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Practicing medicine at the frontlines is hard. It's damn hard. Every minute you need to be alert, ready to respond to important problems and potential life or death situations. The current medical practice environment -- with excessive bureaucracy, suboptimal information technology, and extreme time pressure with patients -- adds exponentially to the mix, and can make for a very stressful job.
Make no mistake, even without these added burdens, being a doctor is tough enough. It's certainly not a job for the fainthearted. At the same time, it's an incredibly rewarding career, and there can be few better things than getting to form relationships with patients and their families, seeing patients through their illness and recovery, and watching them walk out the door healthy.
Recently, I wrote about an experience I had when someone remarked to me about how impressed they were with physicians always needing to be on their "A-game" while at work. There's no time to sneak away while you're on duty, switch off, or relax in a dark room (unless you're a radiologist). Directly related to this is another aspect of working in medicine -- or for that matter, any busy profession -- that is really not discussed enough. And that's how healthy (or conversely unhealthy) habits contribute to us not quite being at our best. If you look at other fields where there's talk about people being on their A-game, it's invariably a performance-type situation, an athlete or musician, say. Ask anyone in these fields how important lifestyle habits are to their overall level of performance (diet, activity, underlying psychology, etc.); they will tell you they are critical.
I've likened being a doctor to . Whether physicians always appreciate it or not, we are. Everybody around us -- from the patient and nurse to the housekeeping staff and cafeteria cashier -- view us as leaders. Your interactions are likely to be acutely remembered by others, and your words carry enormous weight when you are walking around in that white coat. It's important to do everything possible to be at your peak, to get to the correct diagnosis and treatment, and communicate well at the same time. Here are three health tips to focus on:
1. Don't Ignore Your Diet
What we eat is the fundamental building block of how we are going to feel. In the interests of keeping things succinct, I will give you a few simple key tips. Generally, you want to avoid sudden sugar "highs and lows" during the day. Always eat a healthy breakfast before starting work (such as oatmeal with fruit). For lunch, ensure a well-balanced meal with a healthy protein (avoid red meat) and favor low-glycemic carbohydrates (brown rice, whole wheat or multi-grain bread) over the higher glycemic index ones (fries, potatoes in general, white pasta, and bread), which will produce rapid rises in blood sugar. Generally, most people find that eating too many carbs for lunch contributes to post-lunch lethargy. Something you should think about if you have a waiting room of patients to see or a couple of surgeries to perform.
In terms of snacking, you may need a mid-morning and mid-afternoon snack to give you a boost. Pick a healthy option like a fiber bar, fresh fruit, or a handful of nuts (almonds or walnuts). Working in healthcare, you will often find yourself surrounded by treats like candies and chocolates. You don't need to avoid treats entirely (life is dull if you are too restrictive), but certainly don't make eating them a daily habit.
As for what you drink, it's essential to stay hydrated while at work (dehydration is a chronic problem among the general population). Pure water is ideal -- avoid sodas. Remember the classic rule of trying to drink at least 2 liters of water a day (eight 8-ounce glasses) doesn't apply to everyone, but can be used as a benchmark for a younger, healthy person.
Tea and coffee are fine, but don't go over the top on the caffeine fix, and limit it to a maximum of two coffees per work day. I personally don't drink coffee, but most people around me in healthcare appear to be addicts.
2. Be Active
Depending on your specialty, you may or may not be particularly active during the day. Some fields, such as hospital medicine, can lead to several thousand steps a day. But primary care, not so much. I work out in the gym before starting work, but that requires getting up very early, which may not be everyone's cup of tea. However, I still strive to be as active as possible while at work.
If you are sitting down for most of the day or standing still in the OR, get up and take a good brisk walk whenever you have some downtime, and a longer one at lunchtime -- leave the clinic or hospital and go outside if you can. Hopefully, you do other aerobic exercise outside of work too, but a brisk walk is at least categorized as moderate intensity. Also, try taking the stairs and ascending or descending as briskly as you can -- safely, while holding onto the side! -- as this can burn significant calories. More importantly, from the performance perspective, you will receive an energy boost with a burst of cardiovascular activity like stair climbing or brisk walking.
3. Have a Positive Mindset
Our internal mindset and how we communicate is also a cornerstone of our performance. If you have a negative mindset, dislike your job, and have overwhelmingly negative interactions with those around you, there's no way you can be doing good work and performing at your best. If this is you, there are only two things you can do: change yourself or change your circumstance.
To be working at your peak, you must show up at work with a positive mindset and be determined to have meaningful interactions. Obviously as a doctor, our most important interactions are those with our patients.
A couple of things that may also help you: practice gratitude and avoid hanging out with other negative colleagues as they will ultimately only bring you down. Remember how many good things there are about your work: you are in a field with lots of demand, you have the option to move to another institution or seek out alternative arrangements, and you live in America, which alone puts you in the top percentile of the world in terms of opportunity and choice!
A final point is to strive for mental calmness so that when the barrage of issues hits you as soon as you step into the hospital or clinic, you are ready. For many people, a small amount of meditation in the morning, or even a few deep breaths with mindfulness right before you step onto the stage, can help reset that adrenaline and cortisol.
If you want to be at your best during crazy busy work days, always keep in mind the above three areas of physical and mental wellness. And never underestimate the link between the two either.
is an internal medicine physician, author, and an independent healthcare experience and communication consultant. He is co-founder of .
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