These are tumultuous times for practicing physicians. The health care landscape is changing at breathtaking pace and less and less of our time is spent doing what we were actually trained to do: taking care of patients. I absolutely love the patient care part of my job, do everything possible to always remember why I went to medical school in the first place, and maintain focus on the aspects of my work which bring me the most personal satisfaction.

Here are my ten rules for frontline physician sanity:

1. Clearly separate clinical from bureaucratic work. As more of our day is being spent on tick box and administrative duties, try to have a clear separation between the direct clinical work, when you are on show to the world and practicing your true art, and when you are performing those mind-numbing bureaucratic tasks. Also don’t be afraid to tell any administrator (politely and diplomatically of course) to either email you with any issues, but not to call or page you while you are seeing patients.

2. Try to spend as much time as possible with patients. Have an acute awareness of the time you are spending at your screen during the day. For most physicians, every extra minute will greatly increase the chances of burnout and professional misery. Try to view the computer as the tool it’s supposed to be (and in an ideal world should be), not as the main focus of your whole job as a doctor. Check out my article about how I do this, so I can actually spend more of my day doing what I love.

3. Work out the computer shortcuts. Following on from the above point, every computer system will have its own unique quirks and shortcuts, that can significantly speed up your workflow. Spend time familiarizing yourself with these and document the minimum amount necessary for good clinical care and other necessary bureaucratic requirements.

4. Take regular breaks. Doctors are humans after all. The long hours are grueling, and due to the unpredictable nature of medicine, doctors are nearly always running behind. Before you know it, your lunch break should have been 3 hours ago. Be strict with yourself about taking regular breaks, even if they are very short and involve you just closing your eyes and deep breathing (mindfulness exercise). Clear your mind at every opportunity. Also, remember to eat regular healthy snacks during your day.

5. Make friends with those you work with. Any job is a whole lot better if you get to know, and ideally befriend, those around you. And that doesn’t just mean your immediate colleagues. Also the nursing, kitchen and even house staff. People you encounter every day. Have you been working with someone for an awfully long time, and have no clue whether they have children, holiday abroad, or own a dog? Get chatting to them.

6. Empower yourself to improve the system. Change happens one small step at a time. There are undoubtedly countless ways that the system you work in, can be made better. Have you noticed a glitch in a process, a problem with patient care, or a glaring safety gap? Then give feedback! Whether or not anything immediately changes, your job is a lot more meaningful if you invest yourself in your workplace.

7. Take everyday frustrations in your stride. There isn’t a health care system in the world which is perfect. All western countries are struggling with the need to control escalating costs and manage chronic disease—all against the backdrop of expensive new treatments and aging populations. You cannot avoid daily frustrations. While they may occasionally get you down, if they are repeating themselves each and every day, is there a better way you can handle them? Another technique is to always come back and make everything about your patient: the zone where it’s all about you helping someone (probably why you first went to medical school).

8. Try to be as on schedule as possible. The reality of medicine is that you can spend 24 hours a day caring for patients, and there will still be more to do. For doctors’ own well-being, it’s important to try to be as organized and strict with time as possible. That doesn’t mean you should cut people off or be in a visible state of hurry. It just means you desire a good work-life balance and will structure your day around trying to finish at a reasonable time.

9. Have some great hobbies and lead a healthy lifestyle outside. Away from the workplace, and even away from family, have something that truly relaxes you and gets you away from it all. If could be hiking, golfing or boating. It could even be something else you’ve always wanted to do like swing dancing or martial arts (even better if it involves learning something new). It also goes without saying that for peak mental health, you should always strive for great physical health. So eat healthy foods and get plenty of exercise! Moreover as a doctor, what could be better than being a role-model for your patients in this regard?

10. Always have a long-term plan. It’s no secret there’s an epidemic of physician burnout and job dissatisfaction out there; that’s directly linked to the monumental loss of control and autonomy in our profession. I’ve found my own way to maintain my great love of medical practice and seeing patients, while also having other creative endeavors going on. If you’re completely happy in clinical practice, then great! If you aren’t though … hopefully, your intention isn’t to leave completely, but whatever your long-term goal is: always be taking small steps to it every day.

Suneel Dhand is an internal medicine physician and author. He is the founder, DocSpeak Communications and co-founder, DocsDox. He blogs at his self-titled site, Suneel Dhand.

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