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Join us as we sit down with general surgeon Scott Ellner to discuss evidence-based strategies aimed at improving the well-being of those on the front lines. In this insightful conversation, Scott delves into a range of techniques, from mindfulness to cold shower therapy, that can help health care professionals navigate the unique challenges they face on a daily basis. By making small changes and implementing self-care practices, individuals can experience significant improvements in resilience, productivity, and overall quality of life. Tune in to gain expert insights and practical tips on how to effectively prioritize self-care in the demanding world of health care. Whether you’re a seasoned pro or just starting out in the field, this episode offers valuable advice tailored specifically to the needs of health care workers. Don’t miss out on this opportunity to learn how to make your well-being a top priority. Take the first step towards a healthier, more balanced life by implementing the strategies discussed in this episode.

Scott Ellner has been a general surgeon for over 20 years, and can be reached at PEAK Health. He has transitioned into health care executive roles due to his passion for patient safety, quality, and value-based care delivery.

He discusses the KevinMD article, “5 days, 5 minutes: life-changing daily habits for health care professionals.”

Our presenting sponsor is Nuance, a Microsoft company.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and get CME for this episode by clicking on the CME link in the show notes. Today we welcome Scott Ellner. He’s a general surgeon, and he’s the founder and CEO of Peak Health Technologies. Today’s KevinMD article is “5 days, 5 minutes: life-changing daily habits for health care professionals.” Scott, welcome back to the show.

Scott Ellner: Great to be here, Kevin, thank you.

Kevin Pho: So Scott’s been on several times. Go to KevinMD.com/podcast to search for his name and prior episodes. Today let’s jump right into your most recent piece. So for those who didn’t get a chance to read it, what’s this one about?

Scott Ellner: Well, it’s really about self-care. And one of the important aspects of being a health care provider, or even a health care executive, is cultivating compassion for others, but for yourself.

And what I really wanted to provide some guidance on in this article is about self-care, and just doing five things that take less than five minutes each every day, just to help you develop a more positive attitude, a better quality of life, and to be able to do the things that you love, like taking care of patients, because you’re also caring for yourself.

Kevin Pho: So tell me, before we get into those five things, why is it so difficult for health care professionals today to take the time out for self-care?

Scott Ellner: So it’s a great question. Why are health care professionals so limited in their ability to care for themselves?

Well, let’s start first off. Life in general is stressful. On average we experience about 10 stressful events a day. But in health care it’s about 10 stressful events every hour. Think of the ICU nurse, or the critical care surgeon, or the family practice physician, who is trying to navigate all the patient needs, and at the same time is just having multiple layers of more and more documentation put on them. And then finding the time to step away and actually care for yourself.

So health care has become incredibly busy, it’s become stressful. It’s an environment where we’re always focusing on the vulnerable populations that we treat, and so we really don’t recognize that we’re not giving ourselves time to rest, to think about or ponder the great things that happened to us and the things that we’re doing. The celebrations of success, we miss out on those.

And so what I’m just suggesting with this article, and I hear it all the time, I don’t have time, I don’t have time, well, you could probably find a little bit of time, maybe put down your phone for a few minutes, and do five quick things throughout the day that will help you.

Kevin Pho: All right, let’s go into those five things.

Scott Ellner: OK. First and foremost, this is something I love to do, and I actually did it this morning, is I take a quick cold shower. And for those of you who don’t like cold, the way I work up to it is I start out with heat, and then while I’m in the shower my body adjusts, I ratchet down the shower so that the water starts to cool off, and eventually I get to below about 60 degrees Fahrenheit.

What that does is, it not only stimulates the T cells in your body to help protect you and build up your immune system, but it also releases neurotransmitters to give you a more positive attitude on the day. It squeezes down on your circulation, so it reduces muscle tightness, muscle soreness, or inflammation, which plagues us when we’re working real hard. And it also wakes you up, it gives you mental clarity.

So just five minutes or less, take a quick cold shower below about 60 degrees Fahrenheit, and work into it.

Kevin Pho: OK, so five minutes, work your way down to a cold shower. And I’ve heard from other guests some of the physiological benefits that you mentioned.

Scott Ellner: Absolutely, yeah. It’s like doing the cold plunges. You’ve seen people do these polar cold plunges and the benefits they get from that. And really it’s an anti-inflammatory response that our body goes into, and it’s incredibly helpful.

Kevin Pho: All right, what’s next?

Scott Ellner: OK, what’s next is some stretching. And a lot of us, as we get older, we become more sedentary. Being sedentary is about as bad as smoking. When you’re not getting up and moving around, your joints become tighter, your muscles start to atrophy. Or even for those of us who are doing a lot of work and moving around throughout the day, as we’re running back and forth with patients, we’re breaking down muscle tissue.

