August eNews 158: Taking Time to Treat Ourselves
A message from VACEP President Cameron Olderog, MD, FACEP
I recently read a newsletter from my favorite local restaurant. In it, the owner wrote about the struggles of continuing to work, navigate restrictions, be innovative in solutions, and keep as many of his staff employed as possible during the pandemic.
He noted how people are coming back to life at a sprint pace. But those who had no choice but to be out in the world during the pandemic, he wrote, have already run a marathon.
I think we feel the same in the emergency department. Everyone is emerging at a sprint, but we are tired from having just run a marathon.
This month, the Senate unanimously passed the Lorna Breen Act. This was a piece of legislation ACEP lobbied for this year. It was sponsored by Senator Tim Kaine of Virginia, and focuses on researching and developing policies to prevent burnout and improve mental health among health care clinicians. It also looks at ways to remove barriers to accessing care and treatment, including consideration of stigma and licensing concerns.
Lorna Breen was a New York emergency physician who died by suicide in Charlottesville last year. The stress of COVID impacted her mental health, and the barriers to seeking treatment led to her death.
As we talked about her situation and the challenges physicians face in seeking mental health treatment — in particular, concerns for their license and credentialing — I was reminded of the struggles we had during my time in the Army. Special forces and other members of the military with security clearances were reluctant to report PTSD symptoms on return from war for fear of losing their job.
Physician or military, people are sacrificially serving the country and afraid of ramifications that could cost them their jobs. We as physicians have been trained to work hard through difficult cases without missing a beat, deal with little to no sleep, and project a calm confidence. It all takes a toll on our mental health and well-being.
If you are struggling with depression or suicidal thoughts, you owe it to yourself, your family, and your patients to seek treatment. Physicians are twice as likely as the general population to die by suicide.
You can start by testing the Crisis Text Line with your needs. This line is recommended by ACEP and the Council of Residency Directors in Emergency Medicine (CORD). Simply text the word HELLO to the number 741741.
More below on a Virginia-based program through the Medical Society of Virginia.
While not as severe, burnout is more common and affects our mental health, family relationships and patient care. Burnout may seem like a syndrome that only affect people “who can’t cut it,” but we have seen much more of it in emergency medicine after this past year. The Physicians Foundation found that in 2020, 61 percent of doctors experienced burnout (up from 40 percent in 2018).
Like my favorite restaurant owner notes in his newsletter, we need to recognize our experience is different than many others, and we need time and space to recover. Rest, have some fun, do something creative. Because if we don’t take care of ourselves, we won’t be able to take care of our patients.
Led by the Medical Society of Virginia, SafeHaven is a confidential resource for emergency physicians and healthcare practitioners in need of support to address career fatigue and other mental health issues. SafeHaven was created by MSV-backed legislation in 2020, and signed into law by Gov. Ralph Northam. The law protects information including proceedings, minutes, records, and reports originating in SafeHaven as privileged. This protection means such information or communications may not be disclosed or produced in a legal proceeding absent a court order. (More on confidentiality here).
