Find Happiness As A Physician

Is It Even POSSIBLE to Find Happiness as a Physician Today?
Keys to Preventing Burnout and Finding Well-being in Medicine Today
Kernan Manion, MD
Internal Medicine Grand Rounds Lecture Series September 13th, 2006 Coastal Area Health Education Center
Helping People Live and Work Well - by Design
www.WorkLifeDesign.org
910-509-1773
Is It Even POSSIBLE to Find Happiness as a Physician Today?

Keys to Preventing Burnout and Finding Well-being in Medicine Today
Kernan Manion, MD
Kernan Manion, MD does not have any conflicting financial interest from commercial entities.
910-509-1773
"To find health should be the object of the doctor. Anyone can find disease."
Dr. A.T. Still Founder of Osteopathic Medicine, 1874

910-509-1773
Maintaining ones own health & well-being should be as important a concern of the physician as treating patients. Otherwise, the doctor becomes the patient."
Kernan Manion, MD 2006
910-509-1773
Physicianhood is not just a job. It is an often high intensity human service focused on the treatment of illness, the prevention of death and the alleviation of suffering.
910-509-1773
RESILIENCY (Affect Reserve Pool) (think "elasticity")
EMOTIONAL RESPONSE - RESILIENCY
EMOTIONAL INTENSITY (think "energy")
TIME
Stressor Event 1 Stressor Event 2

910-509-1773
Think "Muscle Physiology"

Stressor
TIME "X"
2nd Stressor
EMOTIONAL RESERVE / RESILIENCY
Work Phase
Recovery Phase
"Strengthening" & Resiliency =>> "Endurance"
STRESS DURATION

910-509-1773
MAJOR STRESSOR
2nd Stressor
EMOTIONAL RESERVE - RESILIENCY
Recovery Phase (Inadequate)
3rd Stressor
4th Stressor
STRESS RESPONSE DEPLETION i.e. Cognitive / Emotional Exhaustion i.e. BURNOUT STRESS OCCURANCE / TIME

910-509-1773
Traditional Understanding
The Stress Response

Fight ( Anger)
OR
Flight (= Fear [Anxiety])
The Relaxation Response

Non Fight (= Non Anger)
Non Flight (= Non Fear)

910-509-1773
Through the MindSense Perspective
The Stress Response

Anger Anxiety Sadness Shame Pain
(Turmoil)
The Relaxation Response
Love Peace Joy
(Bliss)
Prid e
Delight

910-509-1773
Anger Anxiety Sadness
Love Peace Joy Pride Delight
Shame
Pain

910-509-1773
Anger Anxiety Sadness Shame Pain
Love Peace Joy Pride Delight

910-509-1773
The MindSense Model

Event / Issue (Theme) Internal Dialog(s) Affect(s) Soma Behavior(s)
Sadness
Anxiety
Shame
Affect Pool

910-509-1773
Delight
Peace
Anger
Pride
Love
Pain
Joy

910-509-1773

910-509-1773

910-509-1773

910-509-1773

910-509-1773
Emotion Pastels of Primary Turmoil Affects

Irritation
Worry Glum
ANGER
ANXIETY SADNESS SHAME PAIN
Rage
Panic Grief Mortified Misery
Embarrassed
Hurt

910-509-1773
Emotion Pastels of Primary Bliss Affects

Fondness
Calm Content
LOVE
PEACE JOY PRIDE DELIGHT
Enamored
Serene Euphoric Self-respect Ecstasy
Satisfied
Pleasure

910-509-1773

910-509-1773
Antidotes for dismantling and for replenishment

910-509-1773

910-509-1773

910-509-1773

910-509-1773

910-509-1773
Anatomy & Physiology of a Single Stress Event using the MindSense model
(For those wishing to learn more about the MindSense model, visit the contact page at www.WorkLifeDesign.org
and request that I send you the MindSense audio overview.)

910-509-1773
The MindSense Model

Event / Issue (Theme) Internal Dialog(s) Affect(s) Soma Behavior(s)
Sadness
Anxiety
Shame
Helping People LiveAffect Pool Well - by Design and Work

910-509-1773
Delight
Peace
Anger
Pride
Love
Pain
Joy
CHAOS: the entire array of issues, events and situations within our perceived sphere of concern that may be acting upon us

910-509-1773
CACOPHONY:
the array of internal dialogs (conscious and pre-conscious) one has regarding each of the events / issues / situations in ones CHAOS layer

910-509-1773
TURMOIL: the concurrent negative emotions associated with CHAOS & CACOPHONY

910-509-1773
Burnout
is an occupational stress syndrome which predominantly affects people doing people work. It is manifested by exhaustion, detachment and reduced accomplishment.
910-509-1773
The Triad of Symptoms

(adapted from Maslach and modified)
Fatigue/Exhaustion Detachment Reduced Accomplishment

910-509-1773
Fatigue/Exhaustion
Physical
Cognitive
Emotional

910-509-1773
The work of healing requires cognitive, physical and emotional energy. Energy needs to be replenished. We do NOT have an inexhaustible resource of emotional energy.
910-509-1773
Detachment
From Family & Friends, Colleagues, Patients
Cognitive Physical Emotional

910-509-1773
Reduced Accomplishment
Productivity Quality
Keep in mind that one can maintain productivity & quality, but at significant cost to Energy

910-509-1773
WorkLife Health Continuum

Meltdown Burnout Weardown Functional/Operational Engagement
Fatigue Energy
Detachment Involvement
Accomplishment: Reduced Increased

910-509-1773
Burnout - Potential Outcomes

Traditional thinking about physician health is dichotomous and pathology-oriented:
Doing okay vs. Not doing okay

910-509-1773
But its not just: Doing okay vs. Not doing okay
In reality, theres a continuum of adaptation / maladaptation:
Engaged OK/ Functional Weardown Burnout Meltdown

910-509-1773
Unaddressed Burnout will likely lead to significant emotional, relational, occupational and behavioral impairment.

