tag:blogger.com,1999:blog-48650987924943972922024-03-04T20:40:46.139-08:00Well PhysicianFormer MMA President Patricia Lindholm, M.D., is dedicated to helping her fellow physicians find the joy in medicine, battle burnout and heal themselves.Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.comBlogger24125tag:blogger.com,1999:blog-4865098792494397292.post-88751778525352635182012-10-09T07:43:00.000-07:002012-10-09T07:44:54.343-07:00Leading by example<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMWYuF7jZlFUSveT6gR9QJur6Ib0O9higlsIgBg3gqbe5A8SbeiHH4lUhGtFCK6R-TFBbZXog0gOIcRhvOH5gVoaZqjNeuI4pOTFLs8EgVsLNzB1fbTsSnmNVXeM6bWWRaMz6UjTyx6iE/s1600/PatriciaLindholm.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMWYuF7jZlFUSveT6gR9QJur6Ib0O9higlsIgBg3gqbe5A8SbeiHH4lUhGtFCK6R-TFBbZXog0gOIcRhvOH5gVoaZqjNeuI4pOTFLs8EgVsLNzB1fbTsSnmNVXeM6bWWRaMz6UjTyx6iE/s200/PatriciaLindholm.jpg" width="133" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Patricia Lindholm, M.D. <br />
2010-2011 <br />
MMA president</td></tr>
</tbody></table>
<span style="font-family: "Calibri","sans-serif";">I was
recently alerted to a new <st1:city w:st="on"><st1:place w:st="on">Gallup</st1:place></st1:city>
study that looked at the health and health behaviors of physicians compared to
nurses and to other employed adults. The results were also controlled for
income and education. How did we physicians do? Perhaps the title will give it
away: “U.S. Physicians Set Good Health Example.”<o:p></o:p></span><br />
<br />
<span style="font-family: "Calibri","sans-serif";">Overall,
physicians are in better health compared to the employed adult population.<span style="mso-spacerun: yes;"> </span>The study also lists comparative prevalences
of chronic diseases among physicians, nurses and employed U.S. adults.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span><br />
<br />
<div class="MsoNormal" style="margin: 0in 0in 0pt;">
<span style="font-family: "Calibri","sans-serif";">Our health
behaviors are similar to other highly educated individuals with the exception
of smoking. Only 4 percent of physicians smoke, compared to 15 percent of
nurses and 20 percent of other workers.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 0pt;">
<span style="font-family: "Calibri","sans-serif";">It would be
interesting to see if the findings hold true at each of our clinics and
hospitals. Like all rankings, it can be a motivator for some of us to do
better.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 0pt;">
<span style="font-family: "Calibri","sans-serif";">Here is a
link to the study: <a href="http://www.gallup.com/poll/157859/physicians-set-good-health-example.aspx"><span style="color: blue;">http://www.gallup.com/poll/157859/physicians-set-good-health-example.aspx</span></a><o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 0pt;">
<span style="font-family: "Calibri","sans-serif";"><o:p> </o:p></span><span style="font-family: "Calibri","sans-serif";">It’s great
to see that we appear to be listening to our own advice. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 0pt;">
<o:p> </o:p></div>
Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-38108177830218122282012-03-19T07:28:00.000-07:002012-03-19T07:28:31.575-07:00Remembering friends and looking ahead<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; color: #4aa2b6; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto; text-decoration: none;"><img border="0" closure_uid_g4qebq="2" closure_uid_wn3l47="3" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" style="border-bottom-style: none; border-left-style: none; border-right-style: none; border-top-style: none; position: relative;" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Patricia Lindholm, MD<br />
Immediate Past MMA President</td></tr>
</tbody></table><b style="mso-bidi-font-weight: normal;"></b><br />
<div class="MsoNormal" style="margin: 0in 0in 0pt;">I want to take some time to honor the passing of two physicians whose careers were dedicated to the promotion of physician well-being.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><strong>Remembering our colleagues</strong></div><div class="MsoNormal" style="margin: 0in 0in 0pt;">Jud Reaney, MD was a developmental pediatrician at Park Nicollet and a most valued member of the MMA Physician Well-being Task Force in 2010-2011.<span style="mso-spacerun: yes;"> </span>He worked through the Park Nicollet Foundation to promote physician wellness by coordinating and facilitating physician retreats among other activities.<span style="mso-spacerun: yes;"> </span>He offered to facilitate a retreat for the task force based on the work of Parker Palmer.<span style="mso-spacerun: yes;"> </span>We attended this Courage and Renewal Retreat as a group and I personally found the weekend to be a growth experience and an opportunity to enjoy nature and the companionship of colleagues. <span style="mso-spacerun: yes;"> </span>During the past year we followed Jud’s journey with pancreatic cancer on his Caring Bridge web site.<span style="mso-spacerun: yes;"> </span>Jud was one of those people who seemed to me to have a special aura of deep joy and sincere caring for people.<span style="mso-spacerun: yes;"> </span>The many tributes to him on the Caring Bridge site made evident that many lives were touched by his and made better for having known him.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">Lee Lipsenthal, MD was introduced to some of you last year in my President’s Blog.<span style="mso-spacerun: yes;"> </span>He wrote a book and founded an organization both called “Finding Balance in a Medical Life.”<span style="mso-spacerun: yes;"> </span>His presentations, conferences and writings have been enthusiastically received over the years by our colleagues around the country.<span style="mso-spacerun: yes;"> </span>I recommend his work to you.<span style="mso-spacerun: yes;"> </span>He also wrote a book during the last period of his life when he knew his time was limited by cancer.<span style="mso-spacerun: yes;"> </span>The book is called “Enjoy Every Sandwich.”<span style="mso-spacerun: yes;"> </span>It is in my library and a reminder of the importance of gratitude and mindfulness throughout our lives.<span style="mso-spacerun: yes;"> </span>You can watch a brief video of him discussing his book at <a href="http://www.youtube.com/watch?v=3UIFbOfWwYE">www.youtube.com/watch?v=3UIFbOfWwYE</a>. <span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><strong>Physician well-being symposium</strong></div><div class="MsoNormal" style="margin: 0in 0in 0pt;">Minnesota physicians have an opportunity this spring to attend a special event offered by the Health Partners Institute for Continuing Education.<span style="mso-spacerun: yes;"> </span>On June 7 there will be a physician well-being symposium, “Enhancing Physician Resilience” at the Burnsville Performing Arts Center.<span style="mso-spacerun: yes;"> </span>This will be followed by several performances at the Guthrie Theater of a play written by William Thomas, MD, “Play What’s Not There.”<span style="mso-spacerun: yes;"> </span>The play portrays five physicians at various points in their careers and the stresses and efforts to achieve work-life balance.<span style="mso-spacerun: yes;"> </span>It will be followed by a facilitated discussion.<span style="mso-spacerun: yes;"> </span>For more information and to register, please go to <a href="http://www.physicianwell-being.com/">http://www.physicianwell-being.com/</a>.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">I will try not to be absent so long from the blog in the future.<span style="mso-spacerun: yes;"> </span>I look forward to writing again soon!</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-67427974674599470252012-01-09T12:17:00.000-08:002012-01-09T12:18:39.984-08:00Mindfulness<div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;"></span><br />
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="background-color: white; color: #333333; float: left; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 15px; line-height: 20px; padding-bottom: 4px; padding-left: 4px; padding-right: 4px; padding-top: 4px; position: relative; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; color: #4aa2b6; margin-bottom: 1em; margin-left: auto; margin-right: auto; text-decoration: none;"><img border="0" closure_uid_wn3l47="3" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" style="border-bottom-style: none; border-left-style: none; border-right-style: none; border-top-style: none; position: relative;" /></a></td></tr>
<tr><td class="tr-caption" style="font-size: 12px; text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">Immediate Past MMA President</span></td></tr>
</tbody></table>Often I arrive at the end of a week, a month or a year wondering, “Where did all the time go?”<span style="mso-spacerun: yes;"> </span>This sense of time moving more quickly is common as we age.<span style="mso-spacerun: yes;"> </span>As a child I felt that a year was an eternity.<span style="mso-spacerun: yes;"> </span>Now that we have entered a new year, it seems that last January was only a couple of months ago.<span style="mso-spacerun: yes;"> </span>Am I failing to fully realize each moment in the present?<span style="mso-spacerun: yes;"> </span>Probably.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;">Mindfulness is a practice of being present in the here and now, fully aware of the moment in which we live.<span style="mso-spacerun: yes;"> </span>This concept is at least as old as Buddhism which teaches among other things that we should be awake while we live.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;">Essentially I usually live in my head.<span style="mso-spacerun: yes;"> </span>My thoughts come and go and take me away as if on a train.<span style="mso-spacerun: yes;"> </span>While I am on the thought-train reality is present all around me and I am not aware of it.<span style="mso-spacerun: yes;"> </span>I may be driving to work and not even noticing the landscape around me, rather I am in my own imaginary world.<span style="mso-spacerun: yes;"> </span>When I spend time living in my thoughts the passage of time is not noticed until I awaken to it.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;">I am pleased to see that psychology and other mental health disciplines have been using mindfulness practice in the treatment of anxiety, depression and other affective disorders.<span style="mso-spacerun: yes;"> </span>Being mindful of the present is a therapeutic alternative to preoccupation with worries and negative thoughts.<span style="mso-spacerun: yes;"> </span>Even suicidal thinking can be derailed by a purposeful attention to my breath in the present moment.<span style="mso-spacerun: yes;"> </span>Rather than ruminate on a vicious cycle of self-criticism, I can choose to acknowledge that in this present moment I am alive and can appreciate the song of a bird or the beauty of a sunset.<span style="mso-spacerun: yes;"> </span>I can feel the air enter and leave my lungs, smell the fragrance of clean laundry.