President's Letter

Timothy P. Villegas, M.D.

Timothy P. Villegas, M.D. | President's Letter

I'M SAFE. Are you?

Continuing this month on the theme of applying general aviation principles to the practice of medicine, there's a very easy to remember acronym that is used to make sure a pilot is in good condition to fly: "I'M SAFE". This checklist is clearly applicable to physicians as well, to help make sure that we are
taking care of ourselves, so that we in turn are best able to take care of our patients.

Illness: We've all heard the adage, "physicians make the worst patients." I think most of us would agree that, more than many other occupations, we physicians seem likely to work through pain and illness due to a sense of commitment to our patients and colleagues. It's important to keep in mind that we may be causing more harm than good if we try to press on and provide care when we are less than 100%. This recent flu season probably provided some good examples of this!

Medications: As physicians we all know the potential impact of taking medications on a person's functional capacity. This not only includes many prescription drugs, but of course over-the-counter ones as well. Antihistamines, antiemetics, psychotropics, analgesics, anxiolytics, etc. can all impair physical and mental functioning and potentially contribute to unfavorable results.

Stress: Of course, everyone handles stress differently. Some thrive on it and believe they perform their best under pressure. That said, an accumulation of ongoing stressors, either physiological or psychological, clearly has the potential to adversely affect our judgement and actions as physicians. We need to be mindful of the benefit of stress-reduction techniques, and allow ourselves necessary physical and mental breaks with regularity.

Alcohol: The FAA says a pilot cannot fly unless it has been at least 8 hours since the last intake of alcohol AND blood alcohol content is <0.04%. There aren't such well-defined regulations for physicians, but it seems reasonable to apply the same standard whether you are flying an airplane or performing surgery.

Fatigue: I always found it ironic that with current residency work hour restrictions, we limit the number of hours a physician can work without a break; however, there are no such restrictions once you are out "in the real world". Isn't this when it is the most important ? when there is no attending or upper-level looking over your shoulder or available to ask for assistance? As it stands, it is difficult to quantify how much physician fatigue contributes to medical errors. We all know that studies show sleep-deprivation can have a significant negative impact on judgement and coordination.

Emotions/Eating: This is a two-for-one. As far as emotions go, we all have times in our lives where we find ourselves angry, impatient, upset, frustrated or saddened. There are innumerable emotional states that can adversely affect our job performance. Whether it's recovering from a loss, a fight with a spouse, a disagreement with a colleague or a difficult patient, we need to be aware of our frame of mind, and how to manage it to minimize any negative impact. Eating is more straight-forward: for those with long, physically- and mentally-demanding call nights (dermatologists can skip this part), we need to keep our bodies well maintained, healthy and energized with a well-balanced diet and remember to stay hydrated.

In short, taking care of ourselves by regularly utilizing the I'M SAFE acronym as developed in general aviation is an excellent way for us physicians to make sure we are in the best shape we can be to take care of others. So be safe!