Independent Health Care Practitioners Need Care, Too

The health care practitioner is one of the most valuable resources we have for human kind on the planet. Let’s face it, without nurses, doctors, social workers, therapists, dentists, specialists, etc… the citizens on earth would not enjoy too much in life, since their health would be at jeopardy. Health care practitioners on the other hand are overworked, underpaid, and usually looking out for everyone else, and overlooking their own self care.

I recall when I first received my Master’s in social work. At the time, the starting pay was $18 per hour — and it stayed at that rate for more then five years. There were no raises in the partial hospitalization program I worked in or any of the other social work positions where I was employed. I was paid $50 for each home health visit, which with the driving, Medicare notes, and meetings usually wound up taking, on average, 3 hours. Believe it or not $50 is still the going pay rate for a home health nurse or social worker, nearly 15 years later. But I was like a horse out of the gate, eager to make some money, after being in school for seven years, and working for free for two years during internships. I thought wow I’ll have to work extra hard and long hours to make ends meet with this kind of pay. So what did I do, I worked 70 hours per week for five years. This scenario and the one I will describe below is depictive of most Health health care practitioners, unless perhaps they become administrative, which by the way, is also no easy feat, with long hours and pay that ends up being miniscule to the amount of time they spend at work.

The next step in most health care practitioners’ careers, after being in the trenches, is to get licensed. John F. Kennedy took the bar three times in order to pass, and become an attorney. My own father took the CPA exam three times in order to pass. Most health care practitioner take their licensing exam at least that many times to pass the test to practice independently. So now one may think that’s not too bad since the dough will roll on in after licensure, right? Think again. Office space costs, expenses, duplicate billing to get paid after the first try of getting the insurance company to send a check for services, no-shows, bounced checks, reimbursements declining, no paid vacations, taxes, employee benefits, licensing fees, malpractice insurance etc. When it was all said and done, I did get a raise to somewhere around $25 per hour, working in private practice, for the 10 years I practiced independently.

Somewhere in all of this low pay, long hours and all the giving the independent health care practitioner puts out, his or her own self care may wane. So many providers I have known over the years have health issues. I can count on both hands and feet the number of nurses, doctors, social workers, psychologists and health care practitioners that I personally know have suffered from lack of self care. Always looking out for everyone else is a sign of co-dependency.

The way I describe co-dependency is in a circular clock like format. For the health care practitioner, the giving mode starts at say 12:00 p.m., which keeps on ticking clock-wise, all the way to 9:00, when most humans wouldn’t be able to give unconditionally to others past 3:00, without constant breaks, complaining, and licking their wounds. The healthcare practitioner does this kind of giving day after day, occasionally having a major melt down (i.e., high blood pressure, migraines, illness, psychological breakdowns, heart problems
and general exhaustion to name a few conditions). On occasion, at 9:00 p.m., you can hear the health care practitioner screaming, huffing and puffing and crying out that he or she is being taken advantage of. Usually that lasts until 11:45 when they feel guilty, ashamed they weren’t strong enough to keep moving and helping, and apologetic. At 12:00 they pick themselves up by the bootstraps and the giving and giving and giving cycle starts over.

So the remedy is probably not going to be in better pay, let’s just face that one. The remedy is in the self care practices of health care practitioners. Here are some self-care tips to keep in mind:

1. Don’t work overtime
2. Take scheduled vacations, even though you pay for them
3. Don’t sweat the small stuff (read the book by that same name if you don’t know what this means)
4. Have a good social support
5. Get a mentor who can give you feedback and help out with difficult cases
6. Get a massage regularly
7. Schedule regular doctor’s appointments — and go to them
8. Eat at regular hours
9. Sleep well without getting hooked on medications
10. Go to therapy if you are unhappy or people notice that you are unhappy
11. Exercise every day
12. Do Not believe you are a super hero


About the Author:
Marla Stone, MSW (Retired LCSW) is the founder of South OC Wellness , a health wellness management company specializing in family/employee assistance programs (FEAP). Marla maintained a private practice in South Orange County for the past 10 years specializing in seniors, adults, adolescents and children. Her long term services as an EAP interventionist and an advocate for persons with chronic mental/medical health issues created a niche and expertise in the area of medication/treatment alliance. Marla treated the military personnel from Camp Pendleton’s Marine and Navy Families for many years, creating innovative treatment modalities and interventions for PTSD, dual diagnosis and relationship challenges. Marla is an accomplished public speaker and educator, and the author of Self Impressionism: A Medication/Treatment Alliance Program. Her philosophy is that individuals with mental and/or medical health challenges can achieve and maintain balanced, productive and happy lives.