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;">During the day in my clinic I have learned to treasure the moments that I am with each patient.<span style="mso-spacerun: yes;"> </span>If I am mindful during these encounters I can realize the joy in my work.<span style="mso-spacerun: yes;"> </span>I am learning to be present for a greater proportion of my day.<span style="mso-spacerun: yes;"> </span>I frequently find myself pausing deliberately to take a slow conscious breath and remember that I live only in the present moment.<span style="mso-spacerun: yes;"> </span>I am striving to increase my mindfulness practice and capture as many of my moments as possible.</span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;">If you are interested in mindfulness practice I recommend the books of Thich Nhat Hanh, Jon Kabat-Zinn, Pema Chodron, and others who have been teaching mindfulness for many years.<span style="mso-spacerun: yes;"> </span>I would also recommend enrolling in a Mindfulness Based Stress Reduction (MBSR) course such as offered by the University of Minnesota Center for Spirituality and Healing.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span></div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com1tag:blogger.com,1999:blog-4865098792494397292.post-74583666291960089192011-12-01T11:51:00.000-08:002011-12-01T12:45:35.348-08:00Wellness Challenge Yields Results for Mayo Residents and Fellows<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="background-color: white; color: #333333; float: left; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 15px; line-height: 20px; padding-bottom: 4px; padding-left: 4px; padding-right: 4px; padding-top: 4px; position: relative; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; color: #4aa2b6; margin-bottom: 1em; margin-left: auto; margin-right: auto; text-decoration: none;"><img border="0" closure_uid_wn3l47="3" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; position: relative;" /></a></td></tr>
<tr><td class="tr-caption" style="font-size: 12px; text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">Immediate Past MMA President</span></td></tr>
</tbody></table><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">I recently had a conversation with Noel So, M.D., </span><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">(pronounced like Noelle) </span><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">a resident in physical medicine and rehabilitation at Mayo, who wanted me to share information about a unique wellness activity, she and Ma</span><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">rk Steffen, M.D., preventive medicine resident, are co-chairing-- the <a href="http://www.facebook.com/pages/MFA-Wellness/175258739156467?sk=wall" target="_blank">Mayo Fellows Association (MFA) Wellness Challenge</a>.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">The event that commences December 1 </span><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">builds on the success of the previous MFA Wellness Challenge, which was a 12-week program, chaired by Christopher Weight, M.D. </span><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">A total of 630 residents and fellows, or about half of those at Mayo, participated in the first Wellness Survey, and about 230 went on to enrolled in the MFA Wellness Exam at a cost of $5 per person. The exam measured fitness parameters including body mass index (BMI), percent body fat, and VO2 max. 46 teams of five people competed for the grand prize, which was a trip to the Olympics. The teams earned points for activities such as time at the gym, number of steps walked (measured by pedometers), participation in pre- and post- activity surveys and wellness exams. Another innovative activity was </span><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">“Climb the Clinic” that involved walking up and down the stairs in five Mayo buildings. ID badges given to each participant were scanned at the bottom and top of each stairwell to record completion times. </span><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Dr. So tells me that the presence of the 46 competing teams fostered positive peer pressure that yielded the greatest amount of physical activity. The points earned by each team equaled the number of raffle entries each team received for the grand prize Olympics trip.</span><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgUH0R__PB_umTWBmfxePeRrYwUi7Xkvt77V-i3ey1AlLh-Cv5gc9Wygkiv8gwrJtWA-qYBaTwJcj_WPNQdwfJdDjovtUsUARSwjftHS3I4vt2i6zl6GVwcqII3YoTzFez-exyL0zxUUX0/s1600/Iclimedtheclinc.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgUH0R__PB_umTWBmfxePeRrYwUi7Xkvt77V-i3ey1AlLh-Cv5gc9Wygkiv8gwrJtWA-qYBaTwJcj_WPNQdwfJdDjovtUsUARSwjftHS3I4vt2i6zl6GVwcqII3YoTzFez-exyL0zxUUX0/s320/Iclimedtheclinc.jpg" width="256" /></a><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Other prizes were awarded for:</span><br />
<div class="MsoNormal"><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">•<span class="Apple-tab-span" style="white-space: pre;"> </span>The biggest loser of fat (without being underweight)</span></div><div class="MsoNormal"><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">•<span class="Apple-tab-span" style="white-space: pre;"> </span>The fittest female/fittest male (the best VO2 max)</span></div><div class="MsoNormal"><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><b>Challenge Results</b></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Some statistics from first wellness challenge:</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span></div><div class="MsoNormal"><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">•<span class="Apple-tab-span" style="white-space: pre;"> </span>Collectively the participants walked 171,008,824 steps which is equivalent to 3.4 times around the Earth at the equator;</span></div><div class="MsoNormal"><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">•<span class="Apple-tab-span" style="white-space: pre;"> </span>Over 10,000 trips to the gym; and </span></div><div class="MsoNormal"><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">•<span class="Apple-tab-span" style="white-space: pre;"> </span>189 completed wellness evaluations.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">After the event, a survey was sent to all Mayo residents and fellows about burnout and emotional health. The Wellness Challenge participants as a group reported less burnout, better sleep and better nutrition. T</span><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">he coordinating committee for the Wellness Challenge is clearly a research-oriented group. It was noted that after the event was over there was decreased gym attendance, although it is possible that people were exercising more outdoors in milder weather, since the challenge started January 1st. One question that was raised is how to maintain the motivation of participants to maintain fitness after the formal monitoring period. </span></div><div class="MsoNormal"><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><b>Social Media</b></span></div><div class="MsoNormal"><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">The 2nd Annual Wellness Challenge will be extended to 16 weeks. Dr. So, Dr. Steffen, and the committee will be studying the impact of social media on participation in the challenge. The challenge already has a page on Facebook, which is a social medium that I'm familiar with, but I was educated by Dr. So about <a href="https://www.yammer.com/" target="_blank">Yammer</a>, which is a workplace-based social medium using work e-mail addresses.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">The MFA Athletic Committee has also introduced the concept of “walking meetings” instead of sitting around a table, so that exercise is integrated into the meeting. They are hoping to incorporate it into the Mayo culture. </span></div><div class="MsoNormal"><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span></div><div class="MsoNormal"><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><b>Following in their Footsteps</b> </span></div><div class="MsoNormal"><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">This challenge is a very ambitious undertaking and may seem daunting to some of us, but consider what we can do in our own workplaces and communities. I think any of us can use the concept of monitoring with pedometers as a competitive activity, and perhaps find other parameters that are easily measured. I am going to challenge my local partners who are fitness enthusiasts to design a fun incentivizing wellness program for our group.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">If anyone is looking to do research more broadly on the effects of physical fitness on the mental, emotional and physical health of physicians, I think we can round up quite a few physician subjects across Minnesota. I hope someone will take me up on this challenge!</span></div><div><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span></div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-16416988542366869452011-11-03T12:57:00.001-07:002011-11-03T12:59:28.204-07:00Care for the Caregivers<div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" closure_uid_wn3l47="3" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">Immediate Past MMA President</span></td></tr>
</tbody></table>I have just returned from two inspiring events in the past week.<span style="mso-spacerun: yes;"> </span>First the MMA held a summit meeting on Sharing Solutions to Combat Burnout.<span style="mso-spacerun: yes;"> </span>The conference was conceived as a session to share and learn from people working on physician wellness in their organizations.<span style="mso-spacerun: yes;"> </span>There were a variety of presentations highlighting diverse and unique approaches to addressing wellness in physicians as well as studying the effectiveness of interventions or programs.<span style="mso-spacerun: yes;"> </span>The audience was also asked to share their ideas on how the MMA can help facilitate the development of wellness strategies for physicians.<span style="mso-spacerun: yes;"> </span>It was gratifying to see the interest in the topic and I believe we could easily have spent twice the time in order to answer audience questions and even to lengthen the presentations.<span style="mso-spacerun: yes;"> </span>In the near future the presentations will be made available on the MMA web site with our other wellness resources.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">I also attended the second biennial Canadian Conference on Physician Health.<span style="mso-spacerun: yes;"> </span>The theme for the meeting was “Healthy Physicians = Healthy Communities”.<span style="mso-spacerun: yes;"> </span>I have long admired the Canadian Medical Association’s international leadership in physician wellbeing.<span style="mso-spacerun: yes;"> </span>After having an informal discussion with two Canadian family physicians at breakfast the first morning, it occurred to me why the Canadians have worked on the issue for so long.