THE WASHINGTON POST – Physician Hemant Sharma has worked at Children’s National Hospital for 11 years and serves as its chief of allergy and immunology. The 44-year-old Howard County, Maryland, resident commutes daily to Washington, DC, and rotates among four of the hospital’s facilities, treating patients, teaching and mentoring younger physicians, overseeing administration, and conducting clinical research. He’s aware of how so many demands might affect his well-being and believes addressing burnout is a vital issue for the medical profession – and others.
“I think a number of professions now are facing this challenge, where the chronicity of our daily stress is preventing us from giving 100 per cent of what we want to the populations that we’re serving.”
To tackle these concerns, Sharma co-chairs the hospital’s Provider Well-Being Initiative with Christiane Corriveau, a pediatric intensive-care physician; the committee has established regular meditation and mindfulness sessions at Children’s, among other measures. In addition, the hospital recently joined the Stanford Physician Wellness Academic Consortium and was awarded a grant from Ideas 42 to study work-life conflict in pediatric medical providers.
Sharma has a busy life beyond the hospital: He and his wife, Indira, a partner at a law firm, have three children, all younger than 10; he’s the president of his local Hindu temple; and he volunteers for nonprofits in his community. Here’s what he does to stay at his best. (This interview has been edited for length and clarity.)
Q: What do wellness and self-care mean to you?
A: Wellness for me means taking the time to invest in my own well-being holistically. It’s not only about what we’re eating or how much we’re exercising, but it’s about taking time to take a breath and tap into that source of optimism and enthusiasm, then being able to offer it to others.
Q: You called provider burnout “a silent epidemic” in medicine. What’s the cause, and how do you combat this?
A: Studies show that over half of health-care providers in the United States are burned out. It’s really worrisome, because these are the individuals who are responsible for healing. I think burnout is complex, but there are a number of responsibilities on clinicians’ plates that we didn’t have previously. One example of that would be the electronic health record. Some have made the analogy that when we’re taking care of patients, it’s somewhat like texting while driving. We’re trying to provide this quality experience and connect with patients, and we’re also spending time looking at the computer trying to document that visit.
Personally, my greatest wellness strategy has been meditation.
Q: How did meditation become part of your routine?
A: My wife and I realised how busy and how stressful our lives were becoming about six or seven years ago. We went to this three-day programme from the Art of Living Foundation [a nonprofit known for its stress-relief and yoga programmes] over a weekend and learnt breathing and meditation techniques. It gives me this opportunity every morning to go deep within myself and recharge and tap into a source of vitality and clarity and optimism. I wanted to try to share it with whomever I could because I found that it really did transform my entire life.
Q: How was meditation introduced to Children’s?
A: I invited the founder of the Art of Living Foundation, Sri Sri Ravi Shankar, to Children’s, and he spoke to this notion of healing from within: What can we do to make sure that we’re taking care of ourselves to then be able to care for others?
After he visited, we started doing different things to try to bring meditation to the hospital, such as M&M (Meals and Meditation), which he had specifically advised. Once a month, instructors lead a 20- or 30-minute meditation, and afterward folks share lunch. It’s been really beautiful to see how many people come back month after month. One of the most fulfilling aspects has been having people who work in different parts of the hospital come up to me and say, “It’s helping me find peace within myself.”
Sometimes there might be fear of bringing meditation into environments that might not seem to be ready for it. I think physicians tend to be sceptical, and they want to see the evidence before they try something. But I found, at least here at Children’s National, there’s been just a really welcoming and inviting environment for it.
Q: Do you meditate with your family?
A: It’s become a family pastime. All three of our kids have taken meditation courses. We’re always looking for things that will help improve out children’s happiness and sense of well-being. I can see that their creativity, their interest and their focus have improved and evolved over time. At night, we lead them in their practices, which are 10 or 15 minutes. It’s a way to wind down before story time or before bed. That’s not to say that they’re always willing audiences; it takes a little cajoling to get them to start and to continue.
Q: What’s your morning routine?
A: I meditate in the morning, right when I get up a little before 6am. I have a dedicated place where I go to meditate in the attic. I start the meditation and breathing and do that for about 30 minutes. After that, I start getting ready for the day. The kids wake up and we get them to school. I never miss breakfast. I’m usually on the go because of my long commute; I’m usually eating granola or breakfast bars and drinking a lot of water. I eat a banana every morning or some sort of fruit.
Q: Do you drink coffee or tea, or anything else?
A: I don’t drink any coffee or tea or any caffeine. When I was in residency, and we would be taking calls overnight, sometimes I would drink a little coffee or tea or soda to try to get me through it. But shortly after that, I made a decision that I was going to try to stop caffeine and replace it with water. I was amazed that water actually works better for me, anyway.
Drinking water has become a very popular trend. Everyone’s walking around with their big water bottles; I look around at the residents now and they seem to always be toting their water bottle around. And I love that because I think what it means is that they’re fuelling their body and their cells with this precious resource.
Q: What’s your nighttime routine like?
A: That’s where, as the parent of three kids, it gets challenging. We get home from work and we’re trying to get homework done and get bath time and their bedtimes finished. By the end of the day, oftentimes we’re exhausted. But the longer I’ve been doing this meditation, my body has gotten into a rhythm where it’s ready for bed at the same time every night and ready to wake up at the same time every morning. It forces me to shut down, usually around 11pm. I don’t set the alarm to wake up. Before I had meditation as the anchor of my routine, my sleep was more erratic and less deep.
Q: What about your fitness routine?
A: I do yoga and stretches every morning as part of my meditation practice. I definitely would love to start more of a regular exercise routine. I prioritise the breathing exercises and meditation and the yoga over other exercise because that’s been so impactful for me.
Q: How do you fuel yourself throughout the day?
A: I’m not a vegetarian, but I eat a lot of vegetarian foods. I try to make sure that whatever I’m eating isn’t too heavy, and I like having snack bars or nuts. Folks on my team know that I’m always the one asking them to eat lunch. No matter how busy we get, it’s important to take care of ourselves. I focus less on the specifics of what I eat; the timing is the thing that I think is most consistent for me. I tend to eat lunch at the same time every day and dinner around the same time every day. I tend to not eat too much late at night.
Q: How do you relax?
A: The kids keep us laughing. As a pediatrician, I have the immense blessing of having that experience multiple times every day. Their silliness and innocence and spontaneity helps me unwind. Laughter is one of the most powerful tools to help us relax and chill out.
Q: How do you deal with particularly wrenching cases?
A: One of the most important mechanisms to deal with that is talking about it. The provider well-being committee is developing a peer support programme. The notion is that when colleagues are dealing with patients who may not be doing well or whose care is particularly emotionally gruelling, that we have a mechanism to support each other and to deeply connect with each other. Not feeling alone is really important in terms of our own healing.