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What Do Doctors Know About Their Unemployed Patients?

Anyone who’s ever been downsized or otherwise lost a job knows the feelings: Personal loss (social, financial and routine), self doubt, and in some cases fear of what the future will bring. Unemployment and its cousin, underemployment, are not subjects that a lot of people are comfortable brining up in polite conversation — even with their doctor.

Given today’s tough economic environment, chances are that 15 to 20 percent of the people sitting in most doctors’ waiting rooms are out of work. Do you know who they are? You should. Read more »

*This blog post was originally published at Mind The Gap*

Slow Love: Job Loss, Depression, Pajamas, And Happiness

Slow Love.jpgFrom the “unsubstantiated evidence” files, I wanted to share with you a quick light that popped on in my head while reading a much-discussed article from last weekend’s New York Times Magazine.

In it, former House & Garden magazine editor Dominique Browning vividly shares her experiences following the folding of the magazine in 2007. This long-form essay is adapted from her upcoming book, Slow Love: How I Lost My Job, Put On My Pajamas, and Found Happiness.

Much can be discussed about her experiences, but I was particularly struck by the account of her response to her newfound freedom:

“In this way, being unemployed is a lot like being depressed. You know how there are millions (O.K., a handful) of things you swear you would do if you only had the time? Now that I had all the time in the world — except for the hours during which I was looking for work — to read, write, watch birds, travel, play minor-key nocturnes, have lunch with friends, train a dog, get a dog, learn to cook, knit a sweater, iron the napkins and even the sheets, I had absolutely no energy for any of it. It made no difference that music and books and nature had long been the mainstays of my spirit. Just thinking about them exhausted me. I had absolutely zero experience in filling weeks — what if it became years? — with activity of my own choosing. Being unemployed meant being unoccupied, literally. I felt hollow.” Read more »

*This blog post was originally published at Terra Sigillata*

Job Loss And Its Connection To Illness

Two very interesting articles were published recently on the health effects of job loss and on-the-job rejection.

The first article looks at the health of people who have been fired. They limited their study to previously healthy adults who got sick after they lost their jobs. It didn’t seem to matter why they were let go or how quickly they found a new job. Kate Stully, an assistant professor in sociology at the State University of New York at Albany and author of “Job Loss Can Make You Sick” found that losing a job is linked to a higher risk for high blood pressure, heart disease, heart attack, diabetes or depression. I would also add an increased risk of suicide to this list.

The second article looks at what happens when you’ve been left out (or just think you’ve been left out) of the loop at work. Purdue University’s professor of psychological sciences, Kipling D. Williams, reported that hurt feelings for a perceived slight can affect morale, hurt job performance and productivity, and can even hurt the company financially in his article, “Avoid the Dark About Effects of Leaving Others Out of the Loop”.

The first article looks at how we define ourselves and our place in society by our jobs. The second looks at how damaging a perceived slight can be to productivity. Now these two articles on the surface seem to be talking about two different things. But if we take a closer look, aren’t both of these articles talking about the effects of rejection?

No matter how much we would like to say we don’t care what other people think, we really do care much more so than we might think. And it hurts when we feel left out or feel unwanted. According to the first article, it can even make us physically sick. It matters that we feel needed and accepted by those who play a large part in our lives. And let’s face it; we spend a lot of time with our coworkers so it would naturally follow that these people would have some influence over how we feel about ourselves.

The second article explains how just a small amount of the cold shoulder can have a significant impact on how we feel about ourselves and how we perceive others feel about us.

So how do we cope with feelings of rejection in the workplace? Most of us spend more time with coworkers than we do our families, so they often become our second family. In some cases, our work family may be the only one we’ve got. And family rejection is often the most devastating to our self-worth.

The first step in dealing with any rejection is a critical look at the rejecter as well as the rejected. Is she really rejecting me by talking with another coworker? Sure, we were a team in the meeting, but after the meeting she talked to someone else in the hall. Does this mean rejection, or does this mean she had a follow-up comment to something that person said in the meeting? Is my being fired from my job a reflection on my job performance or downsizing of the company? If it is my performance, was the job really a good fit to begin with? How could I have changed the outcome to better serve me? Could I have stepped up my performance, or changed jobs to one that I liked better? How will I deal with this in the future? Do I really want to be a part of this group in the first place? Is my desire for alliance with this group solely based on popularity? Does this group fit with my own morals and ideals? We all want to fit in, but not at the expense of losing ourselves in the process.

The second step is to realize that in order to feel rejection we must first give someone else the power to do so. Am I setting myself up for rejection? According to psychiatrist, Karen Horney, we tend to move toward, away from, or against others. Am I open and meeting others half way? Am I waiting for others to come to me or making others work harder to approach me? Or am I mistakenly pushing others away from me by rubbing them the wrong way or coming on too strong when all I really want to do is connect? Am I trying to alienate others before they get the chance to alienate or reject me?

The third step is to understand that rejection is a negative experience just like any other and that the hurt lessens when shared with others. Sometimes we can “feel” rejection when we are not being rejected at all. If I was cheated on by a loved one, or a family member raked me over the coals for showing up late for dinner, I would find a sympathetic ear to talk it out with. By discussing rejection, we find that we are not alone. We may even find that our story is not so bad when others share their horror stories of rejection. And don’t worry about fearing that we’ve blown the situation out of proportion. Maybe we have not been rejected at all. Our true friends will be the first to tell us when we are full of hot air. Our fake friends will be the last to tell us when we are wearing our underwear on our heads!

I’ll leave you with a couple of quotes on fitting in:

“I refuse to join any club that would have me as a member” Groucho Marx

“I want my individuality, so why can’t I get a tattoo? Everyone else is.” My neighbor’s teenager

The floor is now open for your comments. Please join in.

*This blog post was originally published at eDocAmerica*

US Radiologists: Jobs Outsourced To India

More hospitals are resorting to so-called “dayhawk” radiology services to read their x-rays.

It’s modeled after the “nighthawk” model, where radiologists (via Shadowfax), in some cases as far away as India, remotely read films in the middle of the night.

Now, the phenomenon is happening during business hours as well, which according to radiologist Giles W. L. Boland, means that “some radiologists can no longer assume long-term job security because their core value proposition can now be outsourced.”

This trend was entirely foreseeable. Cash-strapped hospitals are finding it cheaper to outsource x-ray readings, and furthermore, it seems that both nighthawks and dayhawks provide better service and more timely interpretations. This adds up to a declining need for an in-house radiology staff.

That’s bad news for some. Radiology departments at smaller hospitals may close, and eventually general radiologist salaries will come under pressure.

The answer? Like everything else in medicine, radiology sub-specialists will increasingly be in demand. Expect procedure-based, interventional radiology to grow, since what they do cannot be outsourced. Health care costs will correspondingly rise.

So, like primary care, don’t be surprised if the days of general radiology are numbered.

**This post was originally published at Dr. Kevin Pho’s blog, KevinMD.**

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