The Many Hats We Wear: The Ways In Which We De-Prioritize Ourselves
As physicians, we tend to prioritize everyone else before ourselves. This is a long-standing problem that began probably even before we hit medical school. The personality type that goes into medicine is typically a caretaker. It then makes complete sense that once we get into medical school that we will fall right in line, prioritizing career, prioritizing other patients, prioritizing everything and everyone but our own well-being. It doesn’t end there, residency bring a whole other dimension of self neglect; and we think, if I can just get out of residency things will return to “normal”. However, once you're out in practice we find new ways to deprioritize ourselves.
We make up reasons why others are more important than us. Why do we do this? Perhaps it is the ingrained messages we are given in our medical training. “The patient comes first”, “Eat when you can, pee when you can, sleep when you can…” Or perhaps it is a deeper message ingrained from our own family of origin. “It’s selfish to think about yourself”. Here are the top five reasons/ways that we doctors put our priorities on the back burner.
- Our spouses or significant others need us – As I said, we often wear multiple hats (particularly women physicians). So, now after we have worked 80 hours a week, come home and acted as the super parent, we must now give time to our spouse or significant other. And you will not give yourself first priority because you are too busy feeling guilty that you haven’t had a date night in months; or that you hadn’t had the energy or desire for sex in weeks. So, you pony up devote whatever little bit of energy you have left have to taking care of your spouse.
- Patients need us – As earlier stated, we have been trained from way back in medical school that the patient comes first. It's one of the prime directives of medicine. So, when a patient calls (and seems to be in need), we come to the rescue whether we are in the office, in our homes in the evening, on weekends, and for some of us we answer even when we are away on vacation; and we do this whether it is our responsibility to do it or not. It may seem harmless at first: a call here, and email there; and then before you know it you are working 7 days a week with no free time to spare.
- Our families need us – Of course, as we are spending so much time in the office there maybe some guilt associated with being away from the family. But for moms who are physicians this can be difficult because you may wear several hats in the family: the mom, the cook, the homework helper, the chauffeur, and for some spouse, and parental caretaker. However after working such a hard day, coming home to be supermom (or super dad if this applies to you) it leaves no room for time for anything else. At this point, you might find yourself beginning to get run down. But wait there's more…
- And then there is everything else….There are all the other hats, plates and responsibilities we are juggling that get thrown at us. Things like: "we're short, and I have two cover for the other doctors who are out”, “What about my medical students”, “I’ve got PTA meeting”. There is administrative duty, community service, research, and a host of other things that have us overcommitted and under acknowledged; and as physicians who want to always be seen as a team player; as someone who can make anything happen, we just keep pushing forward even at the cost of our own physical and mental health.
So, why do we do this to ourselves. The simple answer could be this: we are supposed to be invincible. We are not supposed to get sick, depressed, anxious, tired. We are supposed to be superhuman. Now reading this may sound ridiculous, but if you think about the culture of our industry, this is the way we were trained. Take care of everyone else aside beside ourselves. The question is when is enough enough? How can you begin to shift your mindset and take a new action?
- It starts with awareness. Becoming aware that this way of being and doing is not sustainable is the first step to recovery.
- Once we become aware, we then must be willing to take action. Notice what I said… I said be willing to take action, not take action. Sometimes we skip steps. We go from awareness straight to action because we are doing. Taking that pause to become willing before we jump into the deep end gives us space to find the next right thing to do.
- Now that we have become aware, and willing it’s time to take action, right? NO!!! Before actions can be taken a plan must be in place. If we simply start taking actions without any plan, we may end up out of the fire and into the frying pan. So, this is the point that we create a roadmap, a plan of action that will lead us to our desired outcome. Then we can take action!!!
- Finally, we must know that we MAY need to (and be willing to) reach out for guidance. I know, I know, we doctors are supposed to be able to fix it. However is it really logical to think that, that after being brainwashed into this (lone ranger) way of thinking for 8 years, 12 years, and for most of us who have been out in practice 20+ years, that WE ourselves CAN fix our own distorted thinking? Of course not! WE are the fish in water! This is our blind spot. Reaching out for support will allow us access to that blind spot so that we can create new strategies and new actions that will give us new results and new life. Reaching out is NOT a sign of weakness, in fact it’s actually a sign of strength and courage.
Once we are aware, willing, and have the support, we can begin to create our vision, a plan, and the action steps required to make the changes that will give us new life. This is something very beneficial to do this with a mentor or a coach. A coach can see the things that you cannot. Now, Imagine what it would be like if we actually put ourselves first for a change. How would that transform your life? How would that transform your family? Now is the time to begin shifting your mindset and taking action for the good of your well-being and ultimately the well-being your patients, and of others around you.
Maiysha Clairborne MD © 2016
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