How to... manage stress

Research shows that only one in three doctors would see their GP when unwell. There is an enormous pressure on medics not to give in to ill health. Dr Samar Mahmood explores how to avoid the negative effects of stress.

At medical school interviews I remember being asked “How do you manage stress?” I gave the formulaic answer about doing physical exercise, spending time with friends and pursuing my hobbies. I emphasise the word ‘formulaic’ because that’s what it was: an answer that followed a formula, a fixed conventional method for doing something.

The life of a doctor is anything but conventional or formulaic, and to think that a one-size-fits-all statement about stress-management can unlock the key to a healthy work-life balance is, sadly, a myth. I should have answered the question with a question: “Can you ask me again in five years?”

Those five years quickly turned into ten years, but I still didn’t have a winning answer. The truth is work-related stress is a major cross-specialty problem amongst medical professionals (cue the jokes about GPs having time to enjoy a relaxing cup of tea with 90-year-old Granny Smith, whilst on a home visit – this is far from the case). Stress is not something that we are generally warned about or taught how to manage.

On the whole, doctors are very good at managing stress. There is no other profession where a fresh graduate is forced to juggle between managing a dying patient on the ward, a breathless patient in resus and prepping to assist with an emergency laparotomy, in the middle of the night. The stress associated with this level of responsibility, if nothing else, gives doctors a thick skin and vital life experience from the get go. This is one way of looking at it.

However, this type of work isn’t all positive. Work-related stress can have a very damaging effect on one’s health and career longevity without you realising it is happening. In an NHS climate where demand for doctors far outweighs the supply, stress is definitely increasing. Research by Doctors 4 Doctors concluded that one in eight doctors reporting that they used alcohol or drugs to help them cope with work and ill health.

Well in to my career I realised that unfortunately there is no easy way of avoiding or managing stress well. However, some words of wisdom from my parents as I started GP training helped me to change my entire approach to work. I remember venting to them about how my job was keeping me busy, stressed and irritated. I paraphrase slightly, but what they explained can be summarised as follows:

Work will always be stressful and there might not be a lot you can do about it. So you have three options:

1. You can quit in the face of adversity.
2. Wake up each morning worrying about having to endure another day at the office. Allowing miserable feelings and negativity to take over your home and work life.
3. Accept it and make the best of it. Get on with your job calmly, happily and give it your best shot. Remind yourself why you became a doctor and believe that you really are making a difference to people’s lives. And if things get really tough, just remind yourself that you’ll be going home in a few hours anyway!

Fortunately, I chose option three – I accepted the ‘Don’t Whinge Challenge’ while people around me admirably poured buckets of icy water over themselves. Before I knew it, my working day was so much more relaxed. The workload didn’t let up, but I started taking it in my stride. I stopped resenting having to see extra patients at the end of clinic; I stopped minding the busy days where I didn’t have time to eat lunch; I even stopped complaining about having to stay back late.

The result? My performance at work improved significantly and [drumroll please]… I was less stressed. All it took was a shift in perspective and a reminder of why I was actually doing the job, which is something we can all lose sight of at times.

None of this means that we should ignore problems in the workplace. If there are issues, they need to be addressed, so that changes can be implemented to create a healthier working environment.

But until then, breathe, relax and choose to enjoy work.

Dr Samar Mahmood is a GP registrar in South Yorkshire.

Useful links

• BMA, Doctors for Doctors
• BMA Counselling Service and Doctors Advisory Service – 08459 200169
• NHS Practitioner Health Programme
• Healthy Working UK
• British Doctors and Dentists Group
• Sick Doctors Trust
• Doctors Support Network