How sleep, vitamin, and train restore doctor well-being [PODCAST]

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Bodily therapists Kim Downey, Ziya Altug, and Shirish Sachdeva focus on their article “How physicians can reclaim resilience by way of higher sleep, vitamin, and train.” On this episode, Kim, Ziya, and Shirish clarify how the triad of sleep, balanced vitamin, and bodily exercise kinds the inspiration of doctor resilience. They define sensible methods similar to circadian-friendly sleep routines, meal planning to stabilize vitality and temper, and integrating cardio exercise with aware practices like yoga. The dialog emphasizes small, sustainable modifications, institutional helps, and peer accountability programs that make self-care sensible for busy clinicians. Listeners will come away with actionable way of life drugs methods to cut back burnout, strengthen work-life steadiness, and enhance each private well being and affected person outcomes.

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Transcript

Kevin Pho: Hello, and welcome to the present. Subscribe at KevinMD.com/podcast. At present we welcome Kim Downey, Ziya Altug, and Shirish Sachdeva. They’re all bodily therapists and doctor advocates. At present’s KevinMD article is “How physicians can reclaim resilience by way of higher sleep, vitamin, and train.” All people, welcome to the present.

Kim Downey: Thanks, Kevin.

Ziya Altug: Thanks, Kevin.

Shirish Sachdeva: Thanks for having us.

Kevin Pho: All proper. Kim has been on many, many occasions and all the time brings collectively an eclectic group of doctor advocates. So Kim, how did you convey everybody collectively immediately?

Kim Downey: Sure, Ziya linked with me on LinkedIn some time again, after which Shirish reached out to me after I commented on one among Dr. Jonathan Fisher’s posts. We began speaking after which we obtained to satisfy in individual at Jonathan’s e book launch celebration a bit of over a yr in the past, and that was incredible. So then they had been linked, and we simply began speaking and supporting one another’s posts. My thought for this text was that I wished to highlight extra well being care professionals that docs can have of their again pocket professionally and personally.

I’ve had a registered dietitian on my YouTube channel, and she or he’s been on with you to spotlight how they might help docs by serving to their sufferers and in addition how they might help the docs themselves. I additionally had on an area pulmonologist for a similar causes, and docs know that good sleep, vitamin, and train are essential for the well being of their sufferers, although they regularly don’t prioritize these items for themselves.

I used to be attempting to lookup statistics and I discovered that simply 25 to 30 % of docs train, however they might inform all of their sufferers that train is essential. So I wished to collaborate with a few bodily therapists right here to emphasise the significance of those self-care approaches for the docs themselves.

Kevin Pho: Fantastic. All proper. Let’s speak concerning the article itself. Shirish, simply inform us concerning the article and what impressed you to collaborate with Ziya?

Shirish Sachdeva: Sure. Ziya did attain out to me, I feel in June of this yr. Kim and Ziya had already collaborated on this concept and the thought, and so they provided this idea to me. I used to be glad and gracious. I assumed, “That is an superior matter,” as a result of on a day-to-day foundation, we take care of this problem of not getting our life so as. We’re bombarded with so many issues on a day-to-day foundation with our work and with the a number of totally different tasks that now we have.

So I assumed, “It is a no-brainer. We’ve to assist our helpers on a day-to-day foundation.” So I stated sure and I used to be searching for some stats, as Kim was mentioning. We’d seen that there was a examine in Taiwan that was completed on a hospital group, and each totally different career was examined. This was completed in 2018 by Dr. Yi and his colleagues. What they got here out with was that essentially the most strained group in the entire hospital group, after they had been analyzing for metabolic syndrome, had been the physicians.

The overall inhabitants that was examined was round 6,700 folks, and about 18.3 % of them had metabolic syndrome. Amongst physicians, the general share was 12 %. So physicians took the lead on having these points. I feel we will’t have a wholesome group if we don’t have individuals who present well being to others type the identical type of consensus amongst their very own selves. In order that was the explanation primarily why I joined on this enterprise.

Kevin Pho: Thanks, Shirish. Simply for individuals who don’t know what metabolic syndrome is, give us a fast 30-second primer on what that’s.

Shirish Sachdeva: So we’re a cluster of various syndromes in it. You possibly can discuss central weight problems. You possibly can take a look at hypertension. You’re having excessive ldl cholesterol, primarily triglycerides, and a low HDL, which is high-density lipoprotein. So you’ve got these in-built collectively.

