Doctors in Distress: Saving the Lives of Those Who Save Lives | Dr. Ed Ellison | TEDxNaperville

[Music] when I was five years old I was diagnosed with rheumatic fever and thanks to the steroids I had to take I blew up like the Michelin Man it wasn't cute and believe me it wasn't fine I was put on bed rest I wasn't allowed to run and play with my friends and for a five-year-old that's tantamount to torture so my my birthday rolled around my parents were determined to make it special now my big day my my dad hai stood me up on his shoulders and he carried me to the toy store to choose my present well I don't remember the toy that I picked I absolutely remember that act of love and while my illness was a low point in my young life there were actually some good things that came out of it my pediatrician came to our home to care for me that's right doctors made house calls back in the day and he was kind and he helped me and not only did he heal me because clearly my illness did not stunt my growth his compassion and his caring they moved me and they made me realize I wanted to be just like him a healer now you better believe when I told my parents I want to be a doctor they lit up I mean this was 1960s America Marcus Welby time doctors are heroes respected looked up to it's an honorable and noble profession and my parents are so proud that their little boy was going to be a doctor what they didn't know and what I couldn't know was that while Noble and true and good that in medicine I would find an enormous problem and yes there is fantastic positivity there's healing and there's cures and the advances the last 50 years I mean they boggle the mind they inspire the spirit but there is an underside to medicine that has been hidden for far too long and obscuring it is just making it worse it's something that we don't talk about among ourselves in the medical profession and certainly something we don't talk about with our patients but the field of medicine is being strained enormous lis strained by a number of factors and so today I'd like to pull the curtain back and share with you what's ailing our doctors and what you can do to help to begin with the qualities that make you a great physician also are qualities that can contribute to the potential misery of that person that's right I said misery it's sad but it's true it's heartbreaking actually but this is how it takes shape first of all perfectionist make great physicians I mean doctors pay incredible attention to detail we tend to check and recheck and then we we recheck again and while that's a quality that you absolutely want in your physician it can make the people in your personal life a little bit crazy believe me I know and once these perfectionists arrive in medical school that hallowed ground where you're first taught the mystery of healing the human body they're discouraged in every way possible from asking for help people who are drawn to medicine are devoted to taking care of the needs of others and they tend to put the needs of others above their own nearly always so let me bring this to life for you I had a colleague of cardiologist who has severe back pain he was in the hospital for surgery he heard a code blue called down the hall so he wrestled himself up out of bed and he shuffled down the hall to save a life then there's the OBGYN colleague who is admitted to the hospital in labor to deliver her own baby but who leaves her bed and goes next door to assist a colleague with a difficult delivery to bring a new life and the world I mean these are incredible people and they never stop so we have devoted perfectionists who've been conditioned to just suck it up to do whatever it takes to get the job done and they do all night shift check no sleep fine junk food for dinner well hey at least I got the shovel something down my throat an exercise well the standing on your feet for 24 hours count but they learn more they also learn how to swallow their pain how to swallow their fear their fear of failing the earlier their fear of letting someone down their fear of letting someone die and doctors are people who never give up until they do so what does giving up look like well it can look like losing energy and engagement and the things that matter to you they can become disengaged and attached and the people you care about your family your friends your patients you feel ineffective and like you can't accomplish anything you feel like you want to quit and and sometimes they do and there's actually a term for this state of chronic stress and it's called burnout and the symptoms of burnout include emotional and physical exhaustion insomnia loss of appetite loss of focus anxiety depression detachment I mean you get the gist in fact between 2011 and 2014 a Mayo Clinic survey showed that the percentage of physicians in this country who are experiencing at least one symptom of burnout rose from forty five point five percent to fifty four point four percent I mean that's unacceptable that's not okay that's not good for our patients and it's certainly not good for our physicians and you're probably wondering what's contributing to the spike in burnout we know that physicians work long hours but increasingly they're experiencing a sense of loss of control over their work they are measured on everything that they do and while they're dealing with matters of life and death the complexity of medical care is just exploding every single day and then there is the implementation of the electronic health record which has brought many positive attributes to care delivery but has brought with it inefficient workflows that are time consuming and ironically take physicians away from the things that brings in their greatest joy in practice spending time with patients so this can feel like a gigantic pile on especially for perfectionist and remember doctors don't ask for help they just sold you're on and do whatever it needs to be done to take care of their patients so not surprisingly if this isn't addressed matters get worse today many previously well-adjusted engaged physicians are being stressed to the breaking point they are retiring early and they are reducing their clinical practice or they're leaving medicine altogether but it actually gets darker and the last two years data shows that the rate of suicide among male physicians is 40% higher than that than the general public forty percent now men tend to experience burnout as detachment and disengagement what about our women in medicine female physicians rate of suicide is a hundred and thirty percent greater than the general public a hundred and thirty percent now of that is tragic and that is unacceptable and women in medicine experiencing burnout differently than men do because of their gender and the greater expectation for empathy they tend to give and give and give until they have nothing left to give but there's even more sobering information the rate of suicide among physicians is similar to that of combat veterans actually it's higher our combat veterans heroic men and women who put everything on the line for us who endure untold suffering and hardship but did you realize that many of your physicians are suffering too and so you you you wonder where did this all begin and actually it begins in medical school where we take these bright shining stars and we often wear them down to a dull nub studies show that students entering medical school actually have a higher incidence of wellness and resilience and optimism than those entering any other field of graduate study and yet by the time they graduate