4 tools to help physicians, staff and patients manage stress

I'm planning a trip to an amusement park with my family this summer and I'm stressed. While the kids are with sheer joy counting down the days to roller coasters, swimming, exciting sights and delicious treats, I'm bracing for meltdowns, overexcitement, tears, vomiting and other disasters I have yet to imagine.

Of course, I'm not going to let these tensions ruin everyone's good time. I intend to have a blast and ensure that even the messier memories get filed into a very special and happy place. But given a new report out this week from the NPR/RWJF/Harvard School of Public Health about the epidemic levels of stress being experienced by Americans, the roller-coaster analogy is an apt one.

According to the new telephone survey of 2,505 adults, nearly half of the public (49 percent) has suffered a major stressful event or experience over the past year--43 percent of which were related to health. And as an article about the poll in the Boston Globe pointed out, the vicious chicken-or-egg cycle of health adding stress and thus harming our health is one that current medical practice has yet to break.

With some exceptions, such as stress-management programs emerging in health systems in Boston, this critical piece of the puzzle is not addressed in the vast majority of healthcare encounters. For example, only 3 percent of doctors in a survey of family physicians published in a 2013 JAMA Internal Medicine article said they included stress management counseling in their patient visits. The argument is mounting for this dynamic to change. However, incorporating stress management and social support for patients into your practice represents yet another undertaking that will take time for practice leaders--already plenty burdened themselves--to make a widespread reality.

In the meantime, we do have a number of time-tested stress-management tools at our disposal. I know I'll be relying on them as I approach my upcoming family adventure. They also represent good reminders even for days considered business as usual, which are as far from mundane for medical practices as they are for homes with small children.

Thus, before you open your practice doors each morning, take inventory of the following:

Team. I'm far more at ease travelling to a new place with my children knowing I'll have other game-ready adults by my side. Through our combined life experience, we can anticipate snags before they happen and come up with contingency plans. One of our top stories this week focused on the importance of pulling your employee teams together, and we've written much to date on the need for clinical teams to count on one another as well. When you face patients in your office who are clearly stressed--as most of them are, statistically--take the time to identify their support team. Even if they don't have friends or family members who can take part in their care, simply reminding them that you are committed to working with them and that they are not alone can help patients feel less overwhelmed.

Systems. My precociously minded son finds a lot of reassurance in the invisible ink identification stamp issued to matching sets of children and caregivers at Chuck E. Cheese. If your stamp doesn't match that of the child you're with, you are not permitted to exit the building with that child. While it's true that no system is foolproof, doing your best to understand how they work and use them properly can eliminate much low-hanging anxiety. For all of their remaining weaknesses, electronic health records are a wonderful invention. Let them do the work they are intended to do, and reassure patients of the ways they serve as a useful aid to human memory and decision-making.

Education. Having been fortunate to have lived with very few health problems so far, the most stressful times for me as a patient were during my pregnancies and when the kids were infants. But the more I could learn about what was normal versus cause for true alarm, the more comfortable I became (and less frequently called my doctor's office in a panic). For your employees, this sense of security will come from solid training and reinforcement. For patients, point them in the right direction to become educated and empowered via sources you trust, even if it's not feasible for you to relay all of the information they need yourself.

Acceptance. Finally, remember that the expression, "life is like a roller coaster" took hold because it's true. Expect that there will be dips and setbacks--as well as improvements and breakthroughs--and remind your patients of the same. - Deb (@PracticeMgt)