Why taking charge is good for your heart

You may have read this week that women who report high stress on the job have a 40 percent increased risk of being diagnosed with heart disease--the leading cause of death among both men and women, according to the CDC.

What you may not have realized about the at-risk subjects of Brigham and Women's long-running Women's Health Study is that it's not just the ladies sitting in your waiting room you need to be concerned about. It's your staff, your colleagues and even you.

Most of the 17,415 study participants were healthcare workers, "anything from being a nurse's aide all the way to a Ph.D.," lead researcher Dr. Michelle Albert reported Sunday at an American Heart Association conference in Chicago. The women were healthy, 57 years old on average, and had worked full or part-time when the study began in 1999. They filled out surveys about their jobs, rating statements like "My job requires working very fast," and "I am free from competing demands that others make."

Besides being females in the medical field, the respondents at the highest risk for heart problems--including heart attacks, strokes or clogged arteries needing bypass surgery--all had something else in common: a lack of decision-making authority or opportunities to use their unique skills. In other words, they didn't feel in control. (Even though men were not involved in this particular study, it's probably not too big of a leap to conjecture that their hearts don't like being told what to do either.)

Now, with full acknowledgment that I'm not a healthcare professional, nor have I conducted any studies on the issue, I can tell you personally that, all things equal, feeling in the driver's seat can make even the most challenging experiences seem less stressful. In the 10 months since I made the switch from employed to freelance writer, with a similar workload and significantly less child care (i.e., sleep) and security, I feel healthier. Within a week of making every project a personal choice (even though it technically always was), I stopped waking up with searing headaches and feeling my stomach go sour every time I opened my email.

Of course, I'm still just as exposed, maybe more so, to the external forces of the economy, my clients' needs and my kids' disposition for getting sick when I'm on deadline. Nonetheless, the illusion of control has proved to be extraordinarily powerful for my mental and physical health.

On top of that, I run. I'm one of those fortunate people who has discovered the paradox that sweat and exhaustion and even pain can nearly instantly whisk away stress and fatigue. That even in a couple of weeks (hopefully more) when my entire neighborhood will be ensconced in wind-chilled sleet, that it will still be worth it to get up at some ungodly hour and trudge around in it for awhile. Again, it's a choice. If someone else showed up at my door and told me it was time to go frolic around in a blizzard, I would most certainly slam said door and go back to bed. And I might just bring a bag of Doritos and a huffy attitude with me.

The message here is that control--or more accurately, the perception of control--is one of the most critical tools you can give your staff, your patients and yourself. As we reported last week, sometimes all a so-called 'problem physician' wants is a little say-so. Today, we again comment on how taking part in medical decision-making can give patients a better quality of life. We also share a story highlighting hospitals' unprecedented willingness to work with physicians to help create their ideal practice situation. With more employer-hospitals, health systems and regulators honing in on how physicians practice and offices run every day, it behooves all medical professionals to embrace as much personal volition as possible.

Even if it doesn't change reality, controlling what we can is sometimes the only way to cope.

By the way, don't forget to call your Congress representatives beginning today to demand a halt to the devastating Medicare cuts scheduled to begin Dec. 1. - Deb