Helping doctors heal themselves while healing others

We hear all the time about the pressures physicians are under to make the well-being of their patients a priority. What's too often missing from the discussion is recognition of the mental and physical strains that come with that responsibility, putting a physician's own health at risk.

The American Medical Association has long taken a leading role in focusing attention on the health risks that physicians face and what's needed to help them get healthy and stay that way.

In 1973, the AMA Council on Mental Health issued a landmark report that said doctors were susceptible to chronic illnesses such as depression and addiction, and physicians needed to do better at helping ill colleagues. The AMA responded with conferences in 1975 and 1977 to promote physician health.

Through the years, the AMA House of Delegates has adopted policies that encourage states to develop effective physician health programs and outline responsibilities of doctors to maintain their health, have a personal physician and seek appropriate help as needed.

This year represents another high point, with the AMA hosting a conference and presenting new resources designed to promote physician well-being.

The biennial International Conference on Physician Health, co-sponsored by the AMA, was held Oct. 3-5 in Chicago. It drew more than 320 health care professionals and others to present research and examine ways to promote wellness among doctors. The key areas of discussion were: burnout and peer support; workplace wellness; physical and mental well-being; and physician health as related to quality and patient safety.

During the conference, the AMA unveiled "A Physician's Guide to Personal Health," which is part of the AMA Healthier Life Steps initiative. The new guide, free to all doctors, gives information and tools to help physicians lead healthier lifestyles and change their diet, physical activity, alcohol consumption and tobacco use. It is available online (link).

The tool kit provides action plans, progress-tracking calendars and a health screening milestone document. It also discusses how physicians are important role models for their patients. A study in the fall issue of Preventive Cardiology illustrates that point: Doctors who exercised and kept a healthy weight were more comfortable talking to patients about lifestyle choices.

This year the AMA launched the Physician Health e-Letter, a monthly publication with news and information related to physician health topics such as stress, burnout and addiction.

The resources come as studies show that health problems can have an impact even early in a medical career. For example, half of about 2,200 medical students surveyed at seven medical schools reported burnout and 11% considered suicide in the previous year, said a study in the Sept. 2, 2008, Annals of Internal Medicine.

By the end of the first year of residency, 25% of residents had depressive symptoms associated with work hours and stressful life events, according to a study published online April 5 in the Archives of General Psychiatry. A British Medical Journal study in 2008 found that depressed medical residents made six times more medication errors than nondepressed residents.

The completion of residency marks the start of practice but hardly the end of stress, long hours and missed exercise. Patient and physician benefit when the doctor avoids illness. The AMA is helping to make that happen.