Keys to provider stress reduction and thriving practice
Providers in functional and integrative medicine are in a unique position, said Georgia Tetlow, MD, ABOIM, ABPMR, CWSP, at the 2019 Institute for Functional Medicine Annual International Conference in San Antonio, Texas.
Burnout is increasingly common in healthcare, and though functional medicine addresses burnout, in many ways it creates its own, Tetlow said. Struggles with identity, financials, logistics, and starting something new can leave a functional or integrative provider feeling overwhelmed.
Conventional medicine interventions for burnout typically include self-care, meditation, work our limitations, and committing 20 percent of work to meaningful activities, Tetlow said. Mindfulness-based stress reduction (MBSR) is also increasingly common, though more research is needed for practicing clinicians.
A provider’s healthy greatly influences patient health, Tetlow said. Healthier physicians are better able to counsel patients. But as functional medicine continues to grow and evolve, functional and integrative providers are in a unique position for developing burnout stemming from their own challenges.
Under a functional medicine care model, the provider inspires and educations, focusing on healing not curing, as well as readiness and self-motivation for the patient. The process heals the patient, not the provider or a pharmaceutical.
This is challenging for practitioners because the field is changing so rapidly, there are high expectations and challenging patients, and patients often need more conscious and continuous management, Tetlow said. It is relationship-based, comprehensive care that is harder to stay on time, care is more intimate, and some patients do not understand their role in their own healing, and that takes time to develop.
There are steps practitioners can take in adopting or improving a functional or integrative medicine practice while avoiding burnout. Tetlow said to first make the commitment. Make the transition but be realistic. For example, don’t quit your job until your practice is established. This will require learning to manage your time but, more importantly, your expectations in this new model. Lastly, invest in training that will prepare you and help you thrive.
Tetlow also emphasizes the importance of gathering oneself and being a mindful provider. Log your time so you can make time for meaningful activities. Keep a gratitude journal and develop an end-of-day ritual or routine including self-care. Tetlow also suggests body-centered awareness, with compassion, turning towards oneself rather than turning away.
In practice, Tetlow said continue to see symptoms are clues, not problems. “I love these clues because I am confident in my approach to understand them,” said Tetlow. “I appreciate the mystery.”
Approach this patient care model focusing on embodiment, emotional health, boundaries, and saying yes to the now,” Tetlow said. Identify your own needs and give to yourself. Make space and time to recenter during the day and maintain kindness and tenderness. Move forward with excitement and belief in the model, as well as the belief that you are helping patients get well. DO not far judgement or criticism, she said.
Functional and integrative providers often approach their practices with fear of the dollar sign, while also setting unrealistic expectations financially. Providers must realize they may need to create a business entity, marketing, multiple revenue streams. It can be difficult for a provider to commit to themselves and their practices, and there may be doubts about whether the practitioner will be successful. In addition, you are often your own boss and have to play both business and provider roles.
Tetlow said to focus and be in practice, gain experience, and see results. Know your value, own your results and don’t be afraid to take credit. Practice healthy self-promotion. Further, create a support structure of staff, office space, regulatory and educational organizations, insurances, consultants, etc.
A provider must know their value, that they are worth it, and understand the right amount of work and develop a healthy relationship with time. Don’t undervalue your work or your skills. Know your value, own your expertise and who you are, Tetlow said. Know that you are worth your fees. This will create peace and mental stability.
Tetlow said practitioners need to transition to happiness. The field is rapidly advancing, there is lot to learn, and practitioners may have fears. Identify those fears, she said. What’s needed is confidence. Practitioners must have confidence in themselves and in the model and tools available. To become confidence, commit to yourself and your practice, go through discomfort, and learn by doing.
Complete a self-assessment. Tetlow asked attendees to complete an 11-question Honor Self Assessment and identify the most important thing to address. From there, identify your next step. She asked attendees to vitalize their next step. If you can’t visualize, that’s okay, she said. Meditate or call a friend or mentor and share your next step. Consistent self-assesment and visualizing the outcome is an important part of a thriving practice and self-care.
Editor’s note: This article is part of Integrative Practitioner’s live coverage of the 2019 Institute for Functional Medicine Annual International Conference. For a full list of coverage, click here.