Self-Regulation: Key Cornerstone of Doctor's Well-Being

My good friend and colleague, Christopher Simon, will shortly complete (as far as I can tell) Canada's first Ph.D. focused on physician health and well-being.  His postgraduate research is now in the first phase of publication and his data will be of interest to anyone with interest in health-professional sustainability and well-being.

His first paper was released this week, and looked carefully at the link between physicians' self-regulation (i.e., effective management of thoughts, emotions and behaviours, and ability to cope with adversity) and perceived psychological well-being.  As a child psychiatrist, I often help children/youth/families improve and enhance their self-regulatory skills and can't help but understand how these skills are important to all adults, including physicians.

Chris found that there was a strong relationship between self-regulation capacity and the dimensions of "purpose in life" and "environmental mastery", which he concluded suggests that physicians who effectively self-manage may be better able to preserve a sense of purpose and an adequate work-life balance in their daily life.

I've observed that when a physician has either lost their sense of purpose or had it taken away (e.g., clinical restructuring, illness/impairment) they are particularly vulnerable to burnout.  Typically, physicians will work even harder to maintain a sense of service fulfilment or life purpose which only makes things worse.

Self-regulation skills can be taught and/or enhanced.  Psychotherapy, psychoeducation, coaching, and reflection (e.g., mindfulness) can be helpful strategies.  In addition, self-regulation skills apply to a whole host of homeostatic variables such as the ability to attend to exercise, sleep, nutrition, hydration, social connection, and to more complex behaviours such as delaying gratification, managing frustration, and monitoring impulses.  

These skills can also be innate and perhaps screened for as part of application to medical school or a postgraduate education program.  I'm not suggesting poor self-regulation skills should preclude the opportunity to study and practice medicine, but it does seem reasonable to offer skill-enhancing opportunities to those who may have vulnerabilities in this area.

Chris notes that our work is only going to get more complex and suggests that enhancement of self-regulation skills of physicians will not only be of value to themselves, but also for the patients that they serve.