Author + information
- Sarosh P. Batlivala, MD∗ ()
- Blair E. Batson Hospital for Children, Jackson, Mississippi; and the Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi
- ↵∗Reprint requests and correspondence:
Dr. Sarosh P. Batlivala, Pediatric Cardiology, Blair E. Batson Hospital for Children, University of Mississippi Medical Center, 2500 North State Street, Jackson, Mississippi 39216.
“A man's home may seem to be his castle on the outside; inside, it is more often his nursery.”
—Clare Boothe Luce (1)
Early career cardiologists are faced with many challenges as they begin practice. As Tong et al. (2) noted, a “perfect storm” has come together in the form of recent research funding cuts, a decline in reimbursement for clinical activities, and impending cuts in graduate medical education; this storm threatens the success of early career cardiologists at a vulnerable transition. In fact, the number of physician scientists receiving post-doctoral research training and career development awards is at an all-time low (3). With all of these challenges, early career cardiologists would benefit from establishing a professional home soon after completing training.
McKevitt et al. (4) highlighted an important aspect of many a physician’s psyche: “Illness doesn’t belong to us. It belongs to them, the patients. Doctors need to be taught to be ill. We need permission to be ill and to acknowledge that we are not superhuman” (4). Common sense may suggest that a physician’s sense of well-being relates to his or her ability to care for patients. Unfortunately, some physicians have suboptimal personal insight into this matter (5). Furthermore, recent evidence has shown that early career physicians (ECPs), as compared with their mid- and late-career counterparts, have the lowest satisfaction with overall career choice, highest frequency of work-life conflicts, and the highest rates of depersonalization (6,7). Tijdink et al. (8) demonstrated similar findings, with ECPs scoring higher on an emotional exhaustion scale, which they postulated may place ECPs at higher risk for developing burnout. Additional studies have shown that even residents are developing burnout at relatively high rates (9,10).
In medicine, health is defined as the absence of disease (11). Physicians may transpose this disease model to their personal well-being and define wellness as the absence of burnout or distress (12). Physician engagement has been described as the corollary of burnout. Engagement has been defined as “a positive, fulfilling, work-related state of mind, characterized by vigor, dedication and absorption” (13). In fact, Schaufeli et al. (14) suggest that strong professional engagement may be protective again physician burnout.
Given these data and observations, establishing a professional home is a critical task. Tuedio (15) describes home as “a place to preserve connections between our past and present, but also the place where we must continually reconstruct these connections.” Gadamer (16) notes that when we are at home and functioning in our element, “we are open to new things, ready to embark on new enterprises.” He further describes that this may allow us to forget ourselves and our existential pains, so we may “scarcely notice the demands and strains which are put on us…. This is what health is” (16). These descriptions of home embody the professional aspirations of many physicians.
Having a professional home where you are a member of a group can provide a sense of community, of belonging, and of unified purpose. The particularly niche field of pediatric interventional cardiology raises some important issues in terms of where to establish a professional home. As opposed to the adult cardiac population, few children suffer significant heart disease—and fewer still suffer hemodynamically significant heart disease that requires transcatheter assessment and intervention. Given that, my practice includes both pediatric and adult cardiology patients, and I serve at multiple organizations, which could serve as a professional home. The American Academy of Pediatrics (AAP) is 1 option, striving to “improve the health of children everywhere.” Similarly, the American College of Cardiology is another, with the mission to “transform cardiovascular care and improve heart health.” Importantly, both groups encourage collaboration, so I chose both. I have found tremendous professional satisfaction by becoming involved with both organizations.
My involvement with the AAP began in residency, through a combination of good timing, luck, and hard work. I attended a national conference and took a leap when a position on the resident executive committee was vacated without a candidate. I immersed myself in the tasks and networking, and ran for additional positions, culminating in being elected as chairperson of the National Section on Medical Students, Residents, and Fellowship Trainees. Having completed training, I now hold an office on the AAP’s equivalent of the Early Career Section. In a complementary effort, I have become involved in the ACC’s Early Career and Adult Congenital and Pediatric Cardiology Sections. One goal is to foster collaboration between both organizations to better advocate for common issues. Such collaboration has led to important recommendations, including the recent assessment of electrocardiography as a screening tool as well as neonatal screening programs for critical congenital heart disease, among others (17). ECPs can take advantage of similar opportunities to establish a professional home within their local ACC chapter, other professional societies, or at their home institution, among others. The first step is as simple as reaching out and volunteering to help. Creating a professional home with both the ACC and AAP has allowed me to not only advance my career, but to also improve my personal satisfaction and health, which could potentially be transferred to the health of my patients.
RESPONSE: Take a Look Around for Your Professional Home
Dr. Batlivala brings forth a very important aspect of our professional satisfaction in writing about the need to find a sense of belonging. As a pediatric interventional cardiologist, he has both a very small peer group of those who practice in his subspecialty and a very wide variety of choices of professional organizations to make his home. Even for those adult early career cardiologists with a fairly general practice focus, there are a plethora of places to call home. When I was an early career cardiologist, there were far fewer choices to make. Certification in the subspecialties of cardiology did not yet exist, and the multiple cardiology subspecialty organizations had not yet formed.
In 2011, the American College of Cardiology (ACC) recognized the need to provide the necessary support and resources to cardiovascular specialists after they had completed their training program and initiated their careers. At that time, nearly 20% of the ACC’s members were in that stage of practice. In response to this need, the ACC established the Early Career Professionals (ECP) Council and Section. I had the pleasure of serving as senior adviser at the inception of the council, and since its beginning, the council and section have flourished. Many ECPs have found a professional home there or in other ACC sections that focus on subspecialty science and other interests.
Picking a professional home can be daunting. As in other areas of life, volunteering requires work, and getting involved in the ongoing efforts of a group or organization can give a flavor of the group’s mission and interests. Experiencing the energy and momentum of people with similar interests and goals is very powerful, and joining them can greatly enhance our professional satisfaction. As Dr. Batlivala has done, I encourage all ECPs to take a look around and find a professional home. Our profession needs your energy, ideas, commitment, and innovation to continue our efforts in advancing science and excellence in patient care.
- American College of Cardiology Foundation
- ↵BrainyQuote. Clare Boothe Luce quotes. Available at: http://www.brainyquote.com/quotes/authors/c/clare_boothe_luce.html. Accessed October 27, 2014.
- Garrison H.H.,
- Deschamps A.M.
- McKevitt C.,
- Morgan M.
- Maslach C.,
- Jackson S.,
- Leiter M.
- St Claire L.,
- Watkins C.J.,
- Billinghurst B.
- Schaufeli W.,
- Bakker A.
- Tuedio J.
- Gadamer H.-G.
- Maron B.J.,
- Friedman R.A.,
- Kligfield P.,
- et al.