How Doctors Thrive and Achieve Fulfilling Medical Careers
In recognition of World Mental Health Day, Salt Medical Director Kelly Doran chats to Australia’s leading doctor coach – Sharee Johnson about her insights into how doctors can positively maintain their wellbeing, whilst achieving fulfilling medical careers.
With 30 years of experience, Sharee Johnson is well regarded psychologist, professional coach, and mindfulness teacher. Sharee began providing one-on-one and team coaching with doctors and healthcare professionals in 2014. Sharee is passionate about helping doctors take care of themselves and has recently written a book called the Thriving Doctor.
In celebration of Sharee Johnson’s new book, Salt Medical Recruitment are giving away 10 free copies* to doctors in our social network. If you enjoy reading this article and you would like to request a free copy of the Thriving Doctor, please contact us on: [email protected]
Interview with Sharee Johnson
1. What do you enjoy most about working with doctors, and what have you learned about the profession that has surprised you?
There are many things I love about working with doctors – they are an incredibly diverse, resilient group of people who are dedicated to serving the community around them. When a doctor is well, there is a wide ripple effect that spreads out into a workplace and their community. A well doctor perpetuates so much more health in the people around them, than a burned out or overwhelmed doctor. When I coach doctors, the impact on both the individual and the system they work in feels evident.
I have been surprised by three consistent themes. Firstly, how many doctors are deeply committed to working in public health, due to their genuine belief in the right of everyone to have access to healthcare. Secondly, how much doctors are willing to sacrifice for public health, including their own health and personal life. The third is how powerful the culture of perfectionism and competition is in maintaining poor work practice that can make healthcare unsafe for patients and for doctors.
Doctors work in an extremely stressful environment, with pressure to perform and keep their own experiences and emotions to themselves. They are a very compassionate, intelligent, committed group of people who strive for what might seem impossible to others. So, trying to manage their mental health without support, uses a lot of energy. I think it undermines a lot of the individual doctor’s capacity for really great work when it comes to caring and human connection.
I have learnt so many things from doctors since I started working with them and I am privileged and humbled by their trust in me as they have shared their personal stories.
“When a doctor is well, there is a wide ripple effect that spreads out into a workplace and their community”.
2. Is it true that doctors who struggle with their mental health will often avoid seeking help? Why is there still such an ongoing stigma about seeking care within the medical profession?
Doctors are still concerned about the mandatory reporting laws that exist across the country, except in WA. These cultural beliefs, perceptions, and structural impediments are limiting help-seeking by doctors. More generally, societal stigma continues toward mental health challenges.
These powerful cultural stories take time to change. The more stories we hear, the more normalised variation in our mental health becomes. There are some good examples now of healthcare communities that are working hard to change this culture in health. For example, Professor Catherine Crock and the Hush Foundation launched the Gathering of Kindness in 2016 with Mary Freer who now hosts the Compassion Revolution. Cardiologist Geoffrey Toogood started Crazy Socks 4 Docs in 2017. These movements have all been initiated in Australia and resonated around the world. I encourage everyone to get involved in them. Changing culture and systems requires many voices consistently and overtly naming them over a long time.
“Beyond Blue’s National Mental Health Survey of Doctors and Medical Students - found that 59% of doctors felt that being a patient causes embarrassment for a doctor. Whilst 40% of doctors perceived a doctor with a mental health disorder to be less competent than their peers”.
3. There has been a lot of talk about burnout being a major issue within the medical profession. Do you think this has always been an issue or is it now getting worse?
It’s hard to get good data about burnout, but I do think it’s getting worse. The on-call requirements, the length of time training takes, the competitive processes that have developed because of scarcity of training opportunities, and the challenges of rural and remote work are all different when compared to the past. Workforce challenges such as bullying and junior doctors working too many unpaid hours also continue to persist.
Healthcare is incredibly complex to manage. Patient expectations and knowledge has evolved, there is more testing, and the machinery of administration, electronic records and Medicare funding are all more demanding than they were. There is a high level of accountability required by all the stakeholders, and then there are Google reviews! So, while burnout has always been an issue in some form, modern requirements make it much harder for doctors to maintain good mental health.
“A doctor’s human need to be seen, heard, and to be valued is the same as every other human on the planet - and this has been largely ignored”.
4. What are your top tips for helping doctors build sustainable, engaging and enriching long term careers in medicine?
Good mental health starts with being proactive about acquiring the skills of emotional regulation and mind management. Doctors can do that through coaching, courses, and practicing mindfulness. Going to a course or a program won’t be enough though. Doctors need to find peers or a community that will provide support to continue this work – it will be ongoing throughout your career.
