Job Stress

 

I am one of those people that definitely gets affected easily by stress. I was stressed out a lot in residency, where the learning curve was steep, and it never seemed that you had enough time or sleep; but then again, who isn't?  Currently, I feel that working full days in the clinic (with 1 day without pts scheduled per week) with almost 1000 patients of "my own," as well as taking about 3 days (24 hrs x3) of OB call per week is pretty stressful. Mostly, the stress comes from trying to: juggle patients (clinic and hospital), see a full load including "squeezing" same day patients, make appropriate and safe management plans, write all of my notes, be efficient and run on time (despite interruptions, talkative people, and late arrivals), return patient calls and do refills in a timely manner, not keep patients hanging/waiting... and manage some semblance of a "life outside of work" (even with zero kids and few extracurriculars currently in the picture). I often feel that I'm treading water (or drowning). The inbox is never-ending. If I don't tackle some of it on my "day off," it is overwhelming the next day... so there is never really a true "day off." And, on the weekend, there are either more babies to deliver or moms/babies to round on.... until it all starts over on Monday again. Some studies estimate that for a primary doctor to do everything it takes to appropriately manage a panel of patients, you need to work something like 15-18 hours per day.  It sure feels like it.

I feel like not all doctors have stressful lives. Without complaining about my salary, I'd probably work a lot less and make a lot more money if I were a radiologist, dermatologist, ophthalmologist, or anesthesiologist, or working for Kaiser. I'm sure I'd have less stress if I wasn't doing obstetrics and working in the hospital (as rewarding as that can be). But do you think job stress and income are proportional, or should they be?  Not necessarily, it seems. 

Here is some data from some online polls about "most stressful jobs":

 CNBC's list of MOST stressful jobs of 2012 includes the following titles, with their average annual income:

10. Taxi Driver - $22,440
9. Photojournalist - $40,000
8. Senior Corporate Executive - $165,830
7  Public Relations Executive - $91,810
6. Event coordinator - $45,260
5. Police officer - $53,540
4. Military General - $196,300
3. Airline Pilot - $103,210
2. Firefighter - $45,250
1. Enlisted military soldier -  $35,580

Here is a CareerCast list of the ten LEAST stressful jobs of 2013, with median salaries:

1. University professor - $62,050
2. Seamstress - $25,850
3. Medical records technician - $32,350
4. Jeweler - $35,170
5. Laboratory technician - $46,680
6. Audiologist - $66,660
7. Dietician - $53,250
8. Hairstylist - 22,500
9. Librarian - $54,500
10. Drill Press Operator - $31,910

I know that the second list above generated a lot of pushback (largely from university professors who claimed that they definitely had plenty of job stress!). It is interesting to me that doctors didn't make list #1, despite having the highest suicide rate of any profession. Maybe I'm exaggerating my stress. I guess it's more legitimate to be stressed by a job in which you could personally very likely get shot at or die, although physician stress, particularly psychological stress and burnout, is very real and requires real attention as written about very well by KevinMD here. You can also read about, in a yahoo article that recently came to our attention, the stressful jobs that pay badly, which allows me to feel a bit better in that, although I feel stressed a lot of the time, at least we are living on comfortable income.

However, some days I just don't want to be stressed. I want to go to work somewhere where I can work uninterrupted for 8-9 hours and not have to juggle. I want to come in at 8, leave at 5, and have no paperwork or worry hanging over my head. I don't want to be fought with, made to feel incompetent or unsympathetic, deal with others' meltdowns, poor decisions or noncompliance, or have meltdowns myself. I don't want to tell anyone they have cancer. I don't want to feel guilty for taking a "sick" day-- which I haven't taken in about 10 years, although I've definitely been sick (Kelvin recently worked through the flu because we all feel bad cancelling patients).  I sometimes do wonder, though, how much of stress is "internal"-- i.e. self-imposed. I think some people who struggle with perfectionism (definitely guilty here) seem to internalize stress more... and that some parts of me think I'd probably be a stressed out jeweler or seamstress, too.  Is it a good tradeoff to make 25-50% of your current salary but have a 50-75% reduction in stress?  Some days I think, "ABSOLUTELY," and really want to be a librarian, which is my dream job.

But until I go back to school for my library science degree, I will continue to counsel patients and parents, try to get patients to live healthier lives and to get their age-appropriate cancer screening and VACCINES, and head to the hospital at 2 a.m. to bring in new life to the world. THAT keeps me going. I have to remember that, despite the stress, this profession comes with many rewards and that when you have a grateful patient, it is all worth it...

The next chapter

"The future is called 'perhaps,' which is the only possible thing to call the future. And the only important thing is not to allow that to scare you." - Tennessee Williams

It is so hard to believe that it is already December, and we are nearly (1/1/11 [cool date, eh?!] will technically be the mid-way point) half-way through this academic year. Just under seven months remain for me in residency (! Can you tell that I am excited?!). It really does feel like just yesterday that I started as an intern and tomorrow I am supposedly in charge as OB chief.

It is very strange to me, and a bit scary, to contemplate all of the changes that 2011 will bring. Although I have moved every three or four years my whole life, this will be a different kind of move and transition. This is the FIRST time since high school that I have not really had to do formal school/educational applications. Having interviewed at some potential employment sites in California, it amazes me how laid back the "job" interviews have been and how different this "selection" process is from "getting in" to med school or the nail-biting residency match. It is interesting to consider that, while some of my high school friends and second-career friends have been through a number of different jobs (or careers!) by now, I feel as though my *real* life (i.e. you are not a *real* adult until you have a husband and a *real* job ;)) is just getting started!

The job search itself is rather stressful and different now in that there are two people to consider-- K and I have to think in terms of what works best for both of us, with me wanting to do full-spectrum family medicine with OB and c-sections, and him having a National Health Service Corps Scholar requirement to work in a health-professional shortage area. This narrows our choices as far as practice locations but also has made us realize that we will have to accept some tradeoffs, whether that means one or both of us has to commute a long distance daily, do more inpatient time/call than we'd ideally desire, accept a more restricted scope of practice, or live far away from friends/family/airports. Despite the above, in some ways and having now gone on several interviews, I wish we had more restrictions as I am less comfortable having too many choices or "the ball in my court," so to speak. We have some difficult decisions to make should the offers come, and hope to have a job sorted out by next month.

Another reason I hope to have the job situation figured out soon is that we have a lot to do with the upcoming wedding in July. While I feel that we are making good "task" progress (K is an unbelievable help!), including the engagement shoot and prints, purchasing wedding bands, getting my ao dai tailoring in progress, scheduling our pre-cana (Catholic pre-marital class), and initial florist/photographer meetings this past weekend, the checklist seems never-ending.

The dress-shopping itself is exhausting and not really up my alley-- I don't know how many times I have heard recently, "Do you have your dress? You really need to get it now, as it takes many months to get it and then have it altered." This obviously does not seem to help my already-high anxiety level about this whole affair. I have actually had nightmares about not getting everything done in time. I look forward to the day/evening/weekend (is the honeymoon here, yet?! :)) when we don't have to worry about wedding planning which, as I mentioned before, feels like it is a full-time job.

I do realize that everything will come together, eventually, regardless about how much stress I feel worrying about how exactly it is going to come together or the possibility that it won't. Corrie Ten Boom, a 20th century Dutch Evangelist wrote, "Never be afraid to trust an unknown future to a known God." I am working on remembering this faith.