medical students sense of wellness and resilience and optimism is worse than that of any other graduate field so it makes us ask ourselves right what are we doing to our medical students we've talked a little bit about that already right perfectionists don't ask for help suck it up you're a lone ranger you're a superhero and your needs don't matter but then maybe when you get out of medical school things get better right but actually they don't because your training continues there's residency and then there's fellowship for many until eventually we have these newly minted physicians mostly 20-somethings with a burning desire to make a difference in the world into to do well and good for people's lives but they're finishing their training broken down and beaten down and this is the beginning and these are our healers and I know because I'm one of them I followed in the footsteps to be a physician in lockstep I did the training I went without sleep I ate junk and I learned and I suffered but I was also inspired by the gratitude of my patients and the satisfaction of knowing I was making a difference in people's lives and so I did more and I asked for more and took on more as my colleagues do I was called to leadership and now I'm privileged to stand before you as co-leader of one of the largest groups of physicians in the world 21,000 doctors taking care of almost 12 million patients and I have gained perspective I've heard the cries I've attended the funerals I have felt their pain our pain from my vantage point I feel the weight of the responsibility of my role and to me it is profound and it is sacred I lost to medical school classmates to suicide before we had even finished our internship and I have lost colleagues from my Medical Group and that is incredibly painful you know that the cardinal rule of Medicine the oath that we take as physicians is first do no harm first do no harm and how can that be anything but good well let me break this down for you the patient is why we are here absolutely we are drawn to serve but if we don't also recognize and care about the lives of those who save lives those of us who design the systems in which we work those of us who work side-by-side those who receive care from physicians if we don't also care about the lives of those who save lives if we ignore the humanity of the community of those who care for others then we are doing harm and this epidemic it will not stop now we intuitively know this in other settings right you got on an airplane they say before you help someone else put on your own oxygen mask but doctors aren't doing that and they are starving for oxygen and this is a big problem and if we're going to change it we really have to change our thinking our culture inside and outside of the medical profession across society even if it means going against the grain to do it we have to declare our physicians humanity we have a path forward we are beginning at the beginning at Kaiser Permanente we are opening a new medical school and few years we'll be welcoming our first class to our Kaiser Permanente's School of Medicine and these bright young minds we're going to absolutely teach them how to be exceptional physicians because that's non-negotiable we're gonna teach them some other things as well we're going to teach them that their wellness matters we're gonna provide support for them and connect them with each other and resources we're gonna teach them how to set healthy boundaries for their own wellness and about how prevention and nutrition works not just for them patients but for themselves and really importantly we're gonna teach them how to work within these systems to change these systems so they're not busted about by the system but they can be advocates and agents for change to transform and now this is really exciting stuff I mean it almost makes me want to go back to medical school almost and this is exciting for our medical students but what about my colleagues who've been practicing for 10 or 20 or 30 even 40 years what about them we must affirm their humanity too in the medical group that I lead we are applying these same learnings first and foremost declaring their wellness is essential for themselves and the Wellness of our patients and our communities and we're working on those systems that need to be improved and we're providing greater opportunity for flexible schedules that can make their lives work and we're teaching them about support for themselves in that love is medicine and exercises medicine and food as medicine and sleep as medicine for themselves as well as their patients importantly that their wellness matters now we have a lot more to do we have doubt of the shows we're making some progress moving in the right direction but this is a complex problem there's a lot more that we are committed to doing and that end I was privileged to be invited to join a consortium sponsored by the American Medical Association last year I joined esteemed colleagues from the Mayo Clinic and the Cleveland Clinic Duke Vanderbilt Stanford Johns Hopkins and we sat down to talk because the title the consortium was the joy in medicine we couldn't get to the joy in medicine because we were all focused on this epidemic of burnout that we're all seeing and so we committed that we were going to make a difference that we would share what we've learned with each other as broadly as we can and we continue to do that work but we also know that that's not enough if we're going to stem the tide of burnout the epidemic of suicide then all of us have a role to play those of us who design the systems those of us who take part in the systems those of us who receive care we should tell this story the doctors are people too and that may sound trite but it's not if we want our physicians to shine with resilience and with joy we have to consistently affirm their humanity and the critical role that they play in caring for all of us we need them but you know what they need us we need them to recognize that in order to fulfill this noble calling to heal and save lives they must first learn to heal and save their own for the sake of their patients for the sake of their families for the sake of themselves they must know this they must believe this now it might surprise you to hear me say this but in spite of everything that I've shared with you today or maybe even because of it I still love my profession and I want those bright shining stars to seek it out because we need them we need these healers these coaches and champions of health these brilliant minds were dedicated to the Wellness of their patients and their communities but if we're to help them succeed we have to help care for the lives of those who save lives and this is a powerful way that we can do it all of us together can think about the humanity of our physicians and how we affirm their humanity so the next time see your doctor go up to him or her look them in the eye and say hello and say thank you now they're not good at accepting it say it anyway the fact that you are aware and that you care it matters more than you know and the impact of affirming the humanity of our physicians to support those who care for us the impact of one makes a difference for many and that that can make all the difference in the world thank you [Applause] [Music]

Channel: TEDx Talks

Views: 29,500

Rating: 4.9570918 out of 5

Keywords: TEDxTalks, English, Health, Education reform, Happiness, Medicine, Mental health, Sociology, Teaching

Id: udV0tt6SjbQ

Length: 18min 39sec (1119 seconds)

Published: Wed Dec 13 2017