As physicians, we are conditioned to put ourselves last. This long-standing tendency likely began way before we hit medical school. But certainly, our training reinforces it. Think about it: the personality type that goes into medicine is typically a caretaker. And while medical school reinforces this personality pitfall, It doesn’t end there. Residency brings a whole other dimension of self-neglect. We think, “If I can just get out of residency things will return to “normal.” However, once you’re out in practice, we find new ways to de-prioritize ourselves.

We make up reasons why others are more important than us. Why do we do this? Perhaps it is the ingrained messages we are given in our medical training. “The patient comes first.” “Eat when you can, pee when you can, sleep when you can.” Or perhaps, it is a deeper message ingrained from our own family of origin. “It’s selfish to think about yourself.”

Here are the top five reasons/ways that we doctors put our priorities on the back burner.

1. Patients need us. As earlier stated, we have been trained from way back in medical school that the patient comes first. It’s one of the prime directives of medicine. So when a patient calls (and seems to be in need), we come to the rescue whether we are in the office, in our homes in the evening or on weekends. And for some of us, we answer even when we are away on vacation. We do this whether it is our responsibility to do it or not. It may seem harmless at first a call here … an email there. Before you know it, you are working seven days a week with no free time to spare.

2. Our families need us. Of course, as we are spending so much time in the office there may be some guilt associated with being away from the family. But for moms who are physicians, this can be difficult because you may wear several hats in the family: the mom, the cook, the homework helper, the chauffeur and for some spouse and parental caretaker. However, after working such a hard day, coming home to be supermom (or superdad if this applies to you), it leaves no room for time for anything else. At this point, you might find yourself beginning to get run down. But wait there’s more …

3. Our spouses or significant others need us. As I said, we often wear multiple hats (particularly women physicians). So now after we have worked 80 hours a week, we come home and acted as the super parent, and we must now give time to our spouse or significant other. And you will not give yourself priority because you are too busy feeling guilty that you haven’t had a date night in months or that you hadn’t had the energy or desire for sex in weeks. So, you pony up and devote whatever little bit of energy you have left have to take care of your spouse.

4. And then there is everything else. There are all the other hats, plates and responsibilities we are juggling that get thrown at us. Things like: “We’re short, and I have to cover for the other doctors who are out.” “What about my medical students?” “I’ve got PTA meeting!”

There is administrative duty, community service, research and a host of other things that have us overcommitted and under-acknowledged. And as physicians who always want to be seen as a team player and make anything happen, we just keep pushing forward even at the cost of our own physical and mental health.

So, why do we do this to ourselves? The simple answer could be this: we are supposed to be invincible. We are not supposed to get sick, depressed, anxious or tired. We are supposed to be superhuman. Now reading this may sound ridiculous. But if you think about the culture of our industry, this is the way we were trained. Take care of everyone else aside beside ourselves. The question is when is it enough? How can you begin to shift your mindset and take a new action?

• It starts with awareness. Becoming aware that this way of being and doing is not sustainable is the first step to recovery.
• Once we become aware, we must be willing to take action. Notice what I said. I said be willing to take action, not take action. Sometimes we skip steps. We go from awareness straight to action because we are doing something. Taking that pause to become willing before we jump into the deep end gives us space to find the next right thing to do.
• Now that we have become aware and willing, it’s time to take action, right? No! Before actions can be taken, a plan must be in place. If we simply start taking actions without any plan, we may end up out of the fire and into the frying pan. This is the point that we create a roadmap, a plan of action that will lead us to our desired outcome. Then we can take action!
• Finally, we must know that we may need to (and be willing to) reach out for guidance. I know, I know, we doctors are supposed to be able to fix it. However, is it really logical to think that, that after being brainwashed into this (lone-ranger) way of thinking for eight years, 12 years and for most of us who have been out in practice 20 plus years, that we can fix our distorted thinking? Of course not! We are the fish in water! This is our blind spot. Reaching out for support will allow us access to that blind spot so that we can create new strategies and new actions that will give us new results and new life. Reaching out is not  a sign of weakness. In fact, it’s a sign of strength and courage.
• Once we are aware, willing and have the support, we can begin to create our vision, a plan and the action steps required to make the changes that will give us new life. This is something very beneficial to do this with a mentor or a coach. A coach can see the things that you cannot. Imagine what it would be like if we put ourselves first for a change. How would that transform your life? How would that transform your family? Now is the time to begin shifting your mindset and taking action for the good of your well-being and ultimately the well-being of your patients and others around you.

Maiysha Clairborne is an integrative medicine physician and can be reached at The Stress Free Mom MD.  She is the author of The Wellness Blueprint: The Complete Mind/Body Approach to Reclaiming Your Health & Wellness. 

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