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Physicians and Self-care: Why Do We Want to Tough It Out?

Sirosh Masuood, MD

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September 16, 2022

We physicians come to the noble profession to heal and help others. Over years of education and training, we learn to be compassionate and empathic not only toward our patients but also to people around us. Patients' safety and care become our priority. And at some point, we forget about ourselves. We forget that we also need to care for the self and just how important it is.

My physician colleagues often reach out to me to discuss what they are going through; some are seeking advice and some just reach out to vent. One thing that I come across repeatedly is how hard we are on ourselves.

We do not treat ourselves the way we treat our patients. I recall a colleague of mine who once casually asked me what I usually recommend for sleep, and I mentioned a few options. Several months later he approached me to share how he never knew what sleep was until he got his primary care physician to prescribe him some medication for insomnia. He said he felt like a different person.

In my psychiatric practice I emphasize good sleep because insomnia can lead to worsening of most of the psychiatric diagnoses. Depression, anxiety, and bipolar disorder all can get worse if one does not get enough sleep. My colleague, who was fully aware of this fact and who himself made sure that his patients had a good night's sleep, never applied that same rule to himself.

Similarly, another physician friend was experiencing pain after a simple procedure and had a prescription for pain medicine but was afraid to use it. She knew the risks and did not want to be dependent on any medications. After several weeks of enduring pain, she decided to try one dose and felt relief. She did not look stressed at work. She shared that she never knew she would feel so much better after the medication. Similar to my other colleague, this friend is someone who treats patients' pain on a regular basis but forgot about herself.

Physicians are also reluctant to seek treatment for mental health. Due to the COVID pandemic, physicians are going through burnout and stress. This is making them realize the importance of mental health and, fortunately, more of us are open to seeking help. Recently another physician reached out and told me that he was experiencing depression and anxiety, and asked to see me as a patient. He made an appointment. He appeared convinced that he needed treatment; however, he rescheduled four times and then told me that he has to wait for the schedule for the following month. He never got back to me.

I wonder whether he would have rescheduled his appointment if he had to see another specialty? Does he want to tough it out like all other physicians?

We motivate our patients to adopt a healthy lifestyle, to take care of their diet, to exercise, to self-care. We advise them that all of this is important for their physical and mental health, that they will function better at home and at work if they are healthy. Yet, we ignore our own health, our own well-being. We are aware but we choose to ignore. We choose to forget.

Is it because we feel ashamed to admit that we need help or we need medications? Do we feel guilty when we care for self? Or is it because we know too much, and we get scared when it comes to taking any medications? I have not figured that out yet.

As an old saying goes, "You can't pour from an empty cup.'' I am also guilty of pouring out of a half-filled or empty cup for a long time. More recently I recognized that lack of self-care had taken a toll on my well-being. I have made a lot of small but significant changes to how I function, and I can say I feel the difference.

I hope more physicians become aware of their needs and seek treatment that is needed. We have a very stressful lifestyle and we need to take care of ourselves so that we can help others.

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About Dr Sirosh Masuood
Dr Masuood is a board-certified psychiatrist. She completed her general psychiatry training at Mount Sinai/Icahn School of Medicine in New York where she was chief resident. She pursued fellowship training in consultation and liaison (C&L) psychiatry at Long Island Jewish/North Shore Hospital in New York. She has vast experience in outpatient practice and C&L psychiatry. She has worked at Shady Grove Medical Center, Adventist Health Care, where she established the C&L service and served as medical director. Currently she is a partner in a private practice, Excel Psychiatric Consultation, in Germantown, Maryland, where she offers medication management and TMS. Dr Masuood has a special interest in physician well-being and offers psychotherapy and coaching to physicians.

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