Who are the doctors who don't get stressed at work? According to this meta-analysis, the personality type to have is: extravert who is open to experience and has a deep learning style. If you are this type, congratulations! If not, read below, and be sure to check the references at the end.

The Big Five personality inventory measures personality based on 5 key traits:

1. neuroticism
2. extraversion
3. agreeableness
4. openness to experience
5. conscientiousness

There are several approaches to work (SSD):

- Surface-disorganised approach is apparently the worst, and is predicted by surface learning in medical school and by higher neuroticism scores and lower conscientiousness

- Surface-rational approach to work is predicted by strategic learning in medical school, and by less openness to experience and higher conscientiousness

- Deep approach to work is predicted by a deep approach to learning at medical school, by greater extraversion, by greater openness to experience, and by lower emotional exhaustion. This is supposed to be the best.

A deep approach to work occurs in extraverts who are open to experience and have a deep learning style. The surface-rational and surface-disorganised approaches to work are both greater in those with a surface learning style. However, a surface-disorganised approach occurs in individuals with higher neuroticism scores, in those with lower conscientiousness scores, and in those who have been stressed, whereas the surface-rational approach to work occurs in strategic learners and in those who are low in openness to experience.

A workplace climate dominated by a high workload is predicted by higher stress and emotional exhaustion measures five years earlier, and by lower openness to experience. A supportive-receptive workplace is predicted by lower stress and depersonalisation, and a higher sense of personal accomplishment when measured previously, and by a more agreeable personality.

"A critical element contributing to the stress that many conscientious doctors experience is internal". According to researchers, stress is not a characteristic of jobs but of doctors. Different doctors working in the same job being are no more similar in their stress and burnout than different doctors in different jobs.

References:

Stress, burnout and doctors' attitudes to work are determined by personality and learning style: A twelve year longitudinal study of UK medical graduates. BMC Medicine20042:29, DOI: 10.1186/1741-7015-2-29.

Physician Burnout Now A Top Concern Across the United States. Wael Barsoum.

Who blogs? Personality predictors of blogging

From The Lancet:

Small molecule inhibitors of Janus kinase (JAK)

Much of the recent knowledge of the underlying mechanisms that drive rheumatoid arthritis and other diseases has come from preclinical studies of key cytokines, including tumour necrosis factor alpha, interleukin 6, and granulocyte–macrophage colony-stimulating factor. New Janus kinase (JAK) inhibitors include tofacitinib and baricitinib which are approved for treatment of arthritis and other rheumatoid diseases.

Aggressive treatment, early

For a complex, progressive, chronic disease such as rheumatoid arthritis, the timing of intervention is critical. In the past, the recommended treatment approach was slow and steady, referred to as “the pyramid”—ie, a base of physical therapy and non-pharmacological interventions, followed by conservative treatment with non-steroidal anti-inflammatory drugs, then glucocorticoid steroids and, finally, administration of a conventional disease-modifying antirheumatic drug (DMARD). This concept is now inverted. Intensive intervention, initiated earlier, with conventional and biological DMARDs is increasingly recommended.

Biologics and small molecule inhibitors are added to the therapeutic arsenal. Focus on early window of opportunity for management, with treat-to-target approaches that include rapid intervention, and adjustment of medications for patients who do not achieve remission within 6 months. The new campaign, “Don't delay, connect today”, highlights this approach.

Affordability

Biosimilars might provide affordable options.

An unprecedented range of therapeutic options for rheumatic diseases is now available—the new challenge is to make them accessible.

References:

A platinum age for rheumatology - The Lancet http://buff.ly/2slCFPw

From WSJ: As an alternative to meetings, buff bosses are inviting their employees to exercise and work out (video):



Some prospective employers ask baffled applicants to take jogs, lift weights or do sit-ups; ‘I thought I was going to pass out’, says one job applicant. Read more in WSJ here: Thanks for Your Job Application—Shall We Begin at the Squat Rack? http://buff.ly/2qNEG24

The one and only Dr. Roizen shares tips for Living to 100, using some memorable buzz words, among them:

- avoid the "major agers" of stress and lack of sleep
- have a relationship with your food - choose foods that "love you back"

Here is the Cleveland Clinic Chief Wellness Officer, Mike Roizen, M.D.: