can make mistakes and who should look after themselves.

But how to take good care of yourself in a job as a doctor or even a resident? Working as a doctor can at times be very stressful. To much of this stress can lead to problems such as burnout, depression, alcohol misuse etc etc. Most doctors think they can cope with this stress but as other ordinary people coping with stress needs good coping strategies. Doctors normally just keep on working. Run from the first to the next problem without paying attention to their well-being.

This experience is recently supported by research. From this study it was evident that often workplace coping strategies of doctors were inefficient and increased the risk of emotional exhaustion. The most prevalent coping strategy was “just keep on going”, “soldier on” or “get the job done”.

… I don’t think I do much to deal with it at work. I just keep, keep, keep on going and I’m somewhat obsessive compulsive I think. I know I am and I think that most doctors are quite frankly. So part of what relieves my stress is getting everything done. And if I have a dictation that’s hanging over my head like I did today, that stresses me, so I try and get that kind of stuff done… I relieve stress by continuing to work. I mean, it’s kind of sick

This coping strategy is associated with higher frequency of emotional exhaustion. Other coping strategies with high risk on emotional exhaustion were: keep it to myself, go on as if nothing happened. It’s inefficient and can mainly be classified as denial responses to stress.

Better coping strategies were: talking to co workers for emotional and informational support, using humor, joking with staff about stressing incidences. The best coping strategies were those used outside of work such as spending time with family, talking to one’s spouse and physical exercise were associated with lower frequency of emotional exhaustion, they were much healthier coping strategies. They improve mental health in stressful work, they’re better in coping with stress.

These finding, these differences between bad and good coping strategies were consistent with previously published work on this subject. Moreover, it has been shown that time away from work, switching off mentally and enjoying a psychological detachment from work during off-job time, and other leisure activities that allow recovery in between work periods result in positive benefits.

Some limitations of this study

  • This is a bout correlation< coping and emotional exhaustion, not about causation
  • It’s a survey with the possibility of response bias
  • Study done in a single health region, results may not be generalizable

But even with these limitations in mind, it’s sounds very true and recognizable, what do you think?

ResearchBlogging.org
Jane B Lemaire, & Jean E Wallace (2010). Not all coping strategies are created equal: a mixed methods study exploring
physicians’ self reported coping strategies BMC Health Services Research : 10.1186/1472-6963-10-208