Each of us has experienced moments (sometimes long stretches) where stress runs high and the challenges in workplace overpower the peace. It puts us in uncomfortable state, the complete opposite of a calm, meditative mind. How do we manage stress and navigate it without letting it erode how we feel or function?
A friend of mine recently asked me, how do doctors do it? How do they maintain a healthy lifestyle when work consumes so much of their time? Every job has its own challenges; in medicine, the stress can be intense and relentless: working 80+ hours a week, enduring 28-hour shifts, or delivering heartbreaking news to patients and families while remaining calm and collected. Yet somehow, we adapt, physically, mentally, and emotionally, enough to make it through the rigors of training.
The truth is, if you ask different doctors/residents, you’ll get different answers on how they manage stress. Each person developed his/her own tools, not just to survive in a demanding environment, but to thrive in it. We grow by learning from one another, and my hope is that by the end of this article, you’ll walk away with a few of those tools that help doctors stay afloat.
Before we dive in, I’m excited and honored to introduce a special guest contributor to this article: Dr. Vater. She’s a medical oncologist, TEDx speaker, and a passionate advocate for wellness in the healthcare workplace. If you follow her on social media, you’ve likely come across her thought-provoking posts and her genuine passion for advocating not only for her patients but also for the well-being of physicians and healthcare workers. Together, we hope to share practical strategies and honest reflections, not just for the new generation of aspiring doctors, but for anyone navigating a busy, demanding life.
Here are some of the questions I asked Dr. Vater, along with her thoughtful responses:
1) What sparked your passion for workplace wellness advocacy in healthcare?
Dr. Vater: “My overarching career goal is to make the field of medicine more human for both patients and clinicians through these endeavors, because our health is interconnected. When we are well, we are better equipped to care for our patients.
I have become an advocate for clinician well-being over the last decade. This was keenly influenced by witnessing my mother start medical school when I was 9; she completed her rigorous residency training during my teenage years and then entered into a full-time primary care practice. Witnessing her dedication to her patients, along with the challenges and pressures of practicing medicine in the modern era, provided motivation to advocate for other clinicians.
In my own training, I faced a decline in my mental health during residency after a series of months of long hours, fractured sleep, and witnessing illness and loss. I was afraid to seek help and felt defective as a physician. I also felt very alone in the challenges I was facing.”
Dr. Vater then added, “I currently work to enhance the well-being of clinicians through several endeavors. Firstly, I write narrative, nonfiction, and fiction pieces centered around topics often shrouded in shame such as mental health, medical error, compassion fatigue, and moral injury, and am currently working on my first novel. I also spend a lot of time blogging and microblogging to engage with my community on social media.
I also help promote well-being among clinicians by speaking at local and national events, including on the TEDx stage at Rush University and at the Lorna Breen Hero’s Foundation. I was invited to give the commencement addresses at the University of Minnesota Medical School in 2023 and the University of San Diego Medical School in 2024, which were among the greatest honors of my life.
While most of these endeavors are unrelated to my day-to-day job, I integrate these pillars into my clinical career by serving on several wellness committees at the Indiana University School of Medicine, including the advisory committee to the Vice Chair of Wellness.
One of the tools I’ve developed is a wellness behavioral tool (known as the “SMILE Scale”) that clinicians, students, and patients are using to measure their well-being. Utilizing the skills I gained while earning my MPH, I also collaborate on mixed methodology to research salient topics related to physician and trainee well-being.”
2) Residency training is challenging across all specialties. What skills did you build early in training that still serve you in your day-to-day life and help you manage stress?
Dr. Vater: In residency, I would pack a lunch filled with whole fruits and vegetables every day. I’d set a timer on my phone for 30 minutes (pausing as needed for patient care) and try to get in flights of stairs, a walk across the hospital, and leg lifts or squats while standing and typing notes. Of course, I’d sleep on long calls whenever I could.
In my attending career, I’ve tried to cultivate well-being over exhaustion in my career with several carefully selected choices. I chose to specialize in medical oncology, a field with meaningful patient relationships and few overnight emergencies. I work in a large academic practice, which allows me to limit overnight call and weekend shifts. While still working full time, I have two flexible days where I often attend meetings, catch up on clinical work, and write fiction. I also work closely with a registered nurse who supports me in clinic, helps with insurance issues, and answers inbox messages.
My family and I have chosen to stay in the Midwest, where the cost of living is low. We bought a modest home and live below our means. I generally have a regular sleep schedule, exercise consistently, and go to therapy. My family and I take a vacation once a quarter. While I’m still learning to set boundaries, I’ve started to slant towards what feels like thriving.
3) What’s the best piece of wellness advice you’ve ever received?
Dr. Vater: The best advice I’ve received is to remember that we are human beings and we as clinicians matter. We are more than our careers. While our work is vitally important, we deserve the health we strive to give others.
Take-away tools on managing stress:
Tool 1: The micro-time is not so micro…it adds up
It’s easy to dismiss mini breaks during the day as useless. But several of these short pockets of time here and there add up. Instead of letting them slip by, we use them intentionally. A few examples include reply to a pending email, taking a quick walk, stretching, reflecting, or simply breathing. These small moments can help us reset, stay productive, and protect our energy over the long haul. Most importantly, they can act as a buffer to help us manage the very stress that these tasks sometimes create.
Tool 2: Be like water, fluid and adaptable
It’s rare to find the perfect job that checks every box. Maybe the career fits us well, but the management doesn’t. Or maybe everything seems ideal, until the commute starts wearing us down. The truth is, picking the right career is only one piece of the puzzle. The ability to adapt within the job to carve out time for self-care is key for personal well-being.
As Dr. Vater shared, small adjustments helped her navigate the physical and mental demands of training. She took the stairs instead of the elevator and did leg lifts or squats while typing notes. These simple acts weren’t just physically beneficial, they had a psychological impact too. Choosing to take the stairs, for instance, can offer a small sense of accomplishment. Even just taking 5 minutes to be mindful and breathe amidst a busy day can make a big difference. Those five minutes add up to hours of mindfulness by the end of the month, providing physical and mental benefits. Studies have consistently shown that mindfulness practices help manage stress effectively.
Tool 3: Conscious Self-care
It’s said that Einstein often prioritized his intellectual pursuits over his own well-being. This isn’t unique to scientists, it happens in every field. Think back to the last time you were deeply focused on a project. Hours flew by, and you probably forgot to eat or drink. Medicine is no different. Surgery after surgery, patient after patient, sometimes there’s simply no time for a break… unless we make that time.
During my training, I became more aware of this. Now, between cases, I make it a point to take a few minutes, when it doesn’t compromise the schedule or patient care, to drink some water and grab a quick bite. As Dr. Vater mentioned, we have to remember that we are human beings before we are professionals. And that’s true in any career, not just medicine. Conscious self-care means consciously making decisions to briefly prioritize our own health in a day full of chaos, after all, we owe it to ourselves as much as we owe it to our work. Managing the stress at work starts with managing our own health and emotions.
Final thoughts:
Our health is just as important as our career, and stress can come from all directions, both personal and professional. Managing stress isn’t always easy, which is why I believe in making a conscious effort toward self-care. If we leave it to chance, the time for it may never come. The old adage “be like water”, while cliché, carries real wisdom; water flows through cracks, remains still when needed, and moves with the wind rather than against it. It adapts with purpose. Finally, we encounter micro-opportunities every day, moments to pause, take a deep breath, drink some water, and reset. We just need to notice and seize them because these are the moments that could provide the turning point to our day.
Image Credit: José Martín Ramírez Carrasco
