Key to stress free living - PowerPoint Presentation

1. Key to stress free living Specially designed workshop for doctors

2. Doctors under stressDoctors all belong to a profession that is respected all over the world Hard work , patience , intelligence , sacrifice & compassion are few qualities normally associated with doctors Through out their life doctors try to spread feelings of ‘well being’ in society Doctors are often addressed as God or mediums of God as they are instrumental in saving life of humans.

3. Doctors under stressFactors affecting doctors performance Variations in diagnosisVarieties of treatment Clinical outcomes of care Appropriateness, efficiency, and effectiveness of different practicesIncreased overall accountability Complexity and pressures of the healthcare environment

4. Doctors under stressMarked increase in the level of negative emotions among doctor like Anger FrustrationDepressionAnxietyBurnout Suicidal tendency

5. Doctors under stressProblem of stress worsens as most doctors do not recognize that they are under stressPhysicians are so heavily involved in their work and preoccupied with patient care that the thought of being under stress rarely registersPhysicians focus on work and patient care reduces their sensitivity to and awareness of the impact on others that their actions and behaviours have. They do not recognize the subtle symptoms such as irritability, mood swings, apathy, loss of focus, sleep disturbance, isolation, and an overall sense of not being happy as stress signals.

6. Doctors under stressEven after recognizing stress , they do not act fast Their customary default position is that they can handle it themselves. They have lived with stress all their lives and feel like they’re managing it just fine. Physicians are reluctant to share their inner emotional concernsThey take pride in what they do; admitting that they are under stress is often self-perceived as a blow to their egosDiscussing the situation with others also opens up concerns about how their competency and ability to perform may be perceived.

7. Emotional toll make patients out of doctorsIANS Jul 20, 2012, 01.04PM ISTThe white coat, those knowing eyes, that reassuring voice when in pain, a mere glimpse of a doctor puts us at ease. Little does one realise that their back-breaking schedule, odd working hours and "emotional labour" during patient care sometimes takes a toll on doctors' health, pushing them to seek help themselves.This is probably why sometimes doctors, despite knowing it all, take to smoking and even get addicted to it and alcohol, which in turn leads to other health complications, experts say.Sameer Malhotra, head of the psychiatry department at Max hospital, said that many a time he has had people from the medical fraternity sitting on his patient's chair, seeking help to deal with their problems, which are often stress-related."I do have doctors coming to see me, seeking help to deal with problems like anxiety, psychosomatic problems and de-addiction (from nicotine or alcohol)," Malhotra told us.Samir Parikh, director, Mental Health and Behavioural Sciences, Fortis Healthcare, similarly said that doctors often come to him looking for advice on how to manage their stress."The medical profession has a high-stress quotient. Doctors have long, gruelling working hours, which is very taxing. Stress is more like an occupational part of a doctor's job," Parikh told us.

8. Emotional toll make patients out of doctors"Hence there are times when doctors, who are fellow colleagues, come to me looking for advice and suggestions on how to manage their stress," he added.According to Malhotra, emotional stress, more than physical burden, is what affects doctors."Doctors have to constantly give emotional support to their patients, especially in cases of terminal illnesses. You have to understand that doctors are, after all, human beings. And try as they may, they do get affected by their patients' and the relatives' emotional turmoil," Malhotra said."It's especially tough for young resident doctors and students because in addition to their course curriculum, they have to hone their patient handling skills," he added.Author and behavioural trainer at Human Impact Training and Consulting Private Limited, Lata Gwalani, agrees."Doctors have been encouraged to put up a facade of emotional calmness and stability in front of their patients. They are taught to continuously underplay emotions - both in acknowledging others' emotions and in accepting their own. This invalidation of emotion creates a huge build-up of emotional baggage," Gwalani said."Over time, this baggage becomes too unwieldy to carry around. Emotional labour takes its toll on us. While most working people are doing some amount of emotional labour, doctors are perhaps the best examples of extreme emotional labour. Breaking bad news is difficult," she added.