<span style="mso-spacerun: yes;"> </span>These physicians were from different provinces and each in solo practice.<span style="mso-spacerun: yes;"> </span>Each was in practice for about 25 years (like myself) and female (like myself).<span style="mso-spacerun: yes;"> </span>For the most part, Canadian physicians tend to own their businesses and are facing increasing overhead expenses and decreasing payment as are the U.S. physicians.<span style="mso-spacerun: yes;"> </span>More of their physicians are in extremely remote areas where there is little collegial or technological support.<span style="mso-spacerun: yes;"> </span>These two physicians each shared that some years ago they had taken a two-year leave of absence from the practice of medicine due to burnout.<span style="mso-spacerun: yes;"> </span>They do not have colleagues to cover their practices, and often cannot obtain locums coverage.<span style="mso-spacerun: yes;"> </span>If ill or on vacation they have to close their offices.<span style="mso-spacerun: yes;"> </span>Furthermore there is no paid vacation since they are self-employed and they continue to pay the overhead.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">I attended a breakout session regarding the stress of litigation on physicians.<span style="mso-spacerun: yes;"> </span>There was a video scenario of a young rural physician who had been staffing an ER where she saw a patient with a painful swollen leg.<span style="mso-spacerun: yes;"> </span>She felt it was cellulitis, but of course it turned out to be a deep vein thrombosis and the patient died of pulmonary embolus. <span style="mso-spacerun: yes;"> </span>Of course the clinical diagnosis of DVT is not straightforward, which is why we have tests like d-dimer and ultrasounds.<span style="mso-spacerun: yes;"> </span>This doctor would have had to send the patient <u>fifty miles</u> to get an ultrasound!<span style="mso-spacerun: yes;"> </span>That is quite a decision for a remote solo doctor to make.<span style="mso-spacerun: yes;"> </span>I reality-checked the scenario with an OB-GYN physician who had practiced in a remote area and she confirmed that lack of resources is a fact of rural practice.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">There was an interesting “debate” about the issue of limiting physicians’ work hours (or resident work hours).<span style="mso-spacerun: yes;"> </span>Two physician leaders spoke in favor of mandatory work hour limits and two spoke against.<span style="mso-spacerun: yes;"> </span>To my surprise both sides had compelling arguments.<span style="mso-spacerun: yes;"> </span>I believe they were randomly assigned a position to present and of course each had data to support their arguments.<span style="mso-spacerun: yes;"> </span>The ending plenary speaker was Dr. Roberta Bondar who was the first neurologist to take part in a space shuttle mission.<span style="mso-spacerun: yes;"> </span>One of her themes was to maintain our curiosity and continue learning throughout our lives.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">Workshops on “music and medicine”, mindfulness meditation, nutrition, caring for physicians as patients, combating the stigma against mental illness and psychiatry, supporting medical students and residents were presented, among other topics.<span style="mso-spacerun: yes;"> </span>Time was set aside for exercise (run/walk) or mindfulness meditation.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">Having witnessed the strong interest in addressing physician wellbeing among Minnesota physicians, I believe that we should be able to develop a more comprehensive conference in the future.<span style="mso-spacerun: yes;"> </span>We had some visitors from the Dakotas and also several physicians who came for their own personal edification rather than from an organizational perspective.<span style="mso-spacerun: yes;"> </span>I am very proud of the good work that is happening in Minnesota and we have much to offer to our colleagues around the country.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">I am also encouraged that the AMA President-elect, Dr. Jeremy Lazarus, plans to make physician wellbeing the emphasis of his upcoming term.<span style="mso-spacerun: yes;"> </span>It is time to care for the caregivers.</div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-30666641415180816832011-10-06T12:30:00.000-07:002011-10-10T15:37:57.224-07:00Welcome to Well Physician<div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;"></span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">Immediate Past MMA President</span></td></tr>
</tbody></table><span style="font-family: Verdana, sans-serif;">I am back!! No longer the MMA president, my blog has moved to a nearby address.<span style="mso-spacerun: yes;"> </span>The work of promoting physician well-being continues to be a priority for the MMA and for me.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;">For those of you who have been thinking about bringing some physician wellness resources to your community, we are here to help.<span style="mso-spacerun: yes;"> </span>On October 27, 2011 the MMA is convening a conference to share ideas from a number of leaders in the medical community who have implemented or who are developing resources to promote an environment supportive of the health of physicians.<span style="mso-spacerun: yes;"> </span>We will hear some great presentations and also learn from each other.<span style="mso-spacerun: yes;"> </span>If you have ideas please come to share with the rest of us and network with like-minded colleagues throughout Minnesota and the surrounding area.<span style="mso-spacerun: yes;"> <a href="http://events.r20.constantcontact.com/register/event?oeidk=a07e4omsdlz7da72f65&llr=6v6nyvdab">Sharing Solutions to Promote Physician Well-being Conference</a> </span>is free for MMA members and only $35 for nonmembers.<span style="mso-spacerun: yes;"> </span></span><span style="font-family: Verdana, sans-serif;">There is CME credit (4 hours).<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;">Some time ago I shared that I will be attending the 2011 Canadian Conference on Physician Health.<span style="mso-spacerun: yes;"> </span>It will be held in Toronto on October 28-29, 2011.<span style="mso-spacerun: yes;"> </span>The title is<a href="http://www.cma.ca/multimedia/PhysicianHealth/CanadianConf09/CCPH2011_Prelim_EN.pdf."> “Healthy Doctors = Healthy Communities.”</a><span style="mso-spacerun: yes;"> </span>There is still time to register.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;"><span style="mso-spacerun: yes;"></span></span><span style="font-family: Verdana, sans-serif;">For those of you who have not recently checked the <a href="http://www.mnmed.org/Advocacy/KeyIssues/PhysicianWellbeing.aspx">MMA physician well-being page we have added an excellent webinar that AMA presented on physician suicide</a>.<span style="mso-spacerun: yes;"> </span>Two more webinars will be presented in the near future on issues challenging medical students, residents and other physicians.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;">Finally, in this new incarnation of the Well Physician Blog, I am considering inviting guest bloggers to appear from time to time.<span style="mso-spacerun: yes;"> </span>I have some folks in mind and would also love to hear from any volunteers.<span style="mso-spacerun: yes;"> </span>I look forward to continuing the conversation with you all.</span></div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-90717816535726093232011-10-06T12:14:00.001-07:002011-10-06T12:14:42.113-07:00To Err is Human<div class="MsoNormal" style="margin: 0in 0in 0pt;"> <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
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<span style="font-family: Verdana, sans-serif;"><strong>Orginally Posted September 7, 2011</strong></span><br />
<br />
<span style="font-family: Verdana, sans-serif;">I believe that we all recognize the above title as a timeless adage, but also the title of the <place w:st="on"><placetype w:st="on">Institute</placetype> of <placename w:st="on">Medicine</placename></place> report that brought to public scrutiny the problem of medical errors in hospitals and the prevalence of harm that patients experience during their hospitalizations.<span style="mso-spacerun: yes;"> </span>The report jump-started a nascent patient safety movement that now appropriately applies to outpatient care as well.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;">An excellent article appeared this week in <a href="http://www.ama-assn.org/amednews/2011/08/15/prsa0815.htm">AMA News</a> </span><span style="font-family: Verdana, sans-serif;">about physicians who have publicly acknowledged their medical errors.<span style="mso-spacerun: yes;"> </span>They are using such disclosure as teaching opportunities for themselves and other health care professionals, and to highlight that systems improvement is the key to preventing errors.<span style="mso-spacerun: yes;"> </span>The “I’m Sorry” legislation that has been discussed in various states reflects the need to provide transparency to patients and to make amends when they are harmed by medical procedures and decisions.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;">The most interesting part of the article for me is a discussion of how to support physicians who have harmed patients through diagnostic or treatment errors.<span style="mso-spacerun: yes;"> </span>I trained in the era of “shame and blame” when one person was assigned total responsibility for an error.<span style="mso-spacerun: yes;"> </span>This led to a tendency to hide our errors from patients, hospitals and our colleagues.<span style="mso-spacerun: yes;"> </span>Physicians judge themselves quite harshly and question their general competence or even their personal worth when faced with an error.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;">In <city w:st="on"><place w:st="on">Boston</place></city> at the Brigham and Women’s Hospital, a Center for Professionalism and Peer Support was created to reach out to physicians who are in the painful and lonely position of having acknowledged a medical error.<span style="mso-spacerun: yes;"> </span>A number of physician peer advisors are available to reach out to their colleagues and ask about their wellbeing and offer support.<span style="mso-spacerun: yes;"> </span>Similar programs have developed at medical centers around the country.<span style="mso-spacerun: yes;"> </span>A compassionate and human approach to such colleagues can save careers as well as the lives of the physicians who are supported.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;">Several years ago when I served on the board of MMIC (the professional liability company started by MMA some years back) we started the Physician Litigation Support Program.<span style="mso-spacerun: yes;"> </span>Each physician facing a claim is personally contacted by a psychiatrist whose only purpose is to provide support and education to the insured.<span style="mso-spacerun: yes;"> </span>We have received many thanks from recipients of this caring program.</span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: Verdana, sans-serif;">If your training program or health care organization does not have a mechanism to support colleagues who have made errors or who face litigation, what can you do to get such a program started?<span style="mso-spacerun: yes;"> </span>I suggest that the first step is speaking up and insisting that collegial support programs be proactive, supported and expected.<span style="mso-spacerun: yes;"> </span>You should expect to hear from colleagues who want to work with you to make good work happen.<span style="mso-spacerun: yes;"> </span>I suspect you will have richer friendships and happier patients as a result.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span></div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-42515646379819010182011-10-06T12:11:00.000-07:002011-10-06T12:16:12.181-07:00A Common Ethical Dilemma<strong>Originally Posted August 11, 2011</strong><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table>I recently read in the Huffington Post that Dr. Lee Lipsenthal (of whom I have written earlier in this blog) has a recurrence of his cancer and has been told that is the last season of his life. His interview is a demonstration of a remarkable ability to be fully present in life as well as fully present to others as he anticipates their grief. His work has enriched us and will continue to do so for many years to come. <br />
