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Caitlin Whyte (Host): Hello and welcome to the American College of Osteopathic Internists podcast, Docs Off the Clock. Juggling the business of medicine and caring for patients mean doctors always seem to be on the clock. Docs Off the Clock features some of today's best voices in healthcare with tips on how to live a better, balanced life. Thanks for stopping by. The purpose of this podcast is to explore the importance of physician wellbeing and the ongoing need to combat physician burnout. Dr. Julie Sterbank was directly impacted by the death of a colleague and friend. As a member of the ACOI Wellness Committee, she continues to work, to highlight the importance of physician wellbeing and the need to talk about tough issues.

She recently published a piece exploring this in the ACOI Online Newsletter. Now Doctor, physician burnout remains a topic of great importance. How important is it for you to address physician health and wellness?

Julie Sterbank, DO, MPH (Guest): I think that it's extremely important to address this topic, because if we don't take care of ourselves as physician providers, we are not going to be able to take care of other people and give the best to our patients or our colleagues or our family members. So, I think it's of extreme importance that we focus on how best to take care of ourselves. And that includes taking care of our mental health.

Host: Now, how has your personal journey inspired you to become a vocal proponent of physician health and wellbeing?

Dr. Sterbank: So I think my own personal journey, which my journey to medicine was a little bit of the non-traditional route. So it's different than many people. So, I was working full time in academic medicine, in administration, as well as taking prerequisites so that I could apply and go to medical school because I was interested in going to medical school for a very, very young age. So, I was used to working extremely long hours, which in turn, made me realize that I had to give up a lot of other things in order to be able to do what I was doing.

So when I finally got into medical school, the running joke among my colleagues was that I was going to find medical school easy and residency easy because I was so used to doing these long hours. Well, come to find out, anybody in medicine knows that there are still many, many long hours. There is a lot of emotional stress that gets placed on you. You're taking care of patients and families that are in very difficult situations involving their health and wellbeing. And then you have to balance that with being a spouse, a parent, a son or daughter in situations where you have elderly parents. And so as time went on, those things continued to happen in my life.

And I realized that I was giving up so much for my profession, that I wasn't able to give the best that I could to the other important people in my life. So, I think that that really contributed to my first sense that we have to take care of each other, but we also have to be able to, to give our best to others. And how do you self preserve when you know, you, there's only so much you as a human being can do, as well as take care of all these other issues. So, that was really actually the basis for my master's capstone project that I started back in 2017 was to look at physician engagement and wellbeing, actually, in the context of the physician shortage that we have, because we were finding that physicians, because of all the demands that are being placed on them and because of the stress and pressure were actually, leaving the profession of medicine sooner and spending less time in patient care than their predecessors. So, that was contributing to our overall shortage of physicians in America. So, that's really what started me down this path.

Host: What are the barriers you see to addressing this important issue?

Dr. Sterbank: I think the difficulty, especially now in our public health emergency that we're in with the COVID pandemic, is there is just such a great need and great complex needs in healthcare. So, even before the pandemic, the Affordable Care Act was pushing us to try to follow public health measures, to try to get the best public health response that we could with limited resources. Now we are in a situation where the system is, it was taxed before, but it's being taxed beyond belief now. So, that is a huge, huge barrier because at the end of the day, the resources, unfortunately for healthcare are limited.

So we have to figure out how do we best utilize those resources to take care of most people that we can in the best possible way. And that's a very complex problem.

Host: So what are some steps you have taken to find balance in your own life?

Dr. Sterbank: So that's, that's interesting. So, when we asked physicians, myself included, but when we asked physicians, what kinds of things have they done to reconnect, especially during the pandemic, but it gives you some insight to some of the things that work. Physician engagement and wellbeing is such an individualized and such a specific situation for each individual that it requires an individual response. So, I always say to physicians and my colleagues, we have to think about for you, what works, what brings you joy? What kinds of things can you still connect with? And probably the biggest piece of advice that I bring to people is you need to take time away from work and that means truly away. So, that means not at home logging back in to work on charting. That means not going home and logging back in to look at emails related to work. That means really disengaging from all of this stuff, at least for a temporary period of time, so that you can take a break and you can mentally and emotionally recharge.

So, that's probably the biggest piece of advice. So for me, my own personal thing is I do some art on the side. I'm actually an amateur calligrapher. So, I like to spend time in my art studio working on that. I just recently, because I want to stay as physically active as possible. I actually just recently started studying ballet, which is kind of interesting when you're in your midlife, and you all of a sudden decide that you're going to try something like ballet, which is not the easiest thing I would say to try, you know, I do some running on the side. I actually am not a great runner either, but I've found that volunteering with, in terms of pancreatic cancer awareness, because that has affected my family and several family members, I've been able to participate in 5Ks for that.

