All this, of course, takes a toll at home.
“You slight personal relationships and outside interests, which adds to the stress in your life,” Dr. Ruhlen says. “Every time you miss a birthday party or a family activity you’re digging yourself deeper into an unsatisfying family life and giving up things that help you to relax and be healthy.”
Hospitalists also have more to juggle these days because they need to know a lot about both human beings and machines, says Richard Gunderman, MD, PhD, MPH, who speaks internationally on doctors’ health and its role in sustaining a medical career. Dr. Gunderman is associate professor of radiology, pediatrics, medical education, philosophy, liberal arts, and philanthropy at Indiana University Medical School in Indianapolis.
He is passionate about the need for physicians to take care of themselves because “we spend so much time focused on the needs of our patients that we often don’t pay attention to our own health. We spend millions of dollars on the latest equipment but we spend almost no time thinking about our most important resource—our people.”
Another contributor to ill health among hospitalists is exposure to more infections and serious illnesses in the hospital setting. “At the same time they are asked to take care of the sickest people, which puts them under more stress,” Dr. Gunderman observes. “We have new information on the role high levels of stress hormones (catecholamines) play in metabolism and the breaking down and tearing of muscle tissue which can make hospitalists more prone to injuries.”
Dr. Gunderman believes getting to know patients is one of the most fulfilling aspects of being a physician and a stress reliever. Hospitalists may miss out on developing long-term relationships with their patients because of the nature of their jobs, he points out. They also are pressured by financial concerns to minimize the time patients spend in the hospital, which does not promote developing relationships with patients.
As for Dr. Ruhlen, he struggles to follow his own advice. He doesn’t stay up all night anymore. He’s trying to get back into a regular exercise routine and eat healthier. He has a strong relationship with his wife, which keeps him grounded. He also enjoys golfing, spends time with his granddaughter, has taken up photography, and is traveling a little.
Although he still works many hours at the hospital, he is convinced that making time to take care of himself is the answer to a long, healthy career. TH
Barbara Dillard is a medical journalist based in Chicago.