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Dr. Lipsenthal was a presenter at the inaugural program of the Osler Institute’s conference on physician wellbeing last fall in Albuquerque. I am happy to report that the conference will be offered again in the coming year, possibly twice. You can follow the Osler Institute on Facebook. <br />
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Of course I am also following Dr. Kevin Pho on his site KevinMD.com. There are many posts of interest by physicians from around the country. One that caught my eye this week was posted by Michael Kirsch, MD and titled, “Medical ethics in the office should not be a private matter.” It appeared the day after I attended an ethics committee meeting in our newly integrated hospital and clinic. We discussed bringing up examples of daily ethical dilemmas faced in outpatient medicine. Dr. Kirsch lists several such outpatient dilemmas which resonate with me. The problem is that no sooner is the issue behind me than I forget about it and lose the opportunity to fully discuss and analyze it with colleagues. (I suspect it is a function of middle age.)<br />
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Here is an example of an ethical dilemma I have faced many times in my practice (I paraphrase): A patient’s family member sends a note or calls to report some private information shortly before my patient’s appointment, with instructions “not to tell” the patient about who divulged the information, but hoping I can somehow dig into the matter. Do you tell the patient about the conversation? I have reacted differently on different occasions. How about you?Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-46803831216282989182011-10-06T08:29:00.001-07:002011-10-06T08:29:50.309-07:00The Vanishing Oath<div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><strong>Originally Posted June 30, 2011</strong><br />
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Recently I came across a documentary-style independent film written and directed by Ryan Flesher, M.D.<span style="mso-spacerun: yes;"> </span>The title is <a href="http://www.crashcartproductions.com/home">“The Vanishing Oath”</a> and is a story about Dr. Flesher’s journey through burnout and his personal examination of the causes of distress that lead physicians to leave the clinical practice of medicine.<span style="mso-spacerun: yes;"> </span>Those of us in clinical practice know exactly what bothers him and others.<span style="mso-spacerun: yes;"> </span>He also interviews physicians around the country who have left medicine and allows them to tell their stories.<span style="mso-spacerun: yes;"> </span>Random people on the street are also interviewed about their take on physicians and medical care in general.<span style="mso-spacerun: yes;"> </span>I thought this film would be depressing but it was not.<span style="mso-spacerun: yes;"> </span>It is about an hour in length and is accessible to the general public.<span style="mso-spacerun: yes;"> </span>It would be an excellent holiday gift to your favorite insurance company CEO, malpractice attorney or legislator.<span style="mso-spacerun: yes;"> </span>Check it out.<span style="mso-spacerun: yes;"> </span>I believe I ordered it from Amazon.</div><br />
<iframe frameborder="0" height="327" src="http://player.vimeo.com/video/7610236?title=0&byline=0&portrait=0" width="400"></iframe><br />
<a href="http://vimeo.com/7610236">The Vanishing Oath (excerpt)</a> from <a href="http://vimeo.com/user2165116">Lisa Molomot</a> on <a href="http://vimeo.com/">Vimeo</a>.<br />
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</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">Another very interesting book that I am almost done reading is titled <i style="mso-bidi-font-style: normal;"><a href="http://www.amazon.com/Just-Someone-Without-Mental-Illness/dp/0385343795">Just Like Someone Without Mental Illness, Only More So</a></i>, by Mark Vonnegut, M.D.<span style="mso-spacerun: yes;"> </span>(Yes, he is the son of Kurt Vonnegut.)<span style="mso-spacerun: yes;"> </span>Dr. Vonnegut experienced several psychotic breaks during his young adult years and was initially diagnosed with schizophrenia.<span style="mso-spacerun: yes;"> </span>He actually has bipolar disorder and is a practicing pediatrician who trained at <placename w:st="on">Harvard</placename> <placename w:st="on">Medical</placename> <placetype w:st="on">School</placetype> and <place w:st="on"><placename w:st="on">Massachusetts General</placename> <placetype w:st="on">Hospital</placetype></place>.<span style="mso-spacerun: yes;"> </span>It is fascinating to see a first person account of serious mental illness from a successful practicing physician and teacher.<span style="mso-spacerun: yes;"> </span>He also mentions many of the same frustrations noted in “The Vanishing Oath.”<span style="mso-spacerun: yes;"> </span>Yes, he is one of us.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">It is comforting to see that the “elephants in the room” of medicine are exposed and acknowledged publicly by two articulate and courageous doctors.<span style="mso-spacerun: yes;"> </span>Both of these works are enlightening to anyone with an interest in the sociology of medicine.<span style="mso-spacerun: yes;"> </span>They might also be appropriate gifts to relatives who wonder why physicians need to attend to their wellbeing now more than ever.</div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-37550197788604602612011-10-06T08:27:00.001-07:002011-10-06T08:27:58.130-07:00Promoting well-being across professional disciplines<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><br />
<strong>Originally Posted June 2, 2011</strong><br />
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I recently was invited to Rochester to speak about physician well-being to the clinicians at the Olmsted Medical Group. The group is unveiling a new program in professional wellness, led by a committee of four physicians. The first part of the program will be working on acute problems or distress, but further plans include preventive or proactive activities to enhance or maintain well-being in the medical workplace. I look forward to hearing about their progress over the next year and beyond. From the discussions that occurred after my presentation, it was evident that professional well-being is a timely topic indeed. <br />
<br />
Many interesting ideas were generated by the Olmsted group. Allied professionals such as physician assistants and podiatry seem to have an interest in collaborating with us to promote wellbeing across professional disciplines. What a wonderful thought! Imagine what could happen if MMA combined forces with other health professionals in Minnesota to produce cutting-edge conferences and activities to revitalize our colleagues. Think of the valuable networking and relationships that would develop! If this dream excites you, too, I would love to hear from you, particularly if you want to help make them a reality. <br />
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Finally, let me share with you a short video recommended by our colleague, Dr. Craig Chambers. On You Tube called <a href="http://www.youtube.com/watch?v=Cbk980jV7Ao">Validation</a>. I think it will make your day.Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-58933399448021721982011-10-06T08:26:00.001-07:002011-10-06T08:26:37.107-07:00Becoming an Iron Doc<div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><strong>Originally Posted May 5, 2011</strong><br />
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I would like to recommend a book called <a href="http://www.amazon.com/IRONDOC-Practical-Stress-Management-Physicians/dp/0973520744/ref=cm_cr_pr_product_top">IRONDOC: Practical Stress Management Tools for Physicians</a>, by Mamta Gautam, M.D., who is a psychiatrist and is known in Canada as “the Doctor’s Doctor.”<span style="mso-spacerun: yes;"> </span>She works exclusively in the area of Physician Health and helps doctors care for themselves so they can care for their patients.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">The title IRONDOC is an adaptation from Iron Man athletic competitions. For example, in the book Gautam offers 20 training tips (to deal with stress) which are like athletic drills. In addition, the book offers several chapters on the biopsychosocial factors that lead to unhealthy stress in physicians.<span style="mso-spacerun: yes;"> </span>The reader is in the position of being “on the couch” of a skilled diagnostician.<span style="mso-spacerun: yes;"> Gautam adeptly </span>outlines the common personality traits and defense mechanisms of physicians.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">Next she discusses the five early warning signs of stress and then the syndrome of burnout.<span style="mso-spacerun: yes;"> </span>To overcome these obstacles, she develops the concept of the iron doc who is highly skilled in multiple areas, but not the <i style="mso-bidi-font-style: normal;">best </i>in every area.<span style="mso-spacerun: yes;"> </span>So often we insist that we must be the best at all things, which is of course impossible.<span style="mso-spacerun: yes;"> </span>If we are not the best, the thinking goes, then we are not good enough, or even worse, we are failures.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">Another aspect of this book I liked is that it is the size of one of those pocket manuals that we used to carry around in our white coat during training years (anyone remember the Harriet Lane handbook?).<span style="mso-spacerun: yes;"> </span>The chapters are concise and the advice quite practical.<span style="mso-spacerun: yes;"> </span>At the end of the book she recommends various resources the reader can consult for more depth in specific areas.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">To see my other recommendations, visit <a href="http://www.mnmed.org/KeyIssues/PhysicianWellbeing/tabid/3709/Default.aspx">the MMA’s new physician well-being page</a>. We will be continually updating the site, so keep coming back!</div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-83845321120901544662011-10-06T08:24:00.001-07:002011-10-06T08:24:41.514-07:00Physician Wellness Resources<div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><strong>Originally Posted April 14, 2011</strong><br />
