Wrapping Up an Eventful Year

Wrapping Up an Eventful Year

As 2015 comes to a close, I’m guessing many of you are feeling as exhausted as I am. What a year! There have been so many changes and moving parts in the practice of medicine and Health IT it’s been like drinking from a fire hose! ICD-10, Meaningful Use with last minute changes, new e-prescribing certifications, portals and patient engagement, population health management, ACOs and buy-outs, ACA plans, narrow networks and high patient deductibles, reduction in payments from Medicaid and private payers…..I could go on.

Change is hard, but this has been enough to make me start thinking about the traumatic stress reactions we have all been facing. We are supposed to be aware of Adverse Childhood Experiences and the consequences of lifelong trauma. I think it’s time for us to take a deep breath and acknowledge the stress that we have all been under in the healthcare community. The first step in a healthy response to stress is awareness.

I’d like to take this opportunity to celebrate our collective success in surviving a challenging 2015 and to stimulate thinking about how we can best prepare ourselves for 2016 and beyond.

Hats off to YOU!

  • A big KUDOS to all of my awesome colleagues who have fought their way through increasing regulatory and reporting burdens to deliver great care to their patients
  • HIP HIP HOORAY to those of you who remained independent despite pressures from others to incorporate you or make you feel powerless
  • THREE CHEERS for those who aligned themselves with like-minded others for collective strength
  • STANDING OVATION to those staff members who spent countless hours on hold for prior authorizations, appealing ludicrous payer rejections, trying to get their internet connection functional, to get help/support
  • SALUTE to the clinical team who spent hours holding hands, supporting and encouraging patients and families toward optimal health

The work we do every day IS hard. It’s emotionally draining and intellectually exhausting. To pretend otherwise, would be denying the reality of our current environment. However, it is an incredibly rewarding place to be. So, how can we best prepare ourselves for 2016? Let’s learn from the evidence-based models we have for childhood trauma and address resilience and other reasons for optimism.

Our knowledge about what constitutes resilience in children is evolving, but we know that several factors are positively related to such protection, including cognitive capacity, healthy attachment relationships (especially with parents and caregivers), the motivation and ability to learn and engage with the environment, the ability to regulate emotions and behavior, and supportive environmental systems, including education, cultural beliefs, and faith-based communities. (Center for the Study of Social Policy. The protective factors framework. http://www.cssp.org/reform/strengthening-families/thebasics/protective-factors. Accessed May 29, 2014)

So how can we apply that to the practice of medicine in today’s environment?

  • Figure out what gives you the most joy in practicing medicine and make sure you get a healthy dose of it on a regular basis.
  • Increase your knowledge so you are comfortable responding to the changing environment. Set aside protected time to learn more about how to use your EHR, screen/treat mental health issues in your practice, understand practice transformation. We hate to feel incompetent. Give yourself the gift of time to learn.
  • Develop healthy relationships with colleagues. Feeling supported and part of a collaborative community combats feelings of isolation and despair.
  • Create a supportive practice environment with adequate decompression time, an appropriate place to vent and process, and one where there are realistic expectations of how much can be accomplished on any given day.
  • Maintain healthy habits. We counsel our patients every day about the importance of healthy eating habits, exercise and stress reduction. Yet how often have you had coffee and donuts for breakfast (or skipped it), got home too late to exercise or double-booked your entire day?
  • Pursue a work-life balance. Notice I said “pursue.” Balance is something that is forever changing and I’m not sure most of us over-achievers ever get there. Nonetheless, identifying interests outside of work and making time for them are critical.
  • Seek support when you need it. We all need help from time to time, and asking for it is not a sign of weakness. Don’t wait until everything is a crisis!
  • Create an expectation for change and own it. Understand that the practice of medicine is in constant flux. Let us become agents of our own change.

Thanks for the opportunity to work with you. The world is a better place because of what we do individually and collectively. Don’t lose sight of how much of what you do matters!