9. Lifestyle diseases catch up with Mumbai doctors. Sumitra Deb Roy, TNN Jun 30, 2012, 04.42AM ISTMUMBAI: Stress, hypertension, obesity and other lifestyle diseases, which have been dogging ordinary citizens, seem to be catching up with the medical community as well.The seriousness of the problem can be gauged from the fact that at least seven city doctors have succumbed to cardiac arrest in less than a year. Now, the community is unanimous that doctors need to practise what they preach.Ahead of Doctors' Day on July 1, TOI has found out that several hospitals have started focusing on the well-being of medical practitioners. While some are carrying out regular and mandatory health check-ups for doctors, others are making de-stressing programmes a regular feature. Experts say doctors comprise least 2-3% of the patient base.Kurla's Kohinoor Hospital, during a recent check-up, found that three of 32 doctors required coronary angiography after their heart condition did not look normal. "About 12% of them were detected with hypertension and some with moderately high cholesterol levels," said the hospital spokesperson.Fortis Hospital in Mulund was in for a shock when over 50% of its staffers, including consultants, were found to be vitamin D-deficient. "It is a serious issue as vitamin D deficiency can lead to a stream of health problems," said facility manager Dr S Narayani, adding that all those who were deficient were put on supplements for eight weeks. Follow-up action would also be taken.

10. Lifestyle diseases catch up with Mumbai doctorsExperts say stress levels in the medical community are directly proportional to the increasing demands of patients. Interventional cardiologist Dr Dev Pahlajani, who consults with Breach Candy Hospital, says he treats at least 7-10 doctors for serious heart problems on a monthly basis. He quotes a decade-old study conducted in the US on the incidence of coronary artery disease in Asian Indians (CADI), which demonstrates a three-four-fold higher rate of heart disease and diabetes among such physicians and their family members in the US. "Even after so many years, the study is still very relevant for us," he adds.Obesity due to unhealthy eating habits driven by erratic working hours is another growing concern in the community. Dr Siddharth Shah, honorary editor of Journal of Association of Physicians of India (JAPI), said: "Doctors remain extremely busy catering to patients in different centres and working for long hours. For doctors, patients always remain the priority," he said.A KEM neurologist, who recently suffered a heart attack, said mental stress was becoming a bigger problem than physical exertion.Neurosurgeon Dr Manoj Virani admits to severe lower back pain during prolonged spine surgeries, which can last 10-15 hours. He also admits to wearing back and ankle support so that he can keep performing surgeries.The National Accreditation Board for Hospital and Healthcare Providers (NABH) does speak of annual checks for all healthcare workers but doctors say the norm needs to be followed more closely. Medical director of PD Hinduja Hospital Dr Gustad Davar, however begs to differ. "Doctors are by and large fit and lead a healthy lifestyle despite their job being stressful," he said.

11. 15% of doctors in Gujarat die young 28/5/13Medicos Set To Practice What They Preach Radha Sharma | TNN Ahmedabad: The medical fraternity in Gujarat was shocked when leading cardiologist Dr Shrenik Shah (54) died of a massive cardiac arrest in April this year.The death has served as a wake up call for doctors,who now plan to practice what they preach.National secretary of Social Security Services for doctors Dr Yogendra Modi says that 15% of doctors who died in Gujarat were young 55 years of age.Maximum deaths were in the age group of 40-50 years due to either accidents or lifestyle disorders,mainly heart attack and diabetes complications.Of the total deaths,about 15% are between 35-60 years, said Dr Modi.The Ahmedabad Medical Association too has swung into action.We plan to soon launch an annual medical health check up for the doctors, says Ahmedabad Medical Association president Dr Pragnesh Vachrajani.One survey after another has revealed that the life span of Indian doctors has gone down by 10 years.Like in any other profession,there is cut throat competition,stress that is taking toll on doctors.We have lost many colleagues in their 50s to cardiac arrests.It is time to practice what we preach, says leading neuro physician Dr Sudhir Shah,who is the brain behind the CME.