The important thing to consider with stretching is to just take your time and do a few stretches. Again, doesn’t have to be more than five minutes. And what that does is, it increases the blood flow to the areas of the muscles to help them heal. It actually gives you another positive response and release of dopamine to make you feel good. It gives you greater mobility, particularly for joint health, which we see starts to decrease as we age. And it also helps us to just focus on that time to be present, and works on our breathing.

So stretching is an incredibly great way to allow for greater blood flow to get to areas that need it for healing and regeneration of your connective tissue. And it’s a positive experience, it will allow you to move better, feel better, and be more flexible in the work that you do.

Kevin Pho: Any specific stretches that you find more effective?

Scott Ellner: Yeah, for those of us who like to do yoga, a downward dog is a pretty good stretch, which is essentially you’re in what’s called a plank position and you raise your backside up toward the sky, and it stretches out your hamstrings, or the posterior chain of your body, your hamstrings, your calves, gets a little bit of the ankles, and it releases tension on your back.

So doing a downward dog, doing a sit and reach, again to get those hamstrings. For those of you with neck tightness, bringing your arms above your head and just putting your hands behind your head and rotating your elbows back will help with your traps if you’re sitting at a computer for a while. Just doing that for 30 seconds is an incredible release of some of the toxic energy that’s within our muscles.

And I do Peloton. Adrian Williams, who’s one of the instructors with Peloton, he talks about, we harbor a lot of negative or toxic energy in parts of our body, and when you stretch you release that negative energy. And it’s incredibly helpful to generate a positive attitude on your day.

Kevin Pho: So we have cold showers and we have stretching. What’s third on your list?

Scott Ellner: Third is just, and I just shifted over here, I don’t have my orange with me, but just try to get about two pieces of fruit or vegetables a day. We’ve heard five servings, you’ve got to get five servings. It’s hard enough to eat sometimes. I remember being an intern, running around in residency, I don’t think I ate that first week for 24 straight hours.

If you could find a piece of fruit, or two, throughout the day, it actually has been shown, reading through the American College of Lifestyle Medicine, just two pieces of fruit a day will reduce your cancer risk by 20 percent.

So I recommend those fruits that are darker in color, the purple fruits. Also avocado is an incredible fruit. Those with pits have benefits, the omegas, the right kind of fats that you want for your body. It’s great for your skin and your hair, and it also helps with your digestion or your gut health. It promotes the right bacteria in your body for improved overall digestion. And as you know, fiber, the right amount of fiber, can reduce colon cancer risk, which by the way, we are starting to see younger people starting to develop colon cancer, which is a phenomenon that’s very concerning right now.

Kevin Pho: So when you say the purple fruits, like what exactly are we talking? Grapes, pomegranates, berries? What are examples of those?

Scott Ellner: Yes, yeah, good question, the purple fruits. So exactly, so cabbage, pomegranates, eggplant. Really those types of foods have the nutraceuticals within them that will help you to create antioxidant properties throughout your body, improve your immune system, and overall improve your gut health.

Kevin Pho: So we have that nutrition piece. Looking back at your article, I see mindfulness or meditation. So tell us more about that.

Scott Ellner: OK. So I remember with mindfulness, particularly when I was part of a health system and we were going through the pandemic, people were saying, I don’t want another yoga app, I don’t want another meditation app. But in reality, if you can practice just staying still and being present for a few minutes a day, it does incredibly wonderful things to your overall health, starting with your mental health.

It seems like it can be complicated at times. How can I just sit there and think about nothing? Things are coming into my head constantly. It’s called the monkey brain. In reality, don’t worry about it, let those things come in and out. The goal is to not clear your mind completely. I think that’s somewhat of a misperception. Mindfulness, or taking the time to meditate, is really about focusing on breathing and just taking a few minutes for yourself to redirect the energy and let the stress of the day somewhat dissipate.

And I will tell you this, practicing mindfulness or meditation, you can’t do it wrong. So it’s something that I recommend for anybody, particularly if dealing with stress. It will help to put you on a path of better mental health, to redirect and see things in a more positive way.

And frankly, after about five days, that person who cut you off in traffic, you’re going to let it go. You’re not going to be taken in and be involved in an altercation on the road when you’re driving in, because you’ve actually started to create new neural connections to tell you, it’s OK, I’m not going to react to this. It’s a very powerful way of rethinking or reframing your approach on your general daily living.

Kevin Pho: So in terms of getting started, you did allude to apps. Are those a good place to start? I heard the Calm app is effective. What’s your thoughts on that?

Scott Ellner: Absolutely, I use an app myself. And you mentioned the Calm app, there’s Headspace, we used something called Ginger in one of our organizations. Whatever works. An app can basically keep you on track.