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I am always trolling for good physician wellness resources.<span style="mso-spacerun: yes;"> </span>I have several to share with you this time.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">You may have seen an <a href="http://www.nytimes.com/2011/04/02/health/02resident.html?_r=1&emc=eta1.">excellent article in the New York Times</a> on physicians taking control over their work hours and lifestyle.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">What is particularly compelling about this article is that it discusses the decision process of a third-generation physician in choosing her specialty.<span style="mso-spacerun: yes;"> </span>It also discusses the reactions of her father and grandfather who had traditional endless-hour practices.<span style="mso-spacerun: yes;"> </span>Many of us in practice can relate to all three generations and their points of view.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">Another important and exciting resource recently came to my attention.<span style="mso-spacerun: yes;"> </span>There is a <a href="http://www.oslersymposia.org/index.html">conference in May in Albuquerque by the Osler Institute</a> that looks wonderful.<span style="mso-spacerun: yes;"> </span>I personally will not have time to attend but want to pass along the information to you.<span style="mso-spacerun: yes;"> </span>This is the type of conference I have dreamed about creating for Minnesota physicians, but am glad that someone is doing it!<span style="mso-spacerun: yes;"> </span><span class="apple-style-span"><span style="color: black; font-family: "Arial", "sans-serif"; font-size: 10pt;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span class="apple-style-span"><span style="color: black;">Speaking of conferences I will be attending the Rachel Remen workshop on “The Healing Power of Story: Opening to a Deeper Human Connection.”<span style="mso-spacerun: yes;"> </span>Many of you have attended Dr. Remen’s programs and I have heard nothing but rave reviews.<span style="mso-spacerun: yes;"> </span>I am excited to go to this meeting in California in early June</span></span><span class="apple-style-span"><span style="color: black; font-size: 10pt;">.<span style="mso-spacerun: yes;"> </span></span><span style="color: black;">The longer I practice the more I realize that practicing medicine is largely about listening to and honoring our patients’ stories.<span style="mso-spacerun: yes;"> </span>I also have come to appreciate that all human relationships are based in stories and these are the links that often connect us to each other.<span style="mso-spacerun: yes;"> </span>I will be happy to share with you any “pearls” that I find at the workshop.</span></span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span class="apple-style-span"><span style="color: black;">I have another book review for you in my next blog entry.<span style="mso-spacerun: yes;"> </span>Be well!</span></span></div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-76368798562877870852011-10-06T08:23:00.000-07:002011-10-06T08:25:22.031-07:00Reflections on Resilience<div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;"></span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><strong>Originally Posted April 7, 2011</strong><br />
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We have watched with awe and horror as events unfolded recently in Japan.<span style="mso-spacerun: yes;"> </span>A massive earthquake, a devastating tsunami and then nuclear plants close to meltdown.<span style="mso-spacerun: yes;"> </span>To a resident of Japan these events must have felt like the beginning of the end of the world.<span style="mso-spacerun: yes;"> </span>Yet there were many acts of heroism including workers risking death by radiation poisoning to save their families and neighbors.<span style="mso-spacerun: yes;"> </span>The Japanese are well known for their resilience.<span style="mso-spacerun: yes;"> </span>I have no doubt that they will rebuild and work to make their country even more protected from natural disasters.</div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Resilience is the key to carrying on with life in spite of the pain, obstacles and other challenges that we face.<span style="mso-spacerun: yes;"> </span>Every medical student must have resilience.<span style="mso-spacerun: yes;"> </span>The brightest in college are now average students in medical school.<span style="mso-spacerun: yes;"> </span>They must reframe their self-assessment and continue in a medical education.<span style="mso-spacerun: yes;"> </span>As residents we continue to be trainees but assume more responsibility for the care and safety of our patients.<span style="mso-spacerun: yes;"> </span>During residency a mistake can do very real harm.<span style="mso-spacerun: yes;"> </span>The resilient resident confides in and relies on her fellow trainees as well as her faculty.<span style="mso-spacerun: yes;"> </span>If we learn well, we discover that providing health care is indeed a team sport.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">I can recall a number of devastating experiences during residency having to do with poor outcomes for patients.<span style="mso-spacerun: yes;"> </span>As we tend to be perfectionists, I am sure that you understand that I punished myself multiple times, feeling that I was not worthy of the profession, feeling that I had let someone down.<span style="mso-spacerun: yes;"> </span>I felt like a fraud, an imposter.<span style="mso-spacerun: yes;"> </span>I have had similar feelings as an attending physician.<span style="mso-spacerun: yes;"> </span>In talking with close colleagues, I know that I am not alone in having these feelings.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">In moments of professional distress, we need each other.<span style="mso-spacerun: yes;"> </span>We need to support and provide a reality check for a colleague who did their best and yet had a poor outcome.<span style="mso-spacerun: yes;"> </span>The reality in the vast majority of cases is that our colleague is a good, caring physician.<span style="mso-spacerun: yes;"> </span>We would do well to remind our colleagues of this again and again.<span style="mso-spacerun: yes;"> </span>All of us have thought, “There but for the grace of God go I.”<span style="mso-spacerun: yes;"> </span>The wounded healer feels alone and isolated and believes that he is constantly being judged by colleagues and other members of the health care team.<span style="mso-spacerun: yes;"> </span>Sometimes the belief is well founded, which is an indictment of us all.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">In the 25 years in practice after residency, I have become more humble.<span style="mso-spacerun: yes;"> </span>I have stepped off the pedestal I had built for myself over years of striving and pretending to be all-knowing, all-competent.<span style="mso-spacerun: yes;"> </span>I remember once praying for humility some years ago, and then feeling afraid of what would logically happen if my prayer were fulfilled:<span style="mso-spacerun: yes;"> </span>humiliation.<span style="mso-spacerun: yes;"> </span>Well, that has happened but life did not end.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Many things contribute to our resiliency, such as the love and support of our families, friends, and colleagues, and the appreciation of patients and their families.<span style="mso-spacerun: yes;"> </span>Sometimes we also need professional help and therapy to get back on our feet.<span style="mso-spacerun: yes;"> </span>I believe that reaching out for help is a sign of strength and wisdom.<span style="mso-spacerun: yes;"> </span>Receiving care may feel unfamiliar to us but it is part of the complete human experience.<span style="mso-spacerun: yes;"> </span>Try it sometime.<span style="mso-spacerun: yes;"> </span></span></div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-29403591897208802572011-10-06T08:21:00.001-07:002011-10-06T08:21:52.029-07:00Testing for Burnout<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><br />
<strong>Originally Posted March 25, 2011</strong><br />
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In this blog, it has been my goal to provide useful resources to those of you who are interested in physician well-being. I hope to continue to do so in the remaining six months of my presidential term. I wish I could give you a feeling for the many connections that I have made with physicians across the country who are also interested in physician wellness. We have been sharing our work with each other in order to highlight studies and programs that exist or are being developed in the U.S. and elsewhere.<br />
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<div></div>One such connection I’ve made is with Heather Fork, M.D., of Austin, Texas, who writes a blog called “Doctor’s Crossing” (DoctorsCrossing.com). She consults with physicians who face decisions about whether to make a career change or who are battling burnout. I warned her that I would shamelessly borrow some of her material for my blog.<br />
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<div></div>One of the resources Dr. Fork discovered is a simple self test for burnout. It <a href="http://www.mindtools.com/stress/Brn/BurnoutSelfTest.htm">www.mindtools.com/stress/Brn/BurnoutSelfTest.htm</a>. This nonvalidated tool assesses the three dimensions of burnout:<br />
<ul><li>Emotional exhaustion;</li>
<li>Depersonalization – viewing others as objects, developing cynicism, separating ourselves from the people we serve; and</li>
<li>Decreased personal accomplishment – less satisfaction in our work, joyless striving (what I think of as loss of a sense of purpose).</li>
</ul><br />
The prevalence of burnout is staggering, and it starts as early as medical school. Tait Shanafelt and Liselotte Dyrbe, two Mayo Clinic colleagues, have published an expanding volume of work documenting how burnout influences professionalism and the degree to which medical students, residents, and practicing physicians are affected by it.<br />