It generally tends to result in different points like diabetes. We name it syndrome X, which can also be in-built with metabolic syndrome. These a number of syndromes can develop in a single single individual, with gradual year-to-year, decade-to-decade insult to the physique over time, including up a number of points. That’s primarily the place this stems from.

Kevin Pho: So Ziya, that examine that was simply cited the place physicians are taking the lead in metabolic syndrome, that’s not one thing that anybody actually desires to guide on. What are a few of the causes that you just assume are behind that?

Ziya Altug: Properly, the examine that I’m acquainted with that I’ve ready for is the 2025 examine that was within the American Surgeon. They usually had been speaking about self-care, about how weight-reduction plan and vitamin and train and different self-care facets had been helpful for physicians. However I feel if it’s helpful for physicians, it may also be helpful for nurses, different therapists, and the entire well being care group.

Kevin Pho: And Ziya, particular to the well being care professionals that we’re speaking about, what are some easy ways in which we will enhance these numbers? As you realize, these of us in well being care work very lengthy shifts, are very busy, and have little or no time to deal with ourselves. What are some easy methods that you just implement everytime you speak to well being care professionals?

Ziya Altug: I feel the straightforward methods embody making a toolbox for every individual. So my toolbox could also be totally different than Kim’s toolbox, and Kim’s toolbox could also be totally different than yours. This implies placing in that toolbox issues that resonate with that individual. One individual might really feel snug doing a five- to ten-minute Tai Chi program. One other individual might really feel snug doing a mini yoga program. One other individual may exit and stroll. Different folks might need hobbies to de-stress after their shift, which could embody pottery, music, enjoying the piano, and interesting in different hobbies.

Kevin Pho: And Ziya, once you speak to those well being care professionals, how do you discern what comes naturally to them? What resonates with them? Is it simply by way of easy dialog? Do you’ve got a selected set of questions that you just ask these well being care professionals? How will you individualize your solutions to them?

Ziya Altug: If I’m working with anyone in a bodily remedy setting, I’ve extra time as a result of I’ve completed a superb analysis and have completed final result measures and so forth. Nevertheless, if I’m simply talking with a gaggle, I’ve all people assume for themselves when it comes to what the most effective issues are and what feels good for them: simply going out for a stroll, possibly exercising, enjoying the piano, working of their storage on their automobile. Folks intuitively know the issues that make them really feel higher, and it’s leaning on these issues that give the person who consolation.

And for people that don’t know, who’ve by no means tried issues like physique scan meditation or five-finger meditation or different kinds of meditation, possibly they should exit and do some exploration. Perhaps take a yoga class, see if it resonates with them, take a Tai Chi class, see if it resonates, or go into the woods and do a hike. I feel exploration is the important thing.

Kevin Pho: Kim, you’ve completed such an exquisite job advocating for physicians, not solely highlighting a few of the obstacles that we face on daily basis, but additionally offering options. These aren’t simply options from different physicians; you’ve introduced collectively well being care professionals from the allied well being professions. You introduced dietitians, bodily therapists, like we’re doing now. Why is it essential to incorporate a complete spectrum, a holistic method, so to talk, to handle the problem of doctor burnout?

Kim Downey: Properly, I feel when docs share issues on LinkedIn, generally it may well really feel like a vacuum and so they’re preaching to the choir or simply speaking to one another. So once I convey different folks on, it helps docs know that there are different folks in your aspect and in your nook, and so they might help you. Typically it’s physicians, just like the pulmonologist, who will inform docs when they need to search sleep assist themselves.

However then to know that there are dietitians on the market and so they might help your sufferers since you don’t have time to speak about vitamin. So ship them to a dietitian and all people wins. After which it’s the identical factor with bodily therapists. As a result of I’ve seen tales the place surgeons ended up not with the ability to observe anymore. They had been in a lot ache that there was a lifeless cease that affected them completely as a result of they stored pushing by way of. I wish to highlight which you can attain out to a bodily therapist too. We are typically sensible and sort and good staff gamers, and we’re used to collaborating (PT, OT, speech) and to only highlight for docs that there are different folks on the market that can assist you, assist your sufferers, and that can assist you.

Kevin Pho: So Shirish and Ziya, I’m going to ask you related questions. Have you ever, in a bodily remedy session, labored with a doctor? What sort of points did they arrive to you with in a bodily remedy session, and the way did you deal with it?

