Imagine a deep canyon surrounded by mountains. Then imagine in that environment a hiker, who becomes a mere speck, wandering in a vast, seemingly endless landscape.
Not at all unlike our system of healthcare, says Dr. Tambetta Ojong, a fellow of the American Family of Physicians and an adjunct assistant professor at the Campbell University School of Osteopathic Medicine.
Ojong is also a proponent of physician well-being, lifestyle medicine and health literacy, as well as maternity and women’s health. Navigating and accepting one’s place in that rocky environment can also be the first steps on a personal journey to wellness.
“I do feel that sometimes well-being and a journey to wellness is just that,” Ojong told students during the most recent Grand Rounds lecture at the Campbell University School of Osteopathic Medicine. The regular lectures are a required part of their curriculum.
“It’s kind of like you are going against a large healthcare system, and you don’t really know where to start or where to begin. You are one speck, but that one speck does make a difference, especially when (adding) multiple individuals looking for wellness,” she said as part of the interactive discussion.
She projected a slide.
“One a day is a multivitamin and represents the approximate number of physicians who die by suicide daily in the United States,” according to Dr. Catherine Pipas, a noted wellness consultant, speaker and author.
One in five adults in the U.S. lives with a mental illness, and one adult will commit suicide every 11 minutes, Ojong said, citing the Centers for Disease Control and Prevention.
Six critical tenants of wellness fall into these categories: physical, mental, emotional, spiritual, social and environmental.
People in demanding, high-stress jobs, such as physicians, often struggle with one or more of these facets of well-being, which could lead to burnout, “a condition resulting from the chronic inability to emotionally recover from the distress of work in downtime,” she said via a slide.
Physicians, for example, often focus on the needs of others at the expense of their own well-being. Ojong related her journey through burnout and regularly lectures and teaches her colleagues on the subject and process.
“The goal of well-being is not the absence of stressors, because we know that stressors will come. But it’s so that an individual has a toolkit, and the abilities to cope with the normal stresses of life and can work productively and be able to make a contribution to his or her community.”
Ojong related her own battle with burnout. She talked about her first year as a practicing physician. Medical school behind her, the white coat a career reality, the ability to make her own decisions.
Great feelings of success and accomplishment.
“However, for me, year one wasn’t all of those things,” she said. “I actually felt burnt out. I was very frustrated, I was overwhelmed by the administrative burden, by the never-ending in-basket, and by the lack of meeting the different metrics. …”
The signs were there, like ubiquitous billboards along a lonely highway.
Running late, becoming short-tempered and failing to exercise. Staying at work later and later.
Ready to quit.
“Clearly, we had a change of heart.”
Ojong became involved with the N.C. Medical Society and later did a MEDTALK on the role of mentorship, personal traits and practices as physicians transition into attending roles, according to her presentation. She also joined a physician well-being program and continued her work to instruct students and doctors about well-being. At work, she created a “Wellness Watch Committee.”
Setting boundaries and establishing goals, learning to play and to say “no.”
“I think in medicine we’re very serious, we’re very studious, and that’s good,” Ojong said. “But you are dealing with people. And so, I feel like that playfulness, that creativity … we don’t often explore those things.”
Physicians aren’t superheroes.
“There are things we control and things we can’t,” Ojong said.
“We are, first and foremost, human, and I think kind of recognizing that can help you go a long way.
Burnout in healthcare is a crisis, Ojong said, and one must recognize the symptoms.
“Recognize that in yourself, so that you will be able to recognize it in your colleagues. You may be that person that helps a colleague get the necessary help or provide the resources that they need before they go down.”
Encouraging exercise, good nutrition and sleep. Setting time for meditation and reflection. Offering kudos and affirmation.
“Our tendency is to remember the things we should not and forget the things that we should,” Ojong said. “For a lot of us, if you are given a … criticism or negative feedback, you will remember that for days. It doesn’t matter. If I tell you three positive things, the one negative thing that I tell you … that’s what you’re going to focus on.”
Earlier in her lecture Ojong asked the students to gauge their level of wellness, based on the happy and progressively sad faces on a group of cartoon bubbles.
So, what’s your next step to wellness? she asked.
Start by setting a SMART goal she said, that, referencing the acronym, is specific, measurable, achievable, relevant and timely. Ojong says she adopted a daily gratitude practice, allowing her to reframe daily work experiences and continue to develop a positive mindset. For example, Ojong keeps a journal and writes down one positive thing that happened to her on any day.
First, take care of yourself, she said.
Ojong quoted Pipas, the author and speaker: “You must fill your cup before you pour into others. You can’t pour into an empty cup.”