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<div></div>If you think you might be experiencing burnout, take the self-test. If you get a high rating on the burnout scale, I encourage you to find a trusted advisor or therapist to help you refresh your spirit and your view on your work. It is possible to recover from burnout, as I can say that from my own-experience. Do yourself a favor and keep your flame alive!Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-19248610553465598672011-10-06T08:20:00.000-07:002011-10-06T08:20:17.916-07:00Finding Balance<div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><strong>Originally Posted March 3, 2011</strong><br />
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Recently I became aware of the work of Lee Lipsenthal, M.D., an internist who developed a program called “Finding Balance in a Medical Life.” <span style="mso-spacerun: yes;"> </span>He has written <a href="http://www.amazon.com/Finding-Balance-Medical-Life-Lipsenthal/dp/0978532112">a book</a> by the same name that I suspect will be on my reference shelf and used for many years into the future.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">The first half of the book summarizes what is known about the physician personality, the state of physician health and the prevalence of burnout.<span style="mso-spacerun: yes;"> </span>My readings in the area of physician wellbeing over the last two years confirm his analysis. </div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">The second half of the book contains a panoply of tools which can help us find our way out of burnout and back to a life of balance.<span style="mso-spacerun: yes;"> </span>Many of these are familiar to those of us who have studied psychology and neuroscience in the last couple of decades, such as cognitive therapy and emotional shifting.<span style="mso-spacerun: yes;"> </span>Mindfulness meditation is discussed in some detail with exercises that can easily be done over 5-10 minute periods. <span style="mso-spacerun: yes;"> </span>There is an interesting chapter on “Psychosynthesis” which discusses how to identify our personality and sub-personalities and how to use them to respond to a variety of situations.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">By serendipity, I also came across the keynote lecture that Lipsenthal delivered to the annual Scientific Assembly of the American Academy of Family Physicians in 2010 in Denver. The AAFP shared a video of his presentation on their web site for those of us who were unable to attend the meeting. During that talk, Lipsenthal revealed that he was undergoing treatment for metastatic adenocarcinoma of the gastroesophageal junction. Thus far he has survived about 18 months from diagnosis and looks pretty good but is well aware of the poor five-year prognosis.<span style="mso-spacerun: yes;"> </span>By already having established a habit of meditation and daily expressions of gratitude, he was prepared to face the illness with calm.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">The book and the talk both ended with the following words of wisdom:<span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">Balance is knowing that today is a good day to die; that you have lived fully, lovingly and without remorse.<span style="mso-spacerun: yes;"> </span></i></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">May we have many good days. </div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-28123262851225266912011-10-06T08:19:00.000-07:002011-10-06T08:19:06.917-07:00MMA Moves Forward with Physician Well Being Effort<div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><strong>Originally Posted February 22, 2011</strong><br />
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I wish to share with you the progress to date with the physician well-being initiatives at MMA.<span style="mso-spacerun: yes;"> </span>At the January Board of Trustees meeting, the board approved the proposal of the Physician Well-Being Task Force.<span style="mso-spacerun: yes;"> </span>Soon we will be discussing how to implement the recommendations of the group.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">A member survey conducted by the task force indicated strong interest in having regular articles in Minnesota Medicine on topics related to physician well-being.<span style="mso-spacerun: yes;"> </span>I hope that by now you have read the January issue that was dedicated to the topic.<span style="mso-spacerun: yes;"> </span>I am so proud of the contributors to the journal, many of whom were on the task force.<span style="mso-spacerun: yes;"> </span>If you have not seen it, take a look or go to the <a href="http://www.minnesotamedicine.com/PastIssues/January2011/tabid/3625/Default.aspx">Minnesota Medicine web site</a>.<span style="mso-spacerun: yes;"> </span>I truly believe this issue will be a valuable reference for us in years to come.<span style="mso-spacerun: yes;"> </span>For those of you who are interested in member recruitment, this journal would be a good promotional piece for MMA.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">It is my hope that we will offer or sponsor retreats for those of us who need to have “time out” to reflect, rejuvenate and learn new techniques to reduce stress in our lives.<span style="mso-spacerun: yes;"> </span>It is also my hope that these and other offerings will promote the formation of “community” among us.<span style="mso-spacerun: yes;"> </span>It occurs to me that one of the things most lacking in physicians’ lives is a sense of community with our colleagues.<span style="mso-spacerun: yes;"> </span>I am thankful to my local colleagues who have come together for community in our small support groups.<span style="mso-spacerun: yes;"> </span>There is a great deal of healing and soul-feeding that occurs when we can be truthful, trusting and vulnerable to each other in community.<span style="mso-spacerun: yes;"> </span>If you would like to see a similar group in your medical community I would be happy to share our experience with you.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">I continue to be impressed with the Canadian Medical Association’s efforts in the area of physician health.<span style="mso-spacerun: yes;"> </span>I would like you to know that the second Canadian Conference on Physician Health will be held in Toronto October 28 and 29.<span style="mso-spacerun: yes;"> </span>I am planning to attend!<span style="mso-spacerun: yes;"> </span>You can get information about the conference at <a href="http://www.cma.ca/physicianhealth"><span style="color: blue;">www.cma.ca/physicianhealth</span></a>.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">I am currently reviewing a good resource on physician wellness and plan to share it with you soon as a “book review”.<span style="mso-spacerun: yes;"> </span>Stay tuned.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">Be well!</div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-45122195119430631982011-10-06T08:17:00.000-07:002011-10-06T08:17:24.463-07:00Moments of Grace<div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;"></span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><strong>Originally Posted February 3, 2011</strong><br />
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In January, I was a guest at the Zumbro Valley Medical Society’s annual meeting.<span style="mso-spacerun: yes;"> </span>Because I live five hours away from Rochester I checked into a local hotel to spend the night after the meeting.<span style="mso-spacerun: yes;"> </span>Subsequently I had two consecutive days off for travel.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">The meeting was an elegant affair with award presentations, a fine meal and an excellent talk given by Sanne Magnan, M.D., the former Minnesota Commissioner of Health.<span style="mso-spacerun: yes;"> </span>My hosts were extremely gracious.<span style="mso-spacerun: yes;"> </span>The awardees were all inspiring individuals which caused me to ask myself, “So what have I done with <i style="mso-bidi-font-style: normal;">my </i>life?”<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Don’t get me wrong.<span style="mso-spacerun: yes;"> </span>I know as a physician my work helps people every day and is meaningful.<span style="mso-spacerun: yes;"> </span>I am also in a leadership position in my state medical association.<span style="mso-spacerun: yes;"> </span>These are facts.<span style="mso-spacerun: yes;"> </span>However, internally there is often discord between fact and conviction. My own faulty wiring at work, I suppose.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">During a period of socializing at the meeting I was approached by Harriett Hodgson, former president of the MMA Alliance.<span style="mso-spacerun: yes;"> </span>She is an accomplished journalist and author.<span style="mso-spacerun: yes;"> </span>She came to present me with her most recent book, “The Spiritual Woman.”<span style="mso-spacerun: yes;"> </span>What a gift!<span style="mso-spacerun: yes;"> </span>She has a beautiful introduction about the many varieties of meditation and their value and usefulness.<span style="mso-spacerun: yes;"> </span>The book also includes a collection of inspiring quotations that can be used as the basis for a daily meditation.<span style="mso-spacerun: yes;"> </span>I knew that this gift was a moment of grace.<span style="mso-spacerun: yes;"> </span>Perhaps my encouragement of an open discussion of physician wellbeing has significance after all.<span style="mso-spacerun: yes;"> </span>Indeed this gift was nourishment for the soul.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">The experience also reminded me that in medical practice we are presented with moments of grace more often than we recognize: the gratitude of a patient who takes the time to write a card; the sincere “thank you” from a person who felt heard and cared for; the affection that develops when we care for patients over many years, and the hugs from children or from the elderly.<span style="mso-spacerun: yes;"> </span>These are priceless.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">On days when we are discouraged and wonder whether we ought to have chosen a less stressful career, we are likely to have had a moment of grace somewhere, if we only had eyes to see it and the sense to appreciate it.</span></div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-90197539341653029592011-10-06T08:15:00.000-07:002011-10-06T08:15:00.218-07:00Professionalism, Nature or Nurture?<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
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<strong>Originally Posted January 6, 2011</strong><br />
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I have been thinking about the concepts of collegiality and professionalism for a number of months. Trips to the dictionary have been unsatisfactory. After consulting a number of them, I found very limited definitions such as “belonging to a college, such as the college of cardinals in Rome” or being a member of a specific professional group. In other words, there was no behavioral aspect to the definition of collegiality. Perhaps like pornography, we “know it when we see it.”<br />
