Happy New Year to all our readers and contributors – we hope you had a chance to unwind a little over the Christmas holiday period. In previous Dorsal Views, we have touched on the need to help patients to manage their New Year’s resolutions and keep them realistic, measurable, and achievable. In this piece, we will look at how doctors can instead take care of themselves.
It might be reasonable to say now that burnout is firmly on everybody’s radar – or at least it should be. While it’s easy enough to advise a patient to ‘get a hobby’, what if doctors are given the same advice?
Self-care through leisure is not a new concept at all, even for medical professionals. Indeed, it was addressed by none other than Sir William Osler, whom many consider to be the ‘father of modern medicine’, as far back as 1899.
Osler was a vigorous proponent of doctors integrating healthy leisure activities to offset the stresses and strains of their vocations – this work-life balance was termed ‘avocation’ by Osler. Having a passion or an interest outside of medicine is important for professional longevity and even to help maintain empathy, he posited.
Much more recently, a 2011 paper in BMC Medicine touched on the area and provided some interesting data. The authors recruited 4,457 UK-qualified doctors and got a 63.8 per cent response from the participants. It was a follow-up questionnaire, as they were included in four previous studies of medical school selection and training from the eighties and early nineties. The questions were targeted and focused on career satisfaction, work engagement, personal vocational achievements, stress, emotional exhaustion, burnout, and depersonalisation. The questionnaire also included 29 different leisure activities, as well as questions around empathy, personality, and demography.
Regarding the results, they wrote: “Doctors reporting more avocation/leisure activities tended to be women, to have older children, to be less surface-rational, more extrovert, more open to experience, less agreeable, and to fantasise more. Doctors who were more burned-out tended to be men, to be more sleep-deprived, to report a greater workload, and less choice and independence in their work, to have higher neuroticism, lower extroversion and lower agreeableness scores, and to have lower self-esteem.”
Doctors with a greater “sense of vocation/engagement” saw more patients, had greater independence at work, were more extrovert and conscientious and had better self-esteem, they continued. Avocation and leisure activities correlated highly with vocation/engagement, they pointed out, even after taking into account 25 variables.
“In this cross-sectional study there is evidence, even after taking into account a wide range of individual difference measures, that doctors with greater avocation/leisure activities also have a greater sense of vocation/engagement,” the researchers concluded. “In contrast, being burned-out did not relate to avocation/leisure activities (but did relate to many other measures).”
Of course, burnout is a complex phenomenon and highly individualistic. But more research is showing that a major cause is related to the institutions in which doctors and other healthcare professionals work. As the data accumulates, it’s not a bad idea to glance back at Osler’s advice, which is just as relevant now as it was back then. Perhaps even more so.
History, the humanities and literature were just a few of Osler’s suggestions for avocation, although the doctors of our era have an enormous range of options.
As an aside, a 2014 survey by the American Medical Association showed that doctors’ top avocations of choice were predominantly running for under-40s, while doctors over 40 also enjoyed jogging, hiking, cycling or camping, with more than 50 per cent of those over 60 saying they enjoy walking. As you might expect, most doctors were keen readers, and other perhaps predictable avocations included golf, aerobics and cardio, skiing, tennis, and fishing.
Get in touch with us on social media or get in contact by email to let us know what your avocation is, and how it helps you to live your best life and avoid burnout.
And the last word to William Osler: “While medicine is to be your vocation, or calling, see to it that you also have an avocation… some intellectual pastime which may serve to keep you in touch with the world of art, of science, or of letters.”
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