When seeking help, challenges physicians may face include perceived stigma and how admitting they need help could affect their license. Questions such as, “Do you have a mental health diagnosis?” and “Are you on medication?” are difficult. Dr. Zembrzuska says, “These are very invasive questions, and then you may be honest, and it [may] cause problems. … I think it really discourages physicians from seeking care.”
She notes the need for change at the national, state, local, private practice and hospital levels to address burnout. However, healthcare providers themselves should be empowered to take control.
“We have to set priorities, and not everything needs to be done today,” she says. This mindset is easier said than done due to the limited number of hours in a day and staffing shortages. But it’s important to set boundaries.
Strategies
Rheumatologists should focus on what they can control within their day, even if it’s as simple as controlling when to exercise or how many messages to answer. Dr. Zembrzuska also notes the value of finding support from fellow physicians, discussing her own participation in online groups for physician moms and women rheumatologists.
Dr. Zembrzuska said that some national efforts to help healthcare providers with mental health are underway, including the Dr. Lorna Breen Healthcare Provider Protection Act. Passed by the U.S. Congress in 2022, this bill enables more attention, strategies and research for the mental health of providers.
Another effort—although not physician specific—is the establishment of 9-8-8, that people can use to call or text the National Suicide Prevention Lifeline.
Dr. Hausmann and Dr. Zembrzuska discussed coping strategies, such as driving to work and back home in silence—a strategy Dr. Zembrzuska loves as the mother of young children. Looking out the window, even for a few minutes, when working can help individuals reconnect with nature. If nature is unavailable, a plant or two in your office or looking at clouds and the sky can help give you perspective.
When possible, Dr. Hausmann likes to briefly meditate to center himself and clear his mind before seeing a patient.
Mental Health & Patients
Some rheumatology patients may note experiencing problems with anxiety, depression or sleep during an assessment or on a questionnaire. How can rheumatologists address these concerns when patients report them?
“I think [this situation] invites a conversation after you’ve addressed everything else,” Dr. Zembrzuska says. “‘It looks like you might have some difficulty with anxiety, depression or sleep. Tell me about that.’ I think patients will just appreciate having an open conversation.”