Practicing medicine at the frontlines is hard. It’s damn hard. Every minute you need to be alert, ready to respond to a potential life or death situation, and be called to another important problem. 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 faint-hearted. 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 them through their illness, recovering and walking out the door.
I wrote an article a couple of months ago 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 — which 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, like a sportsperson or music artist. Ask anyone in these fields how important lifestyle habits such as diet, activity and underlying psychology, are to their overall level of performance — and they will tell you they are critical.
I liken being a doctor as being on a type of stage. Whether physicians always appreciate it or not — we are. Everybody around us, from the patient and nurse, to the housekeeping staff and cafeteria cashier — views you as a leader. How you interact with everyone is acutely remembered, 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, get to the correct diagnosis and treatment, and communicate well at the same time. Here are three health tips to focus on:
1. 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 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 multigrain bread) over the higher glycemic index ones (potatoes, fries, 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 handful of nuts (almonds or walnuts). Working in health care, 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 not every day.
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, but avoid sodas (especially the high sugar ones). 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 don’t personally drink coffee, but I know most people around me in health care, appear to be addicts.
2. Activity
Depending on your specialty, you may or may not be particularly active during the day. Some fields, such as hospital medicine (my specialty, when I am working in the hospital), can lead to several thousand steps a day. Others in primary care, not so much. I work out in the gym before starting work, but that does require getting up very early, and 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!). This can burn significant calories during the day, but more importantly from the performance perspective — you receive an energy boost with a burst of cardiovascular activity, from both stair climbing and brisk walking.
3. Mindset and communication
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’s only two things you can do: 1) change yourself, or 2) change your circumstances.
To be working at your peak, you must show up at work with a positive mindset, determined to have meaningful interactions (obviously as a doctor, our most important interactions are with our patients).
A couple of things that may also help you: avoid hanging out with other negative colleagues (they will only bring you down ultimately) and practice gratitude. Remember how many good things there are about your work circumstances: you are in a field with lots of demand, you have free decision anytime to move to another institution or seek out alternative arrangements, and hey—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 crazily 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.
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