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Perspectives

Physician, de-stress thyself

Taking steps to manage your stress

By Monisha Vasa, M.D.

Physicians face highly specific environmental stressors that include heavy patient loads, long hours, sleep deprivation, dealing with illness, death and demanding patients on a frequent basis, excessive paperwork and litigious practice environments. In addition, physicians often have personality traits that can add to stress, such as perfectionism, compulsivity, an exaggerated sense of responsibility, self doubt and an excessive need for control.

Acknowledging that stress is created by both the environment and our reaction to that environment gives us a degree of control over changing our experience. There is no one "stress management" solution that is applicable for all physicians, just as the ideal balance between work, love and play will be different for each of us. However, there are some fundamental principles that may be helpful in stress reduction.

Stress management begins with a commitment to move towards a healthier life balance that is in accordance with our personal values and priorities. The steps to achieve this include:

  • Establish your priorities within the domains of work, leisure, personal, family and community;
  • Identify the discrepancies between where the majority of your time and effort is spent, vs. where you want it to be spent;
  • Create concrete and manageable ways to move toward your balance goals.
To achieve balance, work does not have to be drastically reduced or eliminated -- finding ways to make work more rewarding, taking needed breaks, and setting reasonable expectations and boundaries can go a long way in helping create a sustainable and enjoyable medical career. It is critical to distinguish between manageable stress and more severe distress, such as burn-out, major depression, an anxiety disorder, or substance abuse, all of which require formal comprehensive assessment and treatment.

The input of a counselor, mental health professional, mentor, colleague or friend can be invaluable. Resources at Cedars-Sinai include: the Physician Well Being Committee, the Work 'n Life Matters program, and the Department of Psychiatry and Behavioral Neurosciences. State medical societies such as the California Medical Association or specialty specific professional societies also often offer resources for stress management. For more information, please contact Cynthia C. Nast, M.D., chair of the Physician Well Being Committee, at (310) 423-6658 or Denise Brent, manager of Quality Services, at (310) 423-6217.

Dr. Monisha Vasa is a psychiatrist in private practice and a member of the Cedars-Sinai medical staff.