By Brad Roberts, MD, PCMS representative on the CMS Board of Directors
There are lots of important things currently being considered by CMS (the new Colorado public health insurance option, the continued opiate epidemic, the new and ever-increasing cannabis epidemic, managing cost of care discussions, evaluating and advocating in the current liability climate for physicians, scope of practice discussions, physician professional satisfaction… and the list could go on extensively).
That being said, this time of year is always a wonderful opportunity for me to pause and consider whether I am focusing on what is truly most important; to reevaluate goals and look forward to the future with plans to do better. I appreciate that this time of reflection also comes during a holiday season in which society focuses on giving and thinking of others. I hope you will allow me to pause to reflect for a moment with my article for the newsletter as well.
In true medical fashion, I went to the peer reviewed literature to find out if there were any studies done on the physiologic benefits of kindness (I had also just watched the Mr. Rogers movie, A beautiful day in the neighborhood, with Tom Hanks). Sure enough, I quickly found a paper titled ‘it’s good to be good: 2014 Biennial Scientific Report on health, happiness, and helping others by Stephen G. Post. In case it needs to be found on PubMed, the citation it came from is Int J Behav Med. 2005;12(2):66-77.
In the study, Post notes that volunteers have less trouble sleeping, less anxiety, less helplessness and hopelessness, better friendships and social networks, and a sense of control over chronic conditions. He then reviews a number of studies demonstrating improvements with serving others in a wide range of markers including improvements in cholesterol, lower BMI, decreased rates of HTN, and improvements in alcohol addiction treatment outcomes. There were improvements in chronic pain patients including decreased pain intensity levels, decreased degree of disability, and decreased depression when they began to serve as peer volunteers for others suffering from chronic pain.
He also cites changes seen on fMRI studies in the mesolimbic pathway and ventral striatum, the brain’s satisfaction and reward center, which is responsible for dopamine mediated euphoria, with giving. Interestingly, he cites a cross sectional study of 2,682 medical students attending medical school in seven U.S. medical schools in 2009 that found that students experiencing burnout had considerably reduced altruistic attitudes about physician responsibility to society, including less desire to provide care for the medically underserved. A separate study found that health professionals who volunteered to go on medical mission trips scored lower on burnout scales following their return and continued to improve at a six-month follow up.
It may be crucial to solving the problems above for us to step back, pause and serve others. It is in serving that we develop the relationships needed to understand one another; it is there we gain ideas to look outside of the constant drum of our practices and gain new insight; and it is through service that we can regain the altruism that drove us to medicine. And, apparently, as a biproduct, it helps us become healthier and happier as well. With that, I wish you all happy holidays!