Regaining Your Locus of Control

Sheila Giffen, MD (Boise)
How we define our locus of control really affects our ability to feel stress and shift our focus of stress in our lives. So, in medicine, especially lately, there are a lot of external pressures that shift our locus of control to external pressures and make us feel like we're not in control of our lives. I feel like this is a journey for all of us and that we do have more control of our lives that sometimes we feel.

We need to realize that many of those external pressures are going to be here, such as our electronic medical records, recertification requirements, seeing patients every 15 minutes a day.  But even though we have those external pressures and those different experiences that we can't control, we can shift some of that to our internal control. This will decrease in our stress levels and an improve our health as well.
 
When we feel like we're out of control, we can have some downstream health effects that may not be beneficial: there is a higher risk of stroke, heart attacks, and depression as a consequence from not feeling like we're in control of our lives. I think as physicians sometimes we feel like we're above that or we focus solely on our patients and that's not healthy for us. Part of this journey, which has been an interesting experience for myself, is realizing even when I'm in those stressful situations, if I shift that to my control, I can change my behavior, I can change my response to those situations and I can center myself and maybe have a better outcome.
 
When we center ourselves -- sometimes that takes practice and we can do that through exercise, mindfulness, taking a deep breath -- then we can step outside, look at where we are, and then realign our priorities. Sometimes we need to make some essential changes that will have downstream benefits that we may not even be aware of. What we need to realize that we have control first. We take that step to center ourselves, take a deep breath and then refocus and then we can re-channel our energies into perhaps a different way of practicing finding, a new passion in medicine, reorganizing the way we practice.
 
Sometimes it means we may have to make some difficult choices when we realize we have control. Maybe as I change my schedule, I have to take less reimbursement for that, but it's a bigger priority in order to shift my focus to other things that I value. This might be spending more time with my family, re-engaging with my patients, building a community with my staff...that we might not have otherwise done.

Our sense of control is really important as we practice medicine. There are many external pressures that make us feel like we don't have that, but we really do.