Asking for help is the most important skill a doctor can practice. Medicine is collaborative in nature, and doctors can utilise their peers and the community around them, starting with people they trust – sharing that emotional and mental load, and getting respite when necessary. The more overt you can be, the more likely you will practice and improve. My book The Thriving Doctor (out in November) explores this in detail.
Recognise that rest as an important pillar to health and wellbeing. Pause, take a long slow breath, consciously choose how you respond. Do you want a short, sharp, hectic career, or would you like to have a longer, sustainable career in medicine? There are always consequences for pushing beyond your limits. Why do we consistently choose the option that harms the provider? Consider safety first as your foundation principle rather than patient first.
“Creating a community that is supportive is heart-warming and sustaining for individual doctors and strengthens the community of doctors around them. Another human to talk to and to connect with is a survival imperative, not a luxury”.
5. Are there specific triggers or warnings signs doctors need to be on the lookout for when their mental health is experiencing a decline? What first steps can they take to get help if needed?
One of the first warning signs of a mental health decline is not wanting to go to work. Disturbed sleep, appetite changes, lower energy levels, altered mood, or any other changes in usual wellbeing are also signals that it’s time to seek help.
Accessing your trusted support community of family and colleagues is an important step towards getting help – tell them how you’re feeling. If shame, pride, embarrassment, or guilt is holding you back, find a person you can trust to share these emotions with so you can start processing them instead of burning up lots of energy holding onto them.
It’s also extremely important to get professional help. Visit your GP and share how you are feeling. Beyond Blue and Lifeline are also excellent sources for general support that are available around the clock, and you would be surprised how many health professionals use these resources. Those seeking doctor’s mental health support in Australia can also contact Docs4Docs for more specialised advice.
“Doctors report substantially higher rates of psychological distress and suicidal thoughts compared to both the Australian population and other Australian professionals”
6. With so many health workforce issues and departments stretched to capacity, what can healthcare employers do to create safe and healthy workplace cultures?
Walk the talk, listen deeply, be seen, and actively lean into these complex problems. They can offer solutions that can be meaningful. It’s important to look outside health and broaden your understanding of what is possible. Seek creative solutions by not knowing the answer. Solutions that offer only short-term funding, pilots, one-off training workshops, programs with limited investment and volunteer labour, and posters without any action from the leadership are greeted with cynicism and disregard for good reason.
These issues require long term commitment at every level from universities, employers, professional bodies, and every individual healthcare worker – we all play a role. Healthcare is transforming more rapidly because of COVID. I think those who are able to collaborate with non-traditional partners will do well, and those who are invested in safety first and the human connection will be the employers of choice.
“Long work hours, difficulty balancing work and personal responsibilities, and significant work-related stress can contribute to high rates of depression and suicidal ideation”.
7. You have recently written a new book called the “The Thriving Doctor” which is due to be released on the 22nd of November 2021. What is the book about?
The book is for doctors and aims to share some of the many practices from psychology, neuroscience, and meditation that I have shared with my clients for thirty years. I have been working with doctors as their psychologist coach since 2014, helping them respond to their medical life more effectively. These tools and strategies are protective of our mental health, and our wellbeing more generally.
This book is for early intervention or prevention – it is my hope that any doctor who does the work to learn and practice the skills in the book will reduce their risk of burnout significantly. The Thriving Doctor aims to help doctors apply these practices to their world of work for more balance, improved wellbeing, and ultimately to help them be better doctors.
“Well doctors achieve better results with their patients, and they have more fulfilling, sustainable careers. I believe with the right skills many more doctors can achieve that, and we will all benefit”.
If you are interested in learning more about how to become a Thriving Doctor, or you wish to contact Sharee Johnson, please get in touch via the following…
Alternatively, please feel free to contact Salt Medical Recruitment to request your free copy* of the Thriving Doctor book giveaway. Be one of the first 10 in to learn more!
*Book Giveaway T&CS:
The Thriving Doctor will be given away to the first 10 eligible doctors who apply directly to Salt Medical Recruitment. To be eligible all applicants must be Australian based and be a registered Medical Practitioner with AHPRA. Book deliveries will be after release date in December 2021
- https://www.gatheringofkindness.org (8-13 November)
- https://compassionrevolution.care (15-17 November)
Medical Training Survey 2020 conducted by the Medical Board of Australia