Personal view or opinion piece
Open Access

Unfancifying wellness

Margaret Dow[1]

Institution: 1. Mayo Clinic
Corresponding Author: Dr Margaret Dow ([email protected])
Categories: Students/Trainees, Teachers/Trainers (including Faculty Development), Teaching and Learning, Undergraduate/Graduate
Published Date: 13/09/2019

Abstract

Our well-intended focus on wellness may be contributing to fancy, unattainable goals.  Formal programming appears to be helpful in improving resident well-being and burnout, but we may be neglecting the power of modelling the behaviors that have helped us survive as practicing physicians.  Emphasizing daily self-care practices may contribute to a realistic, sustainable path to improved health and wellbeing to complement our more structured efforts.

Keywords: wellness; well-being; burnout; role modeling; self-care

The Art of Daily Wellness

Wellness programming is in your face.  It is in our curricular innovations, our evaluations, our textbooks and journals and guidelines and conferences.  Daily we get the opportunity to learn from an expert how to create programming and sessions and toolkits and resource guides for wellness; it is a wonderful trajectory.  Helping our patients be well is better accomplished if we are, too.  But I wonder if we are working a little too hard at it?  We have spent billions of hours and dollars trying to establish wellness-supporting strategies for patients, learners, and occasionally for ourselves.  We have made it fancy—unattainable—an ultimate outcome instead of a daily process.   Maybe wellness is not always about special programming; maybe it is as simple as turning our focus to what we are already doing that makes us well, and sharing that with our peers and learners.  Mentorship is central to the practice of medicine; why not here?  There are a lot of wheels that needn’t be reinvented. 

Do you have an exercise plan?  You don’t have to be a Crossfitter and demonstrate rope climbing to establish that you exercise.  Talk about it.  Talk about what happens on the mornings that you struggle to get out of bed and lace up your trainers.  Talk about the way running or walking or lifting or dancing helps you manage the day to day stress of OBGYN.  Take the stairs when you round.  Live your fitness.

Did you have a bad outcome?  How did you deal with it?  What steps did you take in the room at the moment to keep your focus and press on?  What did you do to care for yourself afterward?  Did you find resources that you were not previously aware of?  Perhaps there is a venue to collect resources and make sure they are accessible when others need them.  How can you relay parts of that experience- the parts you can comfortably share- with your colleagues? 

Even better- what did you do beforehand that prepared you to make it through a difficult process?  You cannot build an ark during the flood; resilience must be cultivated before the challenges arise.

Do you wrestle with the Sirens of a candy drawer on labor and delivery?  Give in to the middle of the night cafeteria fries? Maybe you become the person who brings a veggie tray with really good hummus sometimes, or perhaps you create a dare on your shift of who can hold out the longest.  Maybe you are already the one toting a water bottle instead of soda. 

Does your sleep habit keep you on track to perform at your best in the middle of the night? Do you “bank” sleep before a hard call schedule? What’s your napping strategy?  Do you stick to your fatigue mitigation plans for residents?  Can you apply the same rules to yourself?

We have a laborist with incredible financial management skills.  He leads financial planning for our residents, and consults with fellow staff members, as well.  Do you have tips or tricks that work? 

Do you have a spiritual practice?  How has it helped you in training or practice?  Proselytizing is not likely to make you friends, but there is a vast difference between selling and telling.

The data suggest that our trainees are doing a better job at social wellness than those who came before; work hour reform has bolstered their ability to stay connected with friends and family.  Can we learn from this?  Social media, for example, has earned such a bad rap, but certainly has its place in connecting to people in healthy ways.  The trusty telephone still works, as does the simple trot over to your next door neighbor’s house.  How do you manage this successfully in your own life right now?  Talk about it.  Let it be known that you value connecting with others- with your community. 

Does environmental wellness sing to you?  Fix the overcrowded bulletin board by the work room.  Launch an impromptu gratitude session on a quiet night shift.  Post the thank you notes from patients who felt grateful for their care.  Encourage kind words and substantive feedback, and model it yourself. 

On my second day of residency, the then-department chair told me to read for five minutes a day.  He suggested picking up whatever journal had just arrived.  He noted that some days, five minutes would turn into forty-five, and other days I might find myself watching the clock.  The habit stuck, and fifteen years later I share it with the residents and students I work with.  Five minutes.  Real life intellectual wellness.   

Medicine is a rigorous lifestyle, and we do not survive practice very long without some solid self-care strategies.  Every single one of us is likely already practicing some wellness activities—maybe even lots of successful strategies.  What we model, often even when we don’t know it, is the real stuff of life.  Wellness doesn’t always have to be fancy or led by a guru or from the latest research or dressed up in fancy yoga pants; it is also our simple, authentic ways of taking care every day (which ironically may not mean every single day).  Talk about it.  Pass it on to the next generation.  Let’s mentor them with an arsenal of real life techniques to help them thrive on a daily basis.

Take Home Messages

  • Wellness is far more than exercise and diet
  • Most (if not all) physicians practice wellness in some way, on most (if not all) days, often without recognizing it
  • Mentorship is a principal element of good teaching and is useful in this context
  • Recognizing and talking about the daily practices that keep us focused and satisfied can encourage our learners to nurture their own wellness practices

Notes On Contributors

Margaret Dow, a laborist and educator at Mayo Clinic, is board certified in OBGYN and obesity medicine, and is a certified yoga teacher and health coach.  She serves as OBGYN clerkship director and oversees wellness curricula across all third year clerkships and OBGYN residency.  She serves on the national CREOG Physician Satisfaction and Wellness Task Force, helping develop and implement resident and faculty wellness curricula.

Acknowledgements

None.

Bibliography/References

None.

Appendices

None.

Declarations

There are no conflicts of interest.
This has been published under Creative Commons "CC BY-SA 4.0" (https://creativecommons.org/licenses/by-sa/4.0/)

Ethics Statement

Ethical approval was not required for this personal view article because it does not report research findings.

External Funding

This article has not had any External Funding

Reviews

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Felix Silwimba - (13/09/2019)
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the article is a reminder of the practice of medicine in the present times. wellness is now fancy among politicians even in low middle income countries like Zambia. it makes me think how are the medical doctors walking the talk, since it is not just about joining in presidential lead workouts or early morning jogging it is much more than that. I recommend every medical educator to read through and reflect.
Laurel Fick - (13/09/2019)
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Dr. Dow brings up some valuable insight into drivers of personal well-being in this opinion piece and advocating for better self-care practices. While I agree we have under-represented our personal self-care practices, I wish the author would have taken the approach that physicians would most benefit from both approaches- self-care and organizational strategies. I felt that the article put a negative slant on departmental/organizational strategies instead of recognizing their value and adding self-strategies.
Possible Conflict of Interest:

I chair our department's well-being committee and have seen positive changes from departmental strategies with this approach. We are also adding in self-care strategies so this piece is very timely.