Cultivating a way of being and doing: Individual strategies for physician well-being and resilience

The practice of medicine is rewarding on many levels, but demands of the work can result in mental and emotional exhaustion, self-isolation, burnout, depression, suicidal ideation and tragically, completed suicide. It is critical to have effective strategies to address the unique stressors of a medical career, mitigate burnout, and buffer the physiologic toll of chronic stress. Using Zwack and Schweitzer's widely published description of approaches to maintaining resilience and approaches to wellness, we have organized these strategies into three broad domains relevant to medical practice: (1) gratification (connection and communication, meaning and purpose); (2) resilience building practices (self-reflection, time for oneself, self-compassion, spirituality); and (3) useful attitudes (acceptance, flexibility, self-awareness). Several techniques are described including mindfulness-based stress reduction, narrative medicine, skillful communication, and practices in self-compassion, gratitude, and spirituality. The focus of the work is to introduce a spectrum of resilience strategies for individual consideration that can be tailored and combined to meet a physician's changing needs over the course of medical training and practice.