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The purpose of this blog is to stimulate thought and discussion about important issues in healthcare. Opinions expressed are those of the author and do not necessarily express the views of CMDA. We encourage you to join the conversation on our website and share your experience, insight and expertise. CMDA has a rigorous and representative process in formulating official positions, which are largely limited to bioethical areas.

A Lack of Self-care in Healthcare

January 18, 2018

by Autumn Dawn Galbreath, MD, MBA

How many times have you gone to clinic when you were sicker than the patients you were treating? Listened to other people’s woes and stresses when your own were weightier? Given your last emotional resources to a patient whose need was less than your family member’s? Forfeited sleep while advising a patient of how curative it is? Advised a patient about nutrition and exercise right after scarfing a quick lunch from the vending machine?

Why do we as a profession care for ourselves so poorly? Granted, it’s partly out of habit. We learned in training to work long hours and ignore our own needs, even needs as basic as food, sleep and toileting. And for many of us, this just became a way of life. But I think it’s deeper than that. The culture of healthcare in which we grew up professionally was a culture of bullying. Raise your hand if you have ever heard someone called a wimp or a slacker for putting his personal needs above his medical responsibilities? And what was said about people who took time off from training due to illness? I cringe to remember the flack I got for going to a family funeral and missing part of a rotation as a medical student. Over the years, various schools have attempted to change this culture, but change is slow. And what we learn in training impacts us in one way or another-either we succumb to imitating it, or we consciously fight against it. Sadly, for countless physicians the former is the path of least resistance.

So how can we care for our loved ones and ourselves as well, or better, than we care for our patients? That’s a difficult question to answer. Sadly, generations of healthcare professionals before us failed resoundingly in this effort. It’s difficult to find a role model to emulate in the path to better self-care. But, on the other hand, the generations coming behind us will need role models, too. Why shouldn’t those role models be us? Why shouldn’t we be the generation of healthcare professionals to break the cycle of abusive training, overwork and poor self-care and lead our profession into a brave new world of healthy physicians with healthy families at home and healthy patients at work?

I do agree with what you’re thinking: “That’s a lot easier said than done!” Of course it is. But everything worth doing takes effort, as my grandmother used to tell me. And the profession won’t change until individual healthcare professionals begin to change. CMDA’s motto when I joined back in medical school was “Changing the face of healthcare by changing the hearts of doctors”-and that’s really what I mean. As doctors’ hearts begin to change, leaning toward caring for themselves and their families, they will be healthier people who have more to offer their patients. And who better to begin such a revolution than us Christians in healthcare?

How do we begin, you ask? I have come to a few conclusions in my recent pondering of this question:


    1. Sit with the Role Model we have access to for all of life. As the Great Physician, Christ strikes the perfect balance between self-care and caring for others and also promises to provide us with all we need to do the work to which He has called us. Carving out time for prayer and Scripture is a challenge for many of us, and yet it’s the critical starting point on the road to any meaningful change.


    1. Listen to wise counsel, especially that of your spouse. If your spouse says your family is not getting enough of you, believe it! And then address it! And if other wise people around you see evidence of overwork and stress, take their feedback seriously. None of us has perfect insight into himself.


    1. Make the changes that you know need to be made. Sometimes the problem is not knowing what we need to do. But more often, the problem is not wanting to do what we know needs to be done. Change the job that is sucking too much of your time and emotional resources. Sell the house (or vacation home or boat or car or…) that is forcing you to keep working as much as you do. Drop the membership whose dues take up a chunk of your monthly budget. And the list goes on. If we are honest with ourselves, very often, we know what needs to be done. The next step is to make preparations and do it. The freedom that comes from the initial sacrifice can be immeasurable.


    1. Reassess often. In training, I used to look forward to the day when I would “figure it out.” That elusive day when I would have my long-term job, when my childcare and education plans for my kids would be clear, when my husband’s career path would be established, when my home would be paid off. I looked forward to knowing the answer to balancing medicine and personal life. Students frequently ask me that same question: “How does a physician find this balance?” My answer with the advantage of two decades behind me is very different from what I know they want to hear. My answer is that there is no single answer. There is only the answer for now, for this stage of life. But the needs of family change, your own health and energy change, the demands of your job change. It’s not a matter of finding an answer. It’s a matter of finding something that works for now and frequently reassessing to know when adjustments are required.


This is not a quick-fix, four-step model to a happier, healthier life. This is a challenge to ongoing introspection and reevaluation. As you prayerfully introspect and evaluate, God will lead you and your family in the direction He has for you. And that, of course, will be the happiest, healthiest possible place to be.

Autumn Dawn Galbreath, MD, MBA

Autumn Dawn Galbreath, MD, MBA

Autumn Dawn Eudaly Galbreath, MD, MBA is an internist in San Antonio, Texas, where she lives with her husband, David, and their three children. Though they met in medical school, David now owns a restaurant in the San Antonio area. Between the two of them, they have experienced multiple career transitions and weathered the resultant stresses on their marriage and family. Autumn Dawn speaks to the issues of Christian marriage, being a working mother in the church, and being a woman in medicine with an engaging humor that brings perspective to these difficult issues.

Autumn Dawn earned her MD from the University of Texas Medical School at San Antonio, where she also completed her internal medicine residency. She earned her MBA from Auburn University in Auburn, Alabama.