Shirish Sachdeva: I used to be simply desirous about that as Kim was speaking concerning the story with the surgeon. I had a gastroenterology surgeon early on in my profession who had ankylosing spondylitis, and he used to have excessive ache. He was properly conscious of it and he would stand all through the day in surgical procedures with the heavy lead coat on him, and that may actually break his again, to the purpose the place he couldn’t observe. So early morning earlier than his shift, he would come within the hospital setting to our PT division. He was the primary affected person, opening the door with us, and he would keep for an hour.

We’d do a full complete rehab for him, after which he would go straight into the OR after that, spend his couple of hours, come again throughout his lunchtime, spend one other 15 to twenty minutes with us, after which return once more after his lunch into the OR. This confirmed one factor. I used to be early in my profession at the moment and was unaware of way of life drugs. I used to be just about not conscious of these issues. So I noticed a holistic thought course of. I assumed, “OK, a doctor, a surgeon at that time, caring for himself earlier than he takes care of others was a superb instance that was being set once I was coaching.” This was me coaching in a tertiary care hospital. That was one thing that I noticed.

And once more, since then, it’s been again and again, now we have seen physicians come to us. There’s no day that goes by that I don’t have both nurses or physicians in my clinic who are available with a number of totally different points. Once more, now we have prime charts of again ache, spinal ache, muscle ache, joint pains; all these are there, little question. However frankly, 80 % of the those that are available our clinic, physicians included and different clinicians included, 80 % of them have a diabetes analysis. That’s arrange on their chart. And that is what we see from APTA’s current stats.

That is an excessive amount of. And I’ll say that in my clinic, I personally see about 100 to 115 sufferers every week. That multiplied by 52 weeks, and you may decide 80 % of these having such metabolic issues. That’s approach an excessive amount of. We’ve to do one thing about it. So we positively must collaborate on this, and there’s no higher strategy to have all staff members on it.

Kevin Pho: And Shirish, what are some easy ways in which clinicians can transfer higher? What are some easy bodily issues that they might do? I do know Ziya talked about some individualized issues like Tai Chi and whatnot, however out of your perspective, what are some simple issues that physicians can implement?

Shirish Sachdeva: We’ve additionally highlighted this in our article. And we’ve introduced in a few of these tidbits, small little churnable factors that we usher in with an instance. I’ll go on these and the place we’re attempting to save lots of time throughout the day, our 24 hours are restricted. So in these 24 restricted hours, eight hours are gone to sleep. That is in case you are sleeping eight hours. That’s one other level we make. However so as to add to that, in 16 hours awake, there are a number of small little issues anybody and everybody can do each hour.

And this can be a day by day activity that I speak to folks about. I say, “Transfer your neck each hour. Flip it left, proper, up, down. Use it to stretch.” It takes three minutes on the prime to get these actions in. It’s nearly memorization and repetition of these issues. Get up out of your desk. In case you are in a sitting job, in case you are doing charting, attempt to have standing desks. Get up, sit down, modify your self. Be inventive. Walks in between sufferers may be useful. Transferring from one spot to a different may be helpful. Having a stroll with the affected person at occasions helps out.

Typically in our clinic, we’d have individuals who have gait remedy and we can have them stroll outdoors the clinic, round the entire constructing. And that provides up properly to my steps. That is the self-care I’m including in there. So, they don’t know that we’re getting them right into a practical atmosphere. I feel physicians can do the identical. We are able to use our socially accessible timeframe in addition to the atmosphere to herald these small micro-breaks. I do know Dr. Jonathan Fisher, as Kim spoke about, I observe him and his ideology. Small little issues he does in his day by day routine, like taking that five-minute break in one other room and simply doing a bit of small meditation for himself. Calming down his breath. This sort of work actually helps.

Controlling our autonomic system within the super-stressful atmosphere that we reside in. And once more, I feel, I can hardly stress anymore that physicians on prime of this chain have essentially the most stress in hospitals, in emergency departments the place you possibly can neglect taking a breath at occasions since you’re leaping from one affected person to a different.

Kevin Pho: Ziya, inform us about an encounter that you just had with a clinician and the issue that they got here to you with, the answer that you just proposed, and you actually moved that needle in that particular person clinician. Inform us a narrative.

Ziya Altug: Sure, thanks. I do have a affected person that I recall years in the past that got here to the clinic once I was working at a big hospital, and he was a neurosurgeon. He got here in with again ache, and once more, as Shirish had talked about, the extended standing utilizing instruments in entrance of their physique for extended intervals of time with no relaxation intervals as a result of the affected person is beneath anesthesia. However he had informed me simply by way of conversations within the bodily remedy that we had been doing, he had informed me two issues that labored for him and maybe this may resonate with different people. For his fingers and for his nervousness and stress, he used pottery as a result of the pottery, the place he put his fingers on it, was like a therapeutic massage to the fingers, and he was creating one thing. He was in a social group, and for him, he discovered the pottery was excellent. Actually, he even purchased a package for his own residence, however he nonetheless loved going to the power to try this with different folks.

