Your health matters.
As health care providers, we face high levels of occupational stress throughout training and practice.
We work long hours, have many demands on our time, and make high-stakes decisions on a daily basis, all in the context of working within an inefficient and at times unjust healthcare system.
As we take on excessive workloads, we are often taught to adopt a mindset of self-sacrifice and duty, prioritizing work demands over our mental and physical health. Some of us may even believe that taking time for personal health is selfish or a sign of weakness.
This expectation to put work above health has many consequences.
This creates a sense among clinicians that in a field so focused on the health of others, our health is not valued. Yet when we disregard the well-being of clinicians, the price we pay as society is high.
Focusing on clinician health not only helps us live longer and happier lives, it makes us better at what we do. The health of health care providers and patients is interconnected: when we are well, we are better equipped to connect with our patients. We are better able to care for them.
To improve the health of clinicians and students, we need multi-level solutions.
In recent years, advancements in treatment options and technology have led to more complex and time-consuming patient care. Changes in the healthcare landscape have increased documentation and productivity demands. Student debt is increasing. Clinicians are committing suicide at alarming rates.
We need regulatory bodies, hospital systems, and training programs to implement multi-level solutions, including changes in reimbursement and documentation, expansion of residency positions, affordable education and re-certification, and creation of a health system that promotes the health of patients and clinicians.
But we cannot wait until systems have changed to prioritize or advocate for our health.
As a physician, I have spent many years learning medicine and taking care of patients, sometimes to the detriment of my health. Last year, I found myself feeling increasingly anxious and exhausted. I knew which behaviors would increase my longevity and well-being, but I was tired and inconsistent. The demands on my time often precluded my ability to take care of my health.
I found myself asking: why do we have memory tools to help us recall important medical information, but no tool to help us prioritize and advocate for our health?
We need a simple tool to support our well-being—one that reinforces healthy habits and simultaneously helps us advocate for change in our environments.
In response, I created a simple tool to support my health, what I have named the SMILE Score.
This tool serves as a daily self-assessment. Each letter (S, M, I, L, E) represents one healthy habit and counts as one point. My daily score ranges from 0 to 5. When my scores are low, my energy level and mood are often lower as well. This tool provides a gentle reminder to get back on track when I'm off, and it provides direction to help me live healthier.
Other physicians, medical students, and I have begun to track our scores over time, across different rotations in diverse hospital and clinic settings. This tool has helped us identify strategies to live healthier, as well as opportunities to advocate for change in our work and home environments.
Other physicians, nurses, and educators have used this tool during wellness training seminars, in primary care clinics, and as part of health curricula in middle and high schools. In our residency program, we are using this tool in our wellness curriculum and are beginning a validation process.
This tool is not meant to be a solution for burnout.
It is not intended to make already resilient and resourceful clinicians feel inadequate. It is not meant to lengthen already-long to-do lists. It is meant to help clinicians and students prioritize and advocate for their health. To remind them that they matter. Their health matters.
If the environments in which we live and work do not support our health, we need to change these environments. This tool can help us identify patterns of health neglect and also advocate for necessary change.
Supporting clinician well-being is essential to sustain our health care workforce and provide excellent care to patients. While multi-level solutions are needed to improve our mental and physical health, the SMILE Score is one tool that can help us prioritize and advocate for our health.