Find Happiness as a Physician

7/31/2019 Find Happiness as a Physician

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Helping People Live and Work Well - by Design

Coastal Area Health Education Center

Is It Even POSSIBLEto Find Happiness

as a Physician Today?

Kernan Manion, MD

Internal Medicine Grand Rounds Lecture SeriesSeptember 13th, 2006

Keys to Preventing Burnout andFinding Well-being in Medicine Today


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Is It Even POSSIBLEto Find Happiness

as a Physician Today?

Kernan Manion, MD

Keys to Preventing Burnout andFinding Well-being in Medicine Today

Kernan Manion, MD does nothave any conflicting

financial interest from

commercial entities.


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"To find health should bethe object of the doctor.

Anyone can find disease."

Dr. A.T. Still

Founder of Osteopathic Medicine, 1874


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Maintaining ones own health

& well-being should be asimportant a concern of the

physician as treating patients.

Otherwise, the doctor

becomes the patient."Kernan Manion, MD 2006


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Physicianhood is not justa job.

It is an often high intensityhuman service focused on thetreatment of illness,

the prevention of deathand the alleviation of suffering.


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TIME

EMOTIONALRESP

ONSE

-RESILIENCY

StressorEvent 1

StressorEvent 2

EMOTIONAL INTENSITY(think "energy")

RESILIENCY(Affect Reserve Pool)

(think "elasticity")


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STRESS DURATION

EMOTIONALRESERV

E/RESILIENCY

Stressor2nd

Stressor

Recovery

Phase

Think "Muscle Physiology"

TIME"X"

Work Phase

"Strengthening" & Resiliency=>> "Endurance"

Recovery

Phase


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STRESS OCCURANCE / TIME

EMOTIONALRESER

VE

-RESILIENCY

MAJORSTRESSOR

2ndStressor

RecoveryPhase

(Inadequate)

3rdStressor 4th

Stressor

STRESS RESPONSE DEPLETION

i.e. Cognitive / Emotional Exhaustioni.e. BURNOUT


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The Stress Response

Fight( Anger) Flight(= Fear [Anxiety])OR

Traditional Understanding

The Relaxation Response

Non Fight(= Non Anger) Non Flight(= Non Fear)


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The Stress ResponseAnger Anxiety Sadness Shame Pain

Through the MindSense Perspective

(Turmoil)


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Love

Peace

Joy

Pride

Delight

Anger

Anxiety

Sadness

Shame

Pain


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Love

Peace

Joy

Pride

Delight

Anger

Anxiety

Sadness

Shame

Pain


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Affect Pool

An

ger

Anx

iety

Sadness

Sha

me

Pain

Lo

ve

Peace

Joy

Pride

Delight

Event / Issue

Internal Dialog(s)

Affect(s)

Soma

Behavior(s)

(Theme)

The MindSenseModel


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Emotion Pastels of Primary TurmoilAffects

ANGER

SADNESS

SHAME

PAIN

Irritation Rage

ANXIETYWorry Panic

Glum Grief

MortifiedEmbarrassed

Hurt Misery


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Emotion Pastels of Primary BlissAffects

LOVE

JOY

PRIDE

DELIGHT

Fondness Enamored

PEACECalm Serene

Content Euphoric

Self-respectSatisfied

Pleasure Ecstasy


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Antidotes for dismantling and for replenishment


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Anatomy & Physiologyof a Single Stress Event

using the MindSense model

(For those wishing to learn more about the MindSensemodel, visit the contact page at

www.WorkLifeDesign.organd request that I send you the MindSense audiooverview.)


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Affect Pool

Anger

Anxiety

Sadnes

s

Shame

Pain

Love

Peace

Joy

Pride

Delight

Event / Issue

Internal Dialog(s)

Affect(s)

Soma

Behavior(s)

(Theme)

The Model


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CHAOS:

the entire array of issues, events

and situations within our

perceived sphere of concern thatmay be acting upon us


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CACOPHONY:

the array of internal dialogs(conscious and pre-conscious)

one has regarding each of theevents / issues / situations in

ones CHAOS layer


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TURMOIL:

the concurrent negative

emotions associated withCHAOS & CACOPHONY


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The Triad of Symptoms(adapted from Maslach and modified)

Fatigue/Exhaustion

DetachmentReduced Accomplishment


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Fatigue/Exhaustion

Physical

Cognitive

Emotional


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The work of healing requires

cognitive, physical andemotional energy. Energy

needs to be replenished.

We do NOT have an

inexhaustible resource ofemotional energy.


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DetachmentFrom Family & Friends, Colleagues, Patients

Cognitive

Physical

Emotional


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ReducedAccomplishment

Productivity

Quality

Keep in mind that one can maintain

productivity & quality,

but at significant cost to Energy


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Meltdown Burnout Weardown Functional/Operational Engagement

Fatigue Energy

Detachment Involvement

Accomplishment: Reduced Increased

WorkLife Health Continuum


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But its not just:Doing okay vs. Not doing okay

In reality, theres a continuum

of adaptation / maladaptation:

EngagedOK/ FunctionalWeardownBurnout Meltdown


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Remember

Burnout is an Occupational Stress Syndromeand it can manifest in MANY WAYS.

But

Burnout Depression

P t ti l O t


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MELTDOWN - the Worklife "Code Blue"

(Clinical performance impairment)Simmering Burnout ("Slow Burn)

Emotional Illness & Addiction

Compassion Fatigue (+ Vicarious

Traumatization / 2ndry PTSD)

Behavioral Issues (e.g. disruptive)Relational Strain

Physical Manifestations of Chronic

Stress Exposure (HTN, MI, CVA )

Detrimental Impact On Organization

Loss of job / career

Fortuitous Job change / Career modification

Renewal & Transformation

- Potential Outcomes


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I find it helpful to divide the matrix ofcontributing causes into 4 majordomains of influence:

Individual

Role & Career

Organizational

Systemic & Environmental

Contributing Causes in Burnout

Domains of Influence and Recurring Themes


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There are innumerable stress issues that may

contribute to ones Burnout (and each persons

stress array is unique.)

Clustering these into theme categories not only

helps get a handle on the predominant issues; it

also helps highlight some common areas that need

to be addressed (e.g. interpersonal communication;

dealing with difficult patients.)

Domains of Influence and Recurring Themes


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The key challenge:

Dismantling ourChaos &TurmoilRealizing our LONGING

and finding our Bliss!

Insert slides here with focus ondismantling burnout / changingenvironment / setting sights onhealthy culture


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Remedies: Overall

Treat the illness.

Dismantle the contributors to your stressand turmoilon an ongoing basis.

Replenish your emotional energy.

Craft your career intentionally.

Aim for thrival, not just survival !


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(Organizational)

EngagementBurnout(Disengagement ) ("Flow")

Burnout Wellbeing

(Individual)

("Ill-being") ("Vitality")


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Unhealthy systems stayunhealthy until they change orare changed.

(If nothing changes

nothing changes.)

I b l k h h


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Kernan Manion,M.D.

Its been an pleasure to speak with you this

morning.

Please consider Work/Life Design a ready

resource for coaching, group practice consulting,

workshops and retreats.

Should you have any questions or wish to

receive specific materials mentioned, pleasecontact me at www.WorkLifeDesign.org.

Please also visit our new resource pagewww.WorkLifeDesign.org/forum/

Wishing you abundant success & happiness !


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Johann Wolfgang von GoetheMasonboro Sound

Wrightsville Beach, NC

Find Happiness as a Physician

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