And when it comes to motion, he had tried many several types of issues: energy coaching, flexibility workouts, and he was a runner. However none of these actually appeared to affect his again ache. The one factor that he did discover was dancing together with his spouse as a result of dance, as he was saying, is totally different actions. You don’t transfer the identical approach. And he stated the repetitive actions simply weren’t working sufficient for him to loosen up his again. However the numerous dances that he and his spouse had been doing had been wonderful. He was going to a studio to do that, and that made him really feel the most effective.

Kevin Pho: We’re speaking to Shirish Sachdeva, Ziya Altug, and Kim Downey. They’re all bodily therapists and doctor advocates. At present’s KevinMD article is “How physicians can reclaim resilience by way of higher sleep, vitamin, and train.” Now, I’m going to ask every of you simply to share some take-home messages with the KevinMD viewers. Ziya, why don’t you go first?

Ziya Altug: My take-home message is that I feel self-care strategies ought to be taught at the same time as early as highschool and even perhaps elementary college and junior highschool, totally different facets of it in order that when persons are entering into their skilled life, it turns into second nature.

Kevin Pho: Shirish, what are your take-home messages?

Shirish Sachdeva: I’ll piggyback on that, however I’d say begin small and self-care is a very powerful care which you can start with. So decide one factor which you can change and go together with that change for a time frame, which is well manageable, and you may monitor that change. Take it from A to Z, after which transfer to the following change. I give this instance to lots of our sufferers. So a few years go by, but when for six months you’re employed on one change, you can have had six modifications within the final three years. So I feel that begins immediately. When you can, decide one. Begin small, do one thing. It may very well be a ten-minute stroll. It may very well be specializing in eight hours of sleep, or it may very well be meals that’s not eaten from a merchandising machine and is home-cooked. So something on these traces, no matter you are feeling, or as Ziya stated, taking a yoga class or Tai Chi or something on these traces. However ensure you begin placing deal with your self earlier than we have interaction with others.

Kevin Pho: And Kim, as all the time, we’ll finish with you. What are your take-home messages for the KevinMD viewers?

Kim Downey: Certain. So a couple of phrases which might be talked about on this article embody resilience, burnout, and yoga. And a few docs cringe after they hear any of these phrases as a result of resilience, they are saying, understandably, “We’re a few of the most resilient folks on the planet.” Which is true, nevertheless it’s like throwing the infant out with the bathwater as a result of resilience really means going by way of one thing difficult and popping out stronger. So the ideas that we spotlight on this article are methods which you can shore your self up.

And the identical factor with burnout. Some docs assume that burnout makes it really feel like a person drawback the place it truly is the system that’s the issue. And in case you would repair the systemic points, they wouldn’t be burned out. I get that, and that’s true. They like the time period ethical damage. They’ve totally different definitions and you may have burnout or ethical damage. However once more, talking to that, whereas we are attempting to alter the system, and I feel increasingly more persons are elevating their voices, there are nonetheless these factors that now we have that may make it easier to individually.

And even yoga, a variety of docs, that’s the large factor. They’ll say, “We don’t want pizza events and yoga.” And yoga may not be for you, however actually a health care provider, the primary time I talked to her, in our first dialog, she stated, “Yoga saved her life.” And I do know women and men physicians who actually do love yoga and it may not be for you, nevertheless it’s simply to open your thoughts to attempt a few of these issues.

And in addition, you shouldn’t want permission. And also you don’t want permission. However in case you really feel such as you do, we’re providing you with permission to place your self first. As a result of some docs will assume like Dr. Michael Hirsch. He was informed he couldn’t have a lunch break. It might throw off the schedule as a gastroenterologist. However when he determined, “I want my lunch,” and by him talking up for himself, then different docs reached out. Nevertheless it was nearly like they wanted permission to ask for staple items, and these items ought to be prioritized: sleep, vitamin, train. So train your personal sense of non-public company, and we’d like docs to be wholesome for us and for themselves.

Kevin Pho: All proper, everybody, thanks a lot for sharing your perspective and perception. Thanks once more for approaching the present.

Kim Downey: Thanks, Kevin.

Ziya Altug: Thanks for having us, Kevin.

Shirish Sachdeva: Thanks for having us.