PCM1: Stress Management for Health Care Professionals

PCM Objectives September 26th Describe the impact of both acute and chronic stress on human physiology, citing specific biochemical changes known and postulated to impact health and disease. List examples of how emerging technology (i.e. imaging) is validating the impact of stress and relaxation on biochemical changes within the body that can impact health and disease. Describe the physiological and biochemical changes associated with ‘the relaxation response and experience reduction of physiological response in a brief stress reduction exercise. List specific examples of the kinds of stress involved in a medical career and describe how each might impact a physician's professional and/or personal life (e.g., mood, cognitive efficiency, physiological changes, relationship issues, addictive behaviors, etc.)
 * Stress causes immune-suppression. The spleen, thymus, and lymph nodes have been shown to be innervated by the sympathetic nervous system. Immune cells react to neuro-transmitters, -hormones and –peptides. Chronic Anger and hostility increase the risk of heart disease. Acute stress can cause increases in blood pressure, heart rate, hemoconcentration and blood viscosity. Depression increases risk of myocardial infarction.
 * Functional magnetic resonance imaging can non invasively measure blood flow to areas of the brain in individuals subjected to stress or relaxation allowing direct evidence for changes induced by stress.
 * Relaxation response can be induced by muscle relaxation, meditation, guided imagery etc. . . And causes decreased heart rate, respiratory rate, oxygen consumption, blood lactate levels, anxiety, and hostility. EEG patterns are also altered.
 * Paperwork
 * Lack of time with family and friends
 * Demands from insurance companies
 * Malpractice concerns
 * Medical errors
 * Income concerns
 * Imperfect system
 * Long years of preparation
 * Time constraints
 * Lack of sleep
 * Dealing with difficult and important decisions and issues and the uncertainty of medicine
 * Difficult, demanding and chronically ill patients
 * Maintaining clinical competence
 * High expectations of self and others
 * Limited time and support to deal with own feelings