12. Physician Suicide Author: Louise B Andrew, MD, JD; Chief Editor: Barry E Brenner, MD, PhD, FACEPIt has been reliably estimated that on average the United States loses as many as 400 physicians to suicide each year (the equivalent of at least 1 entire medical school class).Sadly, although physicians globally have a lower mortality risk from cancer and heart disease relative to the general population (presumably related to self care and early diagnosis), they have a significantly higher risk of dying from suicide, the end stage of an eminently treatable disease process. Perhaps even more alarming is that, after accidents, suicide is the most common cause of death among medical students. In all populations, suicide is usually the result of untreated or inadequately treated depression, coupled with knowledge of and access to lethal means.[1] Depression is at least as common in the medical profession as in the general population, affecting an estimated 12% of males and 18% of females. Depression is even more common in medical students and residents, with 15-30% of them screening positive for depressive symptoms.

13. Depression in PhysiciansAuthor: Louise B Andrew, MD, JD; Chief Editor: Barry E Brenner, MD, PhD, FACEPPhysicians are demonstrably poor at recognizing depression in patients, let alone themselves. Furthermore, they are notoriously reluctant to seek treatment for any personal illness. Research suggests that 1 in 3 physicians has no regular source of medical care.[12] Reluctance to recognize depression in a colleague is a tendency shared and imposed by other physicians, who may be well intentioned, chronically emotionally distanced, and/or feeling temporarily vulnerable themselves. Even when healthy, physicians find it difficult to ask for help of any kind. When they are depressed and feeling less than adequate, they find it even more difficult—and when they do bring themselves to ask, they sometimes find that the help they need is remarkably difficult to obtain. To some extent, however, physicians’ reluctance to reach out is self-imposed. They may feel an obligation to appear healthy, perhaps as evidence of their ability to heal others. Inquiring about another physician’s health can shatter this mutual myth of invulnerability, and volunteering assistance may seem like an affront to a colleague’s self-sufficiency. Thus, the concerned partner may say nothing, while wondering privately if the colleague has become impaired.

14. Depression in PhysiciansUnconsciously defending against this painful vulnerability, colleagues or significant others may fail to notice significant depression or withdrawal, attributing behavioral changes instead to stress or overwork. Nearly every article about a physician’s suicide contains a quotation from some close contact, occasionally a spouse, saying something like, “I never had any idea that he/she was suffering.”[13] Of course, many physician obituaries omit the fact that the “sudden death” was a completed suicide. Depressed physicians who do reach out may find that they receive only limited understanding or sympathy from colleagues. There is no specialized training for a physicians’ physician. Most physicians either shrink from this role or perform it poorly. For many experiencing depression, the early symptoms are physical. A physician unable to diagnose his or her own symptoms commonly feels incompetent. To admit one’s inability to diagnose oneself to another colleague is to admit failure. When this admission is met with avoidance, disbelief, or derision by a reluctant treating physician, it can only reinforce a depressed physician’s feelings of worthlessness and hopelessness. Physicians find it painful to share their experience of mental illness with others and know that doing so is somewhat risky; therefore, published accounts of physician depression are nearly impossible to find. However, in the author’s experience, private consultations with a trusted counselor reveal that symptoms of depression are surprisingly common among physicians.

15. Key to stress free livingmore on dharmeshshah.in A unique workshop developed by an engineer turned spiritualist associated with Shree Shivkrupanand Swami Ashram Trust & Yog Prabha Bharti (Seva Sanstha ) Trust Already 300 + such workshops have been conducted This workshop has been fine tuned specifically for doctors 25 techniques discussed in addition to universally accepted practice of meditation

16. Key to stress free living more on dharmeshshah.in Contents:Stress –definition –reasons Brain waves and stressBasic techniques Fundamental law of science Spiritual techniques Risks involved in medical professionExtra precautions for doctors & medical staff Meditation

17. Key to stress free living more on dharmeshshah.in Duration – Just 3 hrs Cost - free Participation - minimum 50 Language – English / Hindi /GujaratiLocation - can be arranged anywhere Nature of workshop – interactive Objective – joy of giving