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Recently I read an excellent article in JAMA, <a href="http://jama.ama-assn.org/content/304/24/2732.short">“A Behavioral and Systems View of Professionalism,”</a> by Cara Lesser et al that shed light on this issue. <br />
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The premise of the article is that professionalism is a set of competencies that can be taught and learned and that it must be practiced to be developed. Also we are capable of improving upon professionalism as we continue in practice.<br />
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What is professionalism? According to Lesser, professionalism is not an inherent character trait or attitude. Professionalism is defined as a set of behaviors. It appears that collegiality - working collaboratively with other physicians and demonstrating respect for them all in the service of the patient – is one of those behaviors.<br />
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The article also demonstrated how external factors in the practice environment can affect professional behavior. Financial incentives such as pay for performance are not motivators to professional behavior. Pride of purpose and intrinsic motivation are more important. There are therefore two essential players in the service of professionalism: the individual interactions between doctor and patient and organizational management and governance. <br />
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The good news of this research is that there are no hopeless cases. All of us can learn the skills of professionalism and all of us can grow and refine our professional competencies throughout our careers. This is one source of resiliency. And resiliency is the preventive medicine and antidote for burnout. <br />
When our behaviors reflect our values we are whole people and much happier people. We owe it to ourselves and to our patients to work to make the small and large health organizations more conducive to professional behavior and to eliminate perverse incentives in the system.Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-91057690696927801342011-10-06T08:11:00.000-07:002011-10-06T08:11:39.656-07:00Learning to say no<div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;"></span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><strong>Originally Posted December 2, 2010</strong><br />
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We all have multiple roles in life, and I recently found myself filling several of them during my father’s terminal illness and death in early November.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Several weeks ago it was apparent that my father was very ill and needed to be hospitalized.<span style="mso-spacerun: yes;"> </span>The working diagnosis was pneumonia, but it soon became obvious that something more serious was afoot when a thoracentesis uncovered a significant lung mass.<span style="mso-spacerun: yes;"> </span>He allowed the physicians to order scans, cytology, etc.<span style="mso-spacerun: yes;"> </span>Later he confessed that he already knew about the cancer as it had been diagnosed in another medical facility; he confessed this to his sister, not to the physicians. (Imagine trying to diagnose and treat a patient who decided not to share such information with you!) My father liked to keep secrets.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">I was the health care proxy and executor of my father’s estate.<span style="mso-spacerun: yes;"> </span>He lived in <place w:st="on"><state w:st="on">Florida</state></place>, so before getting there, I was doing long-distance work with him and the doctors/relatives/social worker, etc regarding pain management and hospice placement.<span style="mso-spacerun: yes;"> </span>It seemed relatively easy initially to be on the “family” end of a health care crisis.<span style="mso-spacerun: yes;"> </span>My siblings and I arrived in <place w:st="on"><state w:st="on">Florida</state></place> barely in time to say farewell.<span style="mso-spacerun: yes;"> </span>Then it was a blur of arranging cremation, cleaning up his apartment, and selling and giving away household items.<span style="mso-spacerun: yes;"> </span>During the two weeks I was away, I carried out some media interviews for the MMA and answered e-mails and even participated in a conference call.<span style="mso-spacerun: yes;"> </span>As physicians, we are able to go into “crisis management mode” and defer our own emotional reactions to a later time.<span style="mso-spacerun: yes;"> </span>This state of numbness (brain-dead is what I felt at the time) continued for a little while.<span style="mso-spacerun: yes;"> </span>Thankfully, the long drive home from <place w:st="on"><state w:st="on">Florida</state></place> was a buffer between the intensity of the family loss and the return to work and life as usual.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Since returning, I have taken more time to grieve and process what has happened, and I’ve<span style="mso-spacerun: yes;"> </span>surprised myself by saying “no” to a couple of things. Saying no is something I have spent years trying to learn, and with practice I get better at it.<span style="mso-spacerun: yes;"> </span>As physicians, we have been trained to rise to any occasion, to get up and work in the middle of the night, to work with little sleep, and to function in spite of whatever personal issues we are facing.<span style="mso-spacerun: yes;"> </span>We were not trained to nurture ourselves when needed.<span style="mso-spacerun: yes;"> </span>Saying “no” was somehow shameful. I encourage us all to practice the art of saying “no.”<span style="mso-spacerun: yes;"> </span>Obviously this must be done judiciously.<span style="mso-spacerun: yes;"> </span>Sometimes saying “no” to more work and responsibility is actually saying “yes” to life and health.<span style="mso-spacerun: yes;"> </span>One test that I use to decide whether to say “yes” or “no” is to ask this question: “Will this activity suck the life out of me or give me life?”<span style="mso-spacerun: yes;"> </span>It is simplistic, but it works for me.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Are you doing what works for you? </span></div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-73176979950879468962011-10-06T08:09:00.001-07:002011-10-06T08:09:46.747-07:00Chairing a physician well-being task force<div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;"></span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><strong>Originally Posted November 11, 2010</strong><br />
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Over the course of the last six months or so, I have been chairing the MMA Physician Well-Being Task Force.<span style="mso-spacerun: yes;"> </span>While I was President-Elect I knew that this would be the emphasis of my presidential year and wanted to get an early start on the project.<span style="mso-spacerun: yes;"> </span>We have a multidisciplinary group including physicians, chaplains, an attorney and a physician’s spouse.<span style="mso-spacerun: yes;"> </span>We are in the process of generating a report and recommendations to the MMA board on how to address physician well-being.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">If you follow the MMA web site you will soon see a section on physician well being.<span style="mso-spacerun: yes;"> </span>We have generated an extensive bibliography of articles and resources as well as web links.<span style="mso-spacerun: yes;"> </span>We will identify opportunities such as retreats, workshops and educational sessions.<span style="mso-spacerun: yes;"> </span>I also hope to provide information to you about how to start a physician peer support group in your local medical community.<span style="mso-spacerun: yes;"> </span>We hope to produce some video material that can be accessed on-line.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">A great resource in Minnesota is the <a href="http://www.csh.umn.edu/">University of Minnesota’s Center for Spirituality and Healing</a>.<span style="mso-spacerun: yes;"> </span>We will soon have a link to this site.<span style="mso-spacerun: yes;"> </span>The Center has many offerings that are valuable regarding self-care including Mindfulness Based Stress Reduction (MBSR) courses.<span style="mso-spacerun: yes;"> </span>These are based on the pioneering work of Jon Kabat-Zinn at the University of Massachusetts.<span style="mso-spacerun: yes;"> </span>I can enthusiastically recommend this program.<span style="mso-spacerun: yes;"> </span>In my personal journey I have practiced MBSR for about two years.<span style="mso-spacerun: yes;"> </span>When anxious or stressed the mindfulness meditation exercises have a wonderful calming effect on the mind and bIody.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Another mindfulness exercise that many of us are practicing is yoga.<span style="mso-spacerun: yes;"> </span>When we are practicing yoga asanas or another form of exercise we get out of the brain chatter that is constantly happening in our minds.<span style="mso-spacerun: yes;"> </span>We are able to attend to what is real.<span style="mso-spacerun: yes;"> </span>We realize where we are and are able to live in the moment.<span style="mso-spacerun: yes;"> </span>I have not yet arrived at a continuous state of mindfulness (and likely never will) but even brief mindfulness of my breathing, emotions or bodily sensations during a stressful day can be very healing.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">There are several books by Jon Kabat-Zinn that I would recommend if you would like to learn more about mindfulness.<span style="mso-spacerun: yes;"> </span><u><a href="http://www.amazon.com/Full-Catastrophe-Living-Wisdom-Illness/dp/0385303122/ref=sr_1_fkmr0_1?ie=UTF8&qid=1289507744&sr=8-1-fkmr0">Full Catastrophe Living, Coming to Our Senses and The Mindful Way through Depression</a></u> have been very valuable resources for me.<span style="mso-spacerun: yes;"> </span>Do you have other recommendations to share with your MMA Colleagues?<span style="mso-spacerun: yes;"> </span>We would love to hear from you.</span></div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-24390777762245093082011-10-06T08:06:00.000-07:002011-10-06T08:06:55.309-07:00Take your own advice and stay home<div class="MsoNormal" style="margin: 0in 0in 10pt;"><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;"></span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><strong>Originally Posted November 4, 2010</strong><br />