I do use an app myself because I enjoy somebody talking about different forms of practicing mindfulness. I mentioned Peloton before, I do use Peloton. They talk about something called witness meditation, courage meditation, kindness meditation, empathy. There’s different ways of approaching mindfulness.

You can use your watch to help with your breathing. I noticed that on one of your prior episodes there was a short you had about box breathing. Yeah, very, very powerful technique, and an app can help you with that as well. So getting started, if you need a little lift or some instructions, an app is terrific.

Kevin Pho: And for those who didn’t listen to that last episode, just tell us what box breathing is in 20 seconds.

Scott Ellner: 20 seconds. Box breathing is breathing in for about four seconds, and then hold it for about four seconds, breathe out for maybe a little longer, six seconds, hold it for four seconds, and then repeat. So in, across, down, across. Very powerful.

Kevin Pho: All right, so we have four of the five. We talked about cold showers, stretching, fruits and vegetables, and then mindfulness. What’s the last tip that you have for us?

Scott Ellner: Gratitude. For many health care professionals, we grind our way to our achievements, or grit, and the way we got to where we are as highly educated, very well decorated, reputable physicians, clinicians, executives, somebody was there to help us. And gratitude is a great way to feel better.

And so what I like to do at the end of the day, primarily, is write down a few things that I’m grateful for. Many times it’s the people around you. My wife, who’s incredibly supportive. My kids, who keep me on track and tell me I’m old and I’ve got to work out. My dogs, who are like, come on, let’s go outside and go for a walk. My 80-year-old parents, who have always been there for me. And then of course my peers, my colleagues.

So I write down in a journal, I keep a journal of those things, those people I’m grateful for, showing grace, events in my life that happened that I’m grateful for, and I log that every single day.

And it’s very powerful, Kevin. Showing gratitude, acknowledging people, recognizing others, it provides that powerful surge of dopamine that we all talk about, that’s stronger than getting a text message or looking at a TikTok. So I really enjoy sharing gratitude, and I make notes and keep a journal.

Kevin Pho: So you’re a busy surgeon and physician executive. Give us a typical day where you would incorporate some of these techniques into your daily life. Just give us a story or an example of a typical day where these are incorporated.

Scott Ellner: Right. So typically I’m in the OR by 7:30 to start, and I get there a little early to talk to the patients. So I will get up typically before 5:30, which many of you all do.

And the first thing I do is start with gratitude. I always say, I am grateful for this new day. And then what I’ll do is some stretching, I’ll try and get even a workout in as well, which has benefits also. And that’s where I’ll have a piece of fruit or something, or a high protein meal.

Throughout the day, as things start to get a little bit busy in between cases or meetings I have to go to, I start to notice my breathing changes, my stress level goes up, and that’s where I’ll take five minutes to do a little meditation. Sometimes I’ll do the meditation in the morning, I’ll practice mindfulness in the morning and think about or visualize the day, but then I’ll do some mindfulness.

The cold shower, that was done in the morning, or in the evening when I get a chance to do my workout, I’ll do the cold shower to come down. Sometimes I like to do a cold plunge into an ice bath that might be available at one of the gyms I work out at.

But after lunch I’ll write a few things down and think about what I need to do, again visualizing, again practicing that mindfulness. But overall, these five things I talk about, if you do them in five minutes, it’s less than 2 percent of your day. So we have about 86,000 seconds in the day, this is about 1500 seconds of that time that I will allocate.

And I will tell you, I’ve been able to develop these into habits because they were behaviors that I consistently did. And my family’s better for it, the people I work with are better for it, and my outlook is much better also for the patients.

Kevin Pho: We’re talking to Scott Ellner. He’s a general surgeon and a physician executive, CEO and founder of Peak Health Technologies. Today’s KevinMD article is “5 days, 5 minutes: life-changing daily habits for health care professionals.” Scott, as always, we’ll end with your take-home message to the KevinMD audience.

Scott Ellner: OK, a couple tips for people. This is something I do every day, in fact I write it down in my journal.

One is, as I mentioned before, be grateful for every new day. There’s opportunities every new day that comes with us.

Two is, embrace impermanence. Impermanence is change. The only constant in life is change, and just accept it, allow it to happen.

The third is to cultivate compassion for others, but importantly for self. We talked a lot about self-care today and the importance of doing that.

The fourth is to walk the path of wisdom and to always acquire knowledge. By listening to these podcasts, you’re learning about yourself, you’re learning about others, and developing a mindset.

And finally, just recognize that you’re at peace with yourself when you take the time to be present and to practice these things. And it’s incredibly empowering. It raises your vibration, your energy, and you become very magnetic to people.

Kevin Pho: Scott, as always, thank you so much for sharing your perspective and insight, and thanks again for coming back on the show.

Scott Ellner: It’s an absolute pleasure to be here, Kevin. Thank you.