opinion

Your health is important for you and your patients

A message to all physicians from AMA President Jeremy A. Lazarus, MD, on the importance of their personal health and fitness.

By Jeremy A. Lazarus, MD , a Denver psychiatrist and immediate past president of the AMA. Posted Jan. 7, 2013.

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As a psychiatrist, I deal with mental health issues on a daily basis, but that does not mean I am any less susceptible to the threats of stress, anxiety, depression or burnout than any other physician.

In these changing times, stress is a major challenge for all of us. And while physicians generally are healthier and live longer than the population as a whole, we are still subject to the same temptations as our patients to eat on the run, put off exercise, and drink a little too much or too often. Happily, very few physicians smoke, but almost 25% of the U.S. population still does.

Back in October 2012, I was in Montreal to participate in the International Conference on Physician Health (link). The semiannual conference, which is sponsored jointly by the AMA, the Canadian Medical Assn. and the British Medical Assn., focused on physician satisfaction, work-life balance and resilience.

A day or so before the conference, a Canadian physician wrote in the {i}Montreal Gazette{/i} about physician health, specifically his own experience with depression and stress (link). He added that according to one study, 45% of Canadian doctors have symptoms of advanced burnout. If this is to be believed, he said, it indicates an epidemic of stress threatening the health of Canada's doctors. It also indicates that probably a similar number of American physicians are affected by the stress of practicing medicine today.

The AMA was founded more than 160 years ago to meet the needs of physicians and the patients they serve. Today that service includes finding ways to help physicians maintain both a good work-life balance and a healthy lifestyle — and enjoy good mental health.

For that reason, the AMA offers a variety of resources for the physician community. Besides sponsoring the Conference on Physician Health, the AMA has developed a Healthier Life Steps program for physicians. This program offers a Physician's Guide to Personal Health that includes a timeline for physician health screenings plus action plans for healthier eating, increased physical activity, reduced risky drinking and smoking cessation (link).

Another part of Healthier Life Steps is the AMA's Practical Steps for Resilience. If you are having difficulties associated with stress, anxiety or burnout, the AMA offers a reminder that seeking help truly can make a difference personally and professionally. The AMA Physician Health e-Letter is also full of useful information and reminders (link).

For me, personally, physical exercise and music are an integral part of my day, no matter where I am or what else is on my schedule. My running, swimming and bicycling, plus the ability to get lost in wonderful music, are important in maintaining my sense of self and being in top form for my patients.

I am firmly convinced that I would not be able to do justice to this job as AMA president or keep up with my patients if I did not make time to stay healthy and fit.

As physicians, we all have a responsibility to maintain our physical and mental health. Multiple studies have shown that physicians who are mentally and physically fit are far better able to take care of patients. Additionally, physicians who are fit are more likely to counsel their patients toward healthier lifestyles — and more likely to be listened to.

This is no small thing. With the Affordable Care Act's emphasis on prevention and wellness, lifestyle counseling is becoming a much more significant part of medical practice. And since four of the top 10 leading causes of death can be affected by a person's lifestyle choices, it is important that physicians are comfortable with having these discussions.

It's no secret that more than two-thirds of adults and almost one third of children are either overweight or obese; that the number of Americans with diabetes has tripled since 1980, with 18 million diagnosed cases, and an additional 7 million undiagnosed cases; that every 40 seconds someone in the United States has a stroke, which is the leading cause of long-term disability; and that the American Cancer Society has estimated 1.6 million new cancer cases for 2012 alone. And while we have seen the incidence of smoking decrease in this country over a generation, we have also learned recently that states have inadequately funded tobacco prevention and treatment programs, thereby limiting their ability to help current smokers quit and prevent teens and children from ever starting to smoke.

For our country's sake, this must change. As always, physicians are on the front lines.

I know that lifestyle issues can be difficult to bring up with patients. However, it is far more of a challenge to have these conversations with patients if we haven't had a similar conversation with ourselves first.

If you are one of those men or women who keeps promising yourself that “someday soon” you will stop, take stock and change your habits. I suggest that now is the time. We are still early in the new year, which is historically when people do make plans to move forward in a different direction.

Jeremy A. Lazarus, MD , a Denver psychiatrist and immediate past president of the AMA.

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