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A topic of interest to me is “presenteeism” among medical students, residents and physicians.<span style="mso-spacerun: yes;"> </span>Yes, this is the opposite of “absenteeism.”<span style="mso-spacerun: yes;"> </span>Both conditions may be problematic.<span style="mso-spacerun: yes;"> </span>Have you ever presented for work when you were ill?<span style="mso-spacerun: yes;"> </span>I confess that I have committed the act of presenteeism on more than a few occasions over the course of my training and career.</div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Most of us have received the subtle message that illness is a sign of weakness.<span style="mso-spacerun: yes;"> </span>Doctors cannot afford to be ill, and especially cannot afford to be absent from work.<span style="mso-spacerun: yes;"> </span>When we are absent, our colleagues usually have to pick up our workload and may let us know that they resent it.<span style="mso-spacerun: yes;"> </span>Some patients even try to “guilt trip” us after an absence.<span style="mso-spacerun: yes;"> </span>Most of us realize that returning to work after any type of absence means facing a mountain of charts, mail and messages that need addressing.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;"><span style="mso-spacerun: yes;"></span></span><span style="font-family: Calibri;">Is it good practice to work when we have an infectious illness?<span style="mso-spacerun: yes;"> </span>Of course not.<span style="mso-spacerun: yes;"> </span>Would we advise our patients to stay home when ill?<span style="mso-spacerun: yes;"> </span>Of course.<span style="mso-spacerun: yes;"> </span>However, the misguided “macho” ethic of our profession has bullied us into doing the wrong thing for ourselves, our coworkers, and especially our patients.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Is it good practice to work when we are sleep deprived, suicidal, manic, intoxicated?<span style="mso-spacerun: yes;"> </span>Is it heroic to work immediately postoperatively or postpartum contrary to the advice of our physicians?<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;"><span style="mso-spacerun: yes;"></span></span><span style="font-family: Calibri;">Friends, let us permit ourselves to heal when sick, recover from surgery and tend to our mental health—if not for ourselves, then for our patients.<span style="mso-spacerun: yes;"> </span>Let us also have mercy on our students and colleagues and give them the space to care for themselves.<span style="mso-spacerun: yes;"> </span>It is odd that we even need this type of advice, isn’t it?</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">“Physician heal thyself” indeed!</span></div></div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-18631352258739645072011-10-06T08:03:00.000-07:002011-10-06T08:03:59.202-07:00Wellsprings of resilience<div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><strong>Originally Posted October 28, 2010</strong><br />
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As physicians, we confront a host of stressful conditions and adversities, related to patient care, practice management, and just life. The challenge of a long-career in medicine is to learn how to bounce-back from these ups and downs, while still maintaining our equilibrium, openness, and wholeness. This is called resiliency by<span style="mso-spacerun: yes;"> </span>physician-wellness experts. </div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">I recently listened to a <a href="http://prismadmin.cma.ca/living/podcasts-resilient-medical-communities">podcast about physician resiliency by pediatric radiologist Richard Gunderman</a>, M.D., of <place w:st="on"><placename w:st="on">Indiana</placename> <placetype w:st="on">University</placetype></place>. It was part of series of podcasts I highly recommend called <a href="http://prismadmin.cma.ca/healthypracticespodcasts">“Healthy Practices,”</a> which are moderated by Dr. Mamta Gautam, who is known as “The Doctor’s Doctor.” </div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">One of Dr. Gunderman’s thoughts is that aspiring to <i style="mso-bidi-font-style: normal;">significance</i> in our practices and our lives - leading lives that matter - can serve as a wellspring of resilience in ways that striving for success and prestige cannot do. In my view, medicine is a calling, not just a career or a job. I believe that burnout is more likely if we feel like cogs in a big machine, cranking out patient encounters, and racking up RVUs. If we realize that we are actually servants touching the lives of people when they are vulnerable, our work has great significance indeed. <span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">I would love to hear your stories of resiliency.<span style="mso-spacerun: yes;"> </span>How have you recovered from adversity in your professional or personal life?<span style="mso-spacerun: yes;"> </span>Can your life lessons inspire one of your colleagues? Leave a comment here or <a href="mailto:drlind@prtel.com">email </a>me.<span style="mso-spacerun: yes;"> </span></div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-982078454719112442011-10-06T07:56:00.000-07:002011-10-06T07:58:27.673-07:00Useful Canadian Physician Wellness Websites<div class="MsoNormal"><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><strong>Originally Posted October 12, 2010</strong><br />
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As I mentioned in my last post, the Canadians are doing something special when it comes to physician well-being.<span style="mso-spacerun: yes;"> </span>I would like to share some of their resources with you since they are freely available to all of us, and it is not necessary to reinvent the wheel.</div><div class="MsoNormal"><br />
</div><div class="MsoNormal">One resource that I have been following for over a year is the CMA web site <a href="http://ephysicianhealth.com/">ePhysicianHealth.com</a>.<span style="mso-spacerun: yes;"> </span>The content is excellent and includes wellness topics such as nutrition and fitness and resiliency.<span style="mso-spacerun: yes;"> </span>There are also modules on anxiety, depression, burnout, substance abuse, disruptive behavior and so forth.<span style="mso-spacerun: yes;"> </span>The content is updated periodically.<span style="mso-spacerun: yes;"> </span>I was told by some Canadian physicians in <city w:st="on"><place w:st="on">Chicago</place></city> that the site has drawn visitors from numerous countries around the world, with the most frequent use by Russian physicians.<span style="mso-spacerun: yes;"> </span>Check it out!</div><div class="MsoNormal"><br />
</div><div class="MsoNormal">Connected to the ePhysicianHealth.com site is a related site called <a href="http://eworkplacehealth.com/">eWorkplaceHealth.com</a>.<span style="mso-spacerun: yes;"> </span>This has good information on how to make our teams and workplaces healthier for ourselves and our coworkers.</div><div class="MsoNormal"><br />
</div><div class="MsoNormal">Stay tuned for another gem from Canada!</div><shape style="height: 1136px; left: 0px; position: absolute; top: 0px; width: 568px;"><stroke></stroke></shape><shape style="height: 1136px; left: 0px; position: absolute; top: 0px; width: 568px;"><stroke></stroke></shape><shape style="height: 1136px; left: 0px; position: absolute; top: 0px; width: 568px;"><stroke></stroke></shape><shape style="height: 1136px; left: 0px; position: absolute; top: 0px; width: 568px;"><stroke></stroke></shape><br />
<div class="post-outer" closure_uid_s6bxkn="5" style="background: none transparent scroll repeat 0% 0%; border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; left: 1px; margin: 0px; position: relative; top: 1px;"></div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0tag:blogger.com,1999:blog-4865098792494397292.post-76386860781303289162011-10-06T07:14:00.001-07:002011-10-06T07:59:34.336-07:00Physician Wellness is an International Concern<div class="MsoNormal" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; margin: 0in 0in 10pt;"><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" kca="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHTdVItpQhf_OyXQmGjJHfdTTezvYgH6rQypKoKhDXw8lVbX8JU3Vraqftt5jd-w4dbAgHbP3B6QBEvfY0G1qLiObI-EShyfTGNtNyiGkP5EiazntKiRSc7VTwKEh15Ou7PbX-DOC8rwh3/s1600/PatriciaLindholm.bmp" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Patricia Lindholm, MD,</span><br />
<span style="font-family: Verdana, sans-serif;">2010-2011 MMA President</span></td></tr>
</tbody></table><span style="font-family: Calibri;"></span><br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;"><strong>Originally Posted October 4, 2010</strong></span><br />
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<span style="font-family: Calibri;">This week I am attending the<a href="http://www.ama-assn.org/ama/pub/physician-resources/physician-health.shtml"> International Conference on Physician Health</a> in Chicago.<span style="mso-spacerun: yes;"> </span>It is jointly sponsored by the AMA, British Medical Association and Canadian Medical Association.<span style="mso-spacerun: yes;"> </span>There are physicians here from other countries such as Spain, Australia and Saudi Arabia.<span style="mso-spacerun: yes;"> </span>It is clear that we in Minnesota are not alone in our concern for the well-being of physicians.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="font-family: Calibri;">It is interesting to see research data that shows that a physician’s self care practices are directly related to the advice that they give patients about self care.<span style="mso-spacerun: yes;"> </span>For example, a physician who has had colorectal cancer screening is more likely to advise it for their patients.<span style="mso-spacerun: yes;"> </span>If we have adequate exercise and a healthy diet we are more comfortable advising our patients in these areas.</span></div></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">There is an entire “track” at this meeting studying the correlation of physician well being and quality of patient care.<span style="mso-spacerun: yes;"> </span>People are also starting to ask how to make the lives of medical students, residents and practicing physicians better.<span style="mso-spacerun: yes;"> </span>This is foreign territory for a profession that feels its members should care for others at the expense of ourselves.<span style="mso-spacerun: yes;"> </span>There was also a very powerful talk by Dr. Michael F. Meyers on the subject of physician suicide and resilience.<span style="mso-spacerun: yes;"> </span><a href="http://www.ama-assn.org/ama/pub/physician-resources/physician-health.shtml">The abstracts for most of the presentations are available on the AMA web site.<span style="mso-spacerun: yes;"> </span></a></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">I also notice that the British and the Canadians are way ahead of us in the study of the prevention and treatment of distress in physicians.<span style="mso-spacerun: yes;"> </span>However, this month the AMA has released its new toolkit:<span style="mso-spacerun: yes;"> </span>AMA Healthier Life Steps-A Physician’s Guide to Personal Health.<span style="mso-spacerun: yes;"> </span>It is a good start, but there is much more that we must do for our colleagues.<span style="mso-spacerun: yes;"> </span>I am looking forward to advancing this work in Minnesota together with the MMA.<span style="mso-spacerun: yes;"> </span></span></div></div>Minnesota Medical Associationhttp://www.blogger.com/profile/10964836866593353770noreply@blogger.com0