Health, Healing, and Hope through Lifestyle Medicine
It is not surprising that the rate of burnout for physicians has increased. The last few years have proven especially difficult for physicians due to the COVID-19 pandemic and the many challenges that came with it. The Medscape Physician Burnout & Depression Report 2022 Stress, Anxiety and Anger reported a 5% overall increase in burnout from 42% to 47% from 2020 to 2021, with 51% of family medicine physicians reporting burnout. Burnout rates increased for both male (41%) and female physicians (56%). The impact burnout has on physicians is significant, with 54% of physicians reporting a strong or severe impact on their lives.i
Unfortunately, burnout is not just a result of years of practice either. Numerous studies have reported that 45-56% of medical students have at least one symptom of burnout. These high rates continue during residency, with more than 60% of resident physicians reporting at least one symptom of burnout as well.ii
How did most cope with burnout over the last year?
Exercising was the preferred coping mechanism for 48% of physicians, but unfortunately, not all coping methods reported were healthy. Isolating from others (45%), eating junk food (35%), drinking alcohol (24%) and binge eating (21%) were some of the other common methods used to deal with stress.i More than two-thirds of physicians said their personal relationships were affected. While many are likely quick to think that the pandemic was to blame for the increased rate of burnout, surprisingly, this was not the case. Too many administrative tasks were mostly to blame as it has been in previous years. Another reason cited was too many hours of work and lack of control over their lives. So, what can we do?
Awareness is the first step in healing for most things. Most of us are aware that burnout has been a major problem in healthcare for many years. Thankfully, many organizations are committed to better understanding and reducing the challenges faced by physicians. According to the National Academy of Medicine, “there is evidence that interventions focused on work organization can mitigate burnout; thus, health care organizations are a powerful determinant and have a critical role to play in reducing clinician burnout.” But, is there more that we can do as an individual to avoid burnout and reignite our passion for medicine? The answer may be Lifestyle Medicine.
Exhausted and frustrated
If you would have asked me about seven years ago if I was burned out, I would have said no. I did feel overworked though both in my clinical practice and at home. I thought that this was just a normal part of being a physician and a mom. At the time, I was working about 40 hours a week as a family practitioner. Meanwhile, at home, my husband and I were raising four very active children, who at the time were 15, 12, 8, and 5-years old. Since my husband also worked full-time, we often spent our evenings rushing through dinner, doing the laundry, and helping with homework. I often was left feeling exhausted. There was little time for preparing healthy meals, exercising, or doing the things that brought me joy. I noticed a lack of satisfaction at work as well. Though I always enjoyed talking to my patients and getting to know them, I often felt frustrated that despite my best efforts, my patients continued to struggle. The chronic illnesses they were plagued with never really resolved and often worsened despite the recommended treatment plan. The heart healthy and low-carb diets I was trained to teach my patients just didn’t seem to be helping their chronic illnesses improve, and the medications prescribed often came with an array of side effects while barely controlling the problem in the first place. When I looked in the mirror, I too had gained weight over the years despite a healthier diet and worried that I would soon be faced with the same health challenges my patients were battling. That’s when I discovered Lifestyle Medicine.
What is Lifestyle Medicine?
Lifestyle medicine is an evidence-based approach shown to prevent, treat, and even reverse disease using a predominantly whole-food, plant-based diet, exercise, stress management, sleep, avoidance of risky substances, and social connection as a primary treatment modality. As I researched more, I began to recognize that the individual risk factors associated with burnout could be addressed by the six pillars of lifestyle medicine. I quickly joined the American College of Lifestyle Medicine, became board certified in November of 2017, and started applying the principles of lifestyle medicine to my own life.
It was not easy to change my lifestyle, but the more I read, the more convinced I was that this was the answer I had been looking for. One of the first things I did was examined my work-life balance. I realized I would never be able to achieve a healthy lifestyle moving at the pace I was. After re-evaluating my priorities in life, I reduced my clinical hours so that I would have more time to take care of my own health. I gradually switched to a whole-food, plant-based diet, returned to regular exercise, and made sleep a priority in life. I had more time to sit down for family dinners, attend my kids’ sporting events, and do things I loved. To my amazement, I quickly lost 20 pounds effortlessly just by removing meat, dairy, and oil from my diet and replacing it with fruits, vegetables, whole grains, and legumes. I had never been able to lose weight that easily. Along with the weight loss came increased energy, reduced stress and a better outlook on life. The results were simply amazing. I was convinced this was the answer for my patients as well.
After searching for just the right practice setting, this last year I joined PlantBased TeleHealth, a nationwide telehealth practice focused on the prevention and reversal of chronic diseases using lifestyle medicine. I have had the honor of seeing several patients reduce or even eliminate medications, lose weight, and find a renewed joy in life after making significant lifestyle changes. I no longer feel frustrated that my efforts are futile. Rather than focusing on the best medications to treat a chronic illness, I focus on improving the patient’s diet and exercise habits, while minimizing the use of medications. It’s amazing how few medications patients need when they make the necessary lifestyle changes. Many patients have even been able to discontinue anti-hypertensive and anti-diabetic medications after successfully mastering lifestyle changes. I now feel like I am truly helping patients make changes that promote health and healing. Lifestyle medicine has not only made me a better physician, but I now feel invigorated and excited to meet my next patient since I know that I am helping them treat the root cause of their disease, not just helping them manage the symptoms.
So, was I burned out? Of course I was. I was emotionally exhausted, checked out, and felt as if I wasn’t achieving success at home or work no matter my effort. Awareness is key and hindsight is 20/20. Take a moment to become aware of how you are doing. Are you burned out? If so, what can you do to make the changes necessary to heal yourself? If you don’t already know about the practice of Lifestyle Medicine, I encourage you to do your research and identify areas in your life that may need attention. After all, when physicians follow a healthy lifestyle, it not only affects their quality of life, but their patients’ lives as well.
References
i (Kane, Medscape, 2022)
ii Merlo G, Rippe J. Physician Burnout: A Lifestyle Medicine Perspective. Am J Lifestyle Med. 2020 Dec 29;15(2):148-157. doi.org/10.1177%2F1559827620980420. PMID: 33790702; PMCID: PMC7958216.
About the Author Heading link
Dr. Amy Zacharias is Director of Academic Programs for the Department of Family and Community Medicine and an Assistant Professor of Clinical Family Medicine.