So I think that it's, it's this balance, but you have to really look at yourself what works for you. And so even for me, cooking is a great release for me, but for other people, cooking is stressful. For some people, meditation is the best route to go. For others, it can be the physical activity of doing something hard, like running or swimming or biking. So you really have to take a step back and say and think about what works for you. What makes you feel the best and what brings you joy.

Host: How do the principles of osteopathic medicine and treating the whole patient fit into this discussion on burnout?

Dr. Sterbank: Well, I think that it's, it's important because we have to take care of ourselves like we would take care of our patients, right? So we have to look at ourselves as a whole. So you can't have one part of the body without the other parts, all of this interacts. So, that's where I think that it is really important to, you know, definitely acknowledge and take time to take care of your mental health.

And if that means taking time to talk to somebody in terms of, you know, a therapist, a counselor, someone, you know, you're connected with in your religious life. I think those things are just as important as what we preach to the patients. The problem is we always are brought to think, I'm brought up to think, or even in medicine, we, we think that, you know, you have to always be strong. You have to be the one that holds the ship down and holds the fort down and makes everything work. And in the end, you're the one who's responsible and that is a tremendous amount of pressure and stress. And like I said, that's a tremendous amount of pressure and stress, even if you weren't trying to be a spouse, a wife, a husband, a parent, a son or a daughter.

I mean, those things are, you know, in and of themselves can be very stressful throughout the different life cycles. So, even if you didn't have that going on, medicine is still very, very stressful. And especially in this day and age. So, if you don't take that time to be able to take care of yourself and recognize the impact of the mind on the body; then I think what ends up happening unfortunately, is you're going to start experiencing problems either physically or emotionally or mentally. And it does play out in terms of relationships you have with other people. And that's part of what also keeps us healthy is to have healthy relationships and people that support us because at the end of the day, we are all only human and we can all only handle so much.

Host: You know, you gave us a few tips of your own, but what steps can or should a physician take to promote their own wellbeing?

Dr. Sterbank: So I think, as I said before, you have to figure out what works for you and what you're most comfortable with. But most of the organizations, the larger organizations will have things like employee assistance programs that can help. Some of the larger institutions are doing a lot of training on resilience and wellness. And let me preface that by saying, I think that's only one part of the puzzle. So, it's not just the individual that needs to be responsible for this, but we need to actually really lobby healthcare organizations also to be a part of this. And then if there is someone who is struggling, there's actually, there is actually the physician support line, which is a volunteer organization. We can give you the number, but they're at www.physiciansupportline.com. It's 1-888-409-0141. And that's a volunteer organization where you can call in. It's free, it's confidential. And you can talk to somebody about some of your concerns related to this.

Host: And wrapping up, what can a physician do to recognize and help appear they see may need help?

Dr. Sterbank: So, I think first of all, it's very important to listen. And the first step is to listen. And then also to remember not to judge people for where they're at, at that time. I think that's probably the first step is to listen and then to really share your concerns with that person. Now, there are Mental First Aid Health classes that you can certainly sign up for and learn more about what to do in those kinds of situations, if you want to pursue it. But I think that having an honest conversation with somebody to say, you know, I'm concerned about you, what can we do to get you some help is a very reasonable thing to do. And, I think the bottom line is, just to be there for that person in a nonjudgmental way and help them link to some of the other resources. You know, is it an emergent situation where, you know, the person says to you, I'm not in a good place right now and we need to seek emergency care, that certainly can happen. Or is it more of a situation where maybe it's not acute at the moment, but you need to try to get somebody over to some resources, say for example, the Employee Assistance Program, wherever you work, or in terms of counseling, those kinds of things. But I always say step one is listening first, in a nonjudgmental way.

And then being honest about sharing your concerns with that individual and then offering to get some help with them. If they are comfortable with you and are meaning to do that with them together.

Host: Well Doctor, we appreciate your time today. Is there anything else you'd like to share with doctors who may be experiencing burnout or watching a colleague go through burnout, just experiencing this in some form, some way in their own lives?

Dr. Sterbank: Well, I think the biggest thing is to recognize that the situation you're in is not permanent. So I know in my particular situation, as difficult as things got, and we were in a situation where I did lose a colleague to suicide, is to remember that the situation that you're in is not permanent and things can and do still change. And when I say that, I say that with hope. Things can and do change for the better, and there are going to be better times in your life, and they're going to be more difficult times in your life. So, I think it's just really important to remember, that, you know, the situation that you're in is temporary. It may not seem like it at the time, but I'm here to tell you from personal experience it's temporary and, you know, definitely reach out, get some help, talk to the people that you feel comfortable with sharing. And believe me in the end, you will be happy. And the people around you will be grateful if you do that.

Host: Well, thank you again for spending a little time with us today and sharing your story. We look forward to future podcasts, where we will continue to explore issues of importance to you. For additional information, please contact the ACOI directly at 1-800-327-5183 that's 1-800-327-5183, or by visiting our website at acoi.org. You can also email us at acoi@acoi.org. Until next time, be well .