910-509-1773
But
Burnout Depression
Remember Burnout is an Occupational Stress Syndrome and it can manifest in MANY WAYS.

910-509-1773
Burnout
- Potential Outcomes
MELTDOWN - the Worklife "Code Blue"

(Clinical performance impairment) Simmering Burnout ("Slow Burn) Emotional Illness & Addiction Compassion Fatigue (+ Vicarious Traumatization / 2ndry PTSD) Behavioral Issues (e.g. disruptive) Relational Strain Physical Manifestations of Chronic Stress Exposure (HTN, MI, CVA ) Detrimental Impact On Organization Loss of job / career Fortuitous Job change / Career modification Renewal & Transformation
910-509-1773
Burnout
Contributing Causes in Burnout

Domains of Influence and Recurring Themes
I find it helpful to divide the matrix of contributing causes into 4 major domains of influence: Individual Role & Career
Organizational
Systemic & Environmental
910-509-1773
Domains of Influence and Recurring Themes

There are innumerable stress issues that may contribute to ones Burnout (and each persons stress array is unique.) Clustering these into theme categories not only helps get a handle on the predominant issues; it also helps highlight some common areas that need to be addressed (e.g. interpersonal communication; dealing with difficult patients.)

910-509-1773
The key challenge:
Dismantling our Chaos & Turmoil

Realizing our LONGING and finding our Bliss!
Insert slides here with focus on dismantling burnout / changing environment / setting sights on healthy culture

910-509-1773
Remedies: Overall
Treat the illness. Dismantle the contributors to your stress and turmoil on an ongoing basis. Replenish your emotional energy. Craft your career intentionally. Aim for thrival, not just survival !
910-509-1773
(Organizational)
Burnout
(Disengagement )
Engagement
("Flow")
Burnout
("Ill-being")
Wellbeing
("Vitality")
(Individual)

910-509-1773
Unhealthy systems stay unhealthy until they change or are changed. (If nothing changes nothing changes.)
910-509-1773
Its been an pleasure to speak with you this
morning.
Please consider Work/Life Design a ready resource for coaching, group practice consulting,
workshops and retreats.

Should you have any questions or wish to receive specific materials mentioned, please contact me at www.WorkLifeDesign.org. Please also visit our new resource page www.WorkLifeDesign.org/forum/
Wishing you abundant success & happiness !
Kernan Manion, M.D.

910-509-1773
Then indecision brings its own delays, And days are lost lamenting oer lost days. Are you in earnest? Seize this very minute; What you can do, or dream you can,
begin it;
Boldness has genius, power and
magic in it.
Masonboro Sound Wrightsville Beach, NC
Johann Wolfgang von Goethe

910-509-1773

Find Happiness As A Physician

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Find Happiness As A Physician

Uploaded by

Copyright:

Available Formats

Is It Even POSSIBLE to Find Happiness as a Physician Today?

Keys to Preventing Burnout and Finding Well-being in Medicine Today

Is It Even POSSIBLE to Find Happiness as a Physician Today?

Helping People Live and Work Well - by Design

RESILIENCY (Affect Reserve Pool) (think "elasticity")

EMOTIONAL RESPONSE - RESILIENCY

EMOTIONAL INTENSITY (think "energy")

Helping People Live and Work Well - by Design

Think "Muscle Physiology"

EMOTIONAL RESERVE / RESILIENCY

"Strengthening" & Resiliency =>> "Endurance"

Helping People Live and Work Well - by Design

EMOTIONAL RESERVE - RESILIENCY

Recovery Phase (Inadequate)

Helping People Live and Work Well - by Design

The Stress Response

Flight (= Fear [Anxiety])

The Relaxation Response

Non Flight (= Non Fear)

Helping People Live and Work Well - by Design

Through the MindSense Perspective

The Stress Response

Helping People Live and Work Well - by Design

Anger Anxiety Sadness

Love Peace Joy Pride Delight

Helping People Live and Work Well - by Design

Anger Anxiety Sadness Shame Pain

Love Peace Joy Pride Delight

Helping People Live and Work Well - by Design

The MindSense Model

Helping People Live and Work Well - by Design

Helping People Live and Work Well - by Design

Helping People Live and Work Well - by Design

Helping People Live and Work Well - by Design

Helping People Live and Work Well - by Design

Helping People Live and Work Well - by Design

Emotion Pastels of Primary Turmoil Affects

Helping People Live and Work Well - by Design

Emotion Pastels of Primary Bliss Affects

Helping People Live and Work Well - by Design

Helping People Live and Work Well - by Design

Antidotes for dismantling and for replenishment

Helping People Live and Work Well - by Design

Helping People Live and Work Well - by Design

Helping People Live and Work Well - by Design

Helping People Live and Work Well - by Design

and request that I send you the MindSense audio overview.)

The MindSense Model

Helping People LiveAffect Pool Well - by Design and Work

Helping People Live and Work Well - by Design

Helping People Live and Work Well - by Design

Helping People Live and Work Well - by Design

The Triad of Symptoms

Fatigue/Exhaustion Detachment Reduced Accomplishment

Helping People Live and Work Well - by Design

Helping People Live and Work Well - by Design

Cognitive Physical Emotional

Helping People Live and Work Well - by Design

Helping People Live and Work Well - by Design

WorkLife Health Continuum

Accomplishment: Reduced Increased

Helping People Live and Work Well - by Design