We physicians are famous for being the last to acknowledge that we're stressed or even that we require a little routine maintenance. Perhaps it's because giving to our patients is so ingrained in our personalities that we sometimes count everyone else at the table, but forget to count ourselves. We hate to admit when we're tired, sick or when our bodies are showing signs of wear, but we need to be alert to these signs. We can save our practices — even our lives — by taking some time every day to listen to what our bodies and minds are telling us.

Listen to your body

Are you ill? Exhausted? Too worn out to keep the pace you've set? Are weekends or vacations no longer enough for you to feel rested?

Try to be more realistic. If you have hypertension, angina, diabetes or any other illness, don't ignore it, don't treat it yourself, and don't procrastinate about getting the best care available. Look at it this way: If you insist on ignoring the signs of illness or exhaustion, the weeks or months it takes to recover will cost you much more in lost productivity than would a few days off to rest and relax.

Ask yourself: Is it time to slow down? Shrink your practice? Retire? Don't feel pressured to keep going at a 30-year-old's pace if you're 50 or 60. Take time to weigh the realities of your own situation calmly and objectively, and make the changes that you sense would be right for you.

Perhaps all you need is a power nap after lunch. Don't laugh! Winston Churchill and George Bernard Shaw took daily afternoon naps to maintain their productivity. Some older doctors have told me that this simple measure helped them extend their working lives by several years.

Listen to your mind

How high is your stress level? Are you losing sleep, your peace of mind, your optimism and your oomph? Are you just plain burning out?

Many of us have realized that we need to do some daily preventive care to neutralize the stress that comes with practicing medicine. Whether it's exercising, meditating, flying, sailing, relaxing with family and friends, playing a musical instrument or rebuilding a motorcycle, you should make it part of your regular routine. It's as important as anything else you do.

Another way to combat stress is to teach yourself not to get upset about anything small. For example, losing less than an hour's time just isn't worth banging on your arteries. You can also try alternating your tasks so you have some variety in your day and talking to your colleagues about stress and how they manage it. If your own efforts at stress management fail, professional therapy can help; many of us have used it. In any case, don't sacrifice your own peace of mind to keep the ship afloat. As my drill sergeant in boot camp once told me, “You can't lead if you can't survive.”

If the stress just won't go away, there are other honorable alternatives: You can change your group or your practice, or your specialty, or even your career. Medicine is a good profession but a bad obsession that's not worth dying for. And severe stress can kill you.

Listen to your spirit

Is medicine still a labor of love for you? If so, you'll definitely find ways to keep practicing — even if it means learning a new specialty, moving to a new state or adjusting your financial expectations. But no matter how much we love our profession, unrelenting hard work and other pressures of practice can take their toll — especially if we don't acknowledge our own needs. Right now many of you may be going through a period of stress or pain. It will pass, but there's no magic bullet. Start by taking small steps, and keep moving. By listening carefully to your body, mind and spirit, you can obtain the professional satisfaction you've been looking for.