PA, Heal Thyself
By Jennifer Anne Hohman
What does it mean to practice medicine in a healthy, sustainable way, one that promotes the well-being of your patients and also yourself? How can you prevent the main symptoms of burnout—exhaustion, depersonalization and discouragement — from eroding your career and personal well-being?
From my discussions with PAs, I’ve learned that burnout comes mostly from unsustainable schedules and from a feeling of being taken for granted or unable to offer personalized medical care to patients. Given their dedication to patients and to team practice, it is easy for PAs to over-commit, overextend and even to be exploited by unethical employers. One way of making any position healthier is through diligent contract negotiation — to help ensure a fair and sustainable work arrangement.
Step one in burnout prevention is careful assessment of both the contract and practice culture offered by an employer. Ask yourself: On the whole, is this a place where I can practice in balanced manner? Do the physicians I’ll be working with seem to be doing so?
Finally, given the centrality of quality working relationships to PA practice, if you are unable to make the necessary changes and find yourself working with seriously negative practice partners, who are perhaps burned out themselves and have become either absent or abusive in their collaborative style — move on. Being in a toxic clinical partnership is an express route to burnout.
Take Care of Yourself
An important key to a healthy career is cultivating a healthy life beyond clinical practice. Amid the demands of work, how well are you taking care of your own wellbeing in terms of diet, exercise, sleep, and time for family and the interests outside of your practice that engage and inspire you? Are there ways you can commit to improvements in these areas, even sharing your journey with patients when appropriate?
Beyond these basic pillars of health, a new practice in medicine offers a vital new way to practice optimally and prevent burnout: mindfulness. Mindfulness has been described as the intentional cultivation of a nonjudgmental, attentive state of mind that enhances all interactions, including those between provider and patient. How might it apply to and benefit PA practice? PAs’ attentive, empathic listening skills—inculcated during PA education and put into practice every day — are appreciated as an empowering, healing force by patients and offer a model of interaction for the healthcare system.
Many of the skills and attitudes identified with mindfulness lie at the heart of the PA approach to medicine: My clients tell me that connecting personally with patients and acting as their trusted health advocates is key to their professional satisfaction — and also what makes the frequent frustrations of working within a far from ideal healthcare system worthwhile.
Mindfulness brings a new awareness of the subjective dimensions of practice — the need for both PAs and physicians to have the resources they need to be present, cultivate calmness and offer compassion to self and patient. This is an exciting development in the culture of medicine and one that PAs may be uniquely qualified to lead as the profession gains new levels of recognition. As communication, compassion and respect are increasingly understood as keys to effective practice, PAs, already grounded in these principles, are well placed to promote them in the world of medicine. It is my hope that in this area, as in others, PAs will be the standard bearers for a more humane and progressive way of practicing medicine. At a practical level, mindfulness and other wellness promotion efforts can only help you preserve vital resources — of energy, clarity of mind, and positivity that are essential to the demanding work of being a PA.
There is a wealth of online resources for medical providers interested in exploring mindfulness. One of the most comprehensive, featuring videos and interactive exercises, has been collected for clinicians at the University of Wisconsin Department of Family Medicine and Community Health’s Mindfulness in Medicine program. This program was created to “support the well-being of health care practitioners, residents, medical students, patients, and others through mindfulness, and investigate how mindful-ness training influences compassion, joy, career satisfaction, and resilience of clinicians” and is well worth a visit. I hope that readers who may be experiencing burnout or feel on the cusp of doing so will avail themselves of these resources as well as remember that they deserve to have healthy and happy careers.
ADDITIONAL WELLNESS AND MINDFULNESS RESOURCES FOR PAs
Harvard Pilgrim Health Care Burnout Resources for Providers
U Mass Medical School Center for Mindfulness in Medicine, Health Care and Society
Goodness of Heart Resources on Clinician Wellness
Jennifer Anne Hohman is the founder and principal of PA Career Coach, a service dedicated to helping PAs create rewarding, healthy and patient-centered careers. Contact her via email.