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Extreme medicine?


Dr. Carraway
Workplace "burnout" is a term that we usually save for describing other people and their careers. Interestingly, a significant number of physicians — and, yes, even cosmetic surgeons — are on the verge or have full-blown symptoms of this destructive problem.

If you feel that you cannot listen to another set of patients' complaints about your last surgical procedure or you don't want to walk into an exam room anymore, this may be just one sign of this problem affecting you. If your schedule is always overwhelming and you don't have enough time to talk to your patients or run your office, or you left out the correct ICD9 or CPT Codes, then the next event in your life may be the onset of burnout.

Early warning signs include chronic fatigue, anger or flare-ups at those making demands on your time; self-criticism for constantly putting up with the demands that you are unable to meet; cynicism and negativity; chronic irritability, sleeplessness and depression; and psychosomatic disorders such as headache or GI disturbances. Weight loss or gain, irregular diet, loss of appetite or binge eating can also be signs of burnout.

If burnout becomes a true problem, as physicians we tend to in engage in denial. By speaking with a counselor skilled in treating stress-related problems in physicians, we can effect a plan. Books and counseling services can help us to better accommodate our stressful lives.

For those who practice plastic surgery, life can be difficult. We have to balance giving the very best care to our patients, while at the same time, we have to perform a full workload within a reasonable period of time — and then have enough free time for our families and other activities. Since most cosmetic surgeons also have a practice that includes reconstructive work, we know that problems of reimbursement and loss of autonomy in our practices are significant sources of frustration.

Often, just making the effort to "book yourself out" a certain amount of time each week to spend as quiet time or to organize some of your activities outside of the practice can be quite effective in reducing stress. Certainly, we have to take care of ourselves with good nutrition, exercise and sleep habits. Physicians are probably the worst group in regard to taking care of themselves.

Ways to overcome stress can include: looking for the cause, clearing or uncluttering your life from extra obligations, setting goals, seeking counseling, learning to say 'no' to requests, establishing a realistic workweek, and turning off your cell phone, computer and beeper for periods of time.

If there is a strong concern about privacy, consider going online to look at the many references and books. Many current journals also have excellent articles.

Certainly, the many physicians who have fought burnout in a constructive and intelligent manner have been able to counsel others on how to improve their situation and their sense of self-esteem while achieving a better direction in their lives. Don't let burnout even begin to get to you; be proactive in your awareness and prevention of it.

James H. Carraway, M.D.

Plastic and Reconstructive Surgery

Eastern Virginia Medical School

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