Quick Reflections From The Week

{Napa, California}

I’d like to think that I’m quite mindful and reflect on almost anything that stands out in my day causing me to raise an eyebrow or feel that a mini light bulb went off in my head.  I truly believe that the more mindful we are and the closer attention we pay to cues and details, the more meaning we can get out of even the most routine of days.  The following are some of my own reflections from the week, and I hope to encourage you to reflect and do the same!

1. The importance of teamwork.  As a psychiatrist who values coordination of care and hearing other clinicians’ perspectives, I had the opportunity to connect and discuss cases with an awesome psychologist whom I share several patients with.  Being in private practice can feel a bit isolating at times compared to working in a multidisciplinary setting, so I welcome the opportunity to meet and discuss any complex psychological issues that might be impacting my patients.  As several of you may know, I place a much stronger emphasis on psychotherapy than pharmaceuticals when treating my patients.  Therefore, knowing that therapists value my opinion on psychotherapy just as much (or even more) than my expertise in pharmacology helped me feel connected and valued as a team member.
2. Be authentic and speak up.  Since I posted my latest blogpost on physician burnout, I’ve received amazing responses from people telling me that they could relate to my post.  As someone who was always afraid to share my opinion (yes, I’d go to leadership meetings and literally sit there and say NOTHING), it was a testament to how much personal work I’ve done to overcome barriers that got in the way of me voicing my opinion.  I think clinicians can be hypocritical by simply telling patients to exercise more, think positive, stop thinking so much, eat healthier, etc, and even worse if they label patients as ‘non-compliant’ for not executing such changes by their next follow-up appointment.  As if breaking years worth of habits is that easy.  Well, I can say that it took me years to overcome my overwhelming fear of judgment in order to speak up and I’m just happy to have the support of empathetic people who helped me achieve it.
3. Normal vs Pathological.  During sessions with patients, I try to help them discern whether the symptoms they’re experiencing are normal reactions given their circumstances.  This week, several patients chose to hold off on increasing medications after recognizing that they were coping with issues in a fairly healthy manner.  Often times when people are diagnosed with mental illness, any anxious feeling, sense of fatigue, anger outburst, difficulty sleeping, etc, is automatically perceived as problematic rather than a ‘normal’ response.  I’m far more collaborative in my approach, and part of the treatment involves determining whether or not a symptom is ‘normal.’  The decision-making process of determining whether or not to adjust a patient’s med is geared towards first helping my patients gain insight rather than automatically assuming that their symptoms are pathologic.
4. “To find health should be the object of the doctor.  Anyone can find disease.”  ~ A.T. Still.  I am currently reviewing osteopathic principles for an upcoming presentation, and while reading I came across this quote.  There are times during appointments when I’m stuck on which medication to prescribe next, though I noticed that I experience clarity the moment I get an opportunity to practice the above quote with my patients.  I have several patients who have tried an extensive list of meds, yet start to observe more improvement when the sessions shift from solely focusing on meds to helping them heal from years of trauma, neglect, medical illness, heartbreak, addiction, etc.  Doing so reminds me of the reason I pursued a career in medicine in the first place.