How giving back to the community can recharge
Like most people, Gary L. LeRoy, MD, a primary care physician in Dayton, Ohio, usually just wants to go home after work. He puts in long days as an assistant dean at Wright State University's Boonshoft School of Medicine and doing clinical work at the East Dayton Health Center, where he's practices for two decades.
Still, he finds time for an impressive list of volunteer obligations, including hours at a local free clinic, homeless shelter, the Red Cross and local schools.
“I have to admit that sometimes when my volunteer night at the clinic comes up, I go somewhat begrudgingly. I’ve worked all day and I feel kind of burnt out,” LeRoy says. “Without fail, those hugs and handshakes make you feel, ‘Oh my gosh, that’s why I keep coming back to this thing.’
“I’m dragging in the door, and I’m skipping out.”
The hugs and handshakes prove his volunteer work helps others. The “skipping out” proves that’s it’s somehow helping him too.
It’s a refrain repeated by other physicians who give away their time to charitable causes: Volunteering has its own rewards. And the research bears it out. After adjusting for socio-demographic factors, multiple studies have shown that adults who volunteer enjoy better mental and physical health and lower mortality rates.
For physicians, there are additional benefits. Volunteering, even to causes unrelated to medicine, can be a sort of inoculation against what’s become an epidemic of physician burnout, says Gail Gazelle, MD, FACP, FAAHPM, a hospice and palliative care physician in Boston who also provides executive coaching for physicians and physician leaders.
Primary care doctors are especially at risk, she says, because they deal with problems that have no easy fixes, including rising costs, government scrutiny and administrative hassles. “Doctors become disconnected from their sense of meaning and purpose and accomplishment,” Gazelle says. “That’s the biggest problem with burnout.”
Even as they continue to help patients, doctors can begin to feel isolated, that they are not accomplishing much, that they’ve lost a sense of meaning in their work. Emotional depletion, feelings of inadequacy, cynicism and depersonalization soon follow. One client Gazelle coaches, an oncologist, told her that interactions with patients had started to feel like “business transactions.”
Volunteering can be an antidote, Gazelle says. “Volunteering is like a dose of ‘I’m efficacious and I have things to contribute in the world,’” she says. “It’s kind of like a reset, to help somebody get back on the path of being able to see the worthiness of what they do and then their inherent worth.”
About a decade ago, the economic crisis began clobbering the already-struggling rust belt community of Youngstown, Ohio, near where Thomas E. Albani Jr., MD, has his solo primary care practice. He began seeing and hearing about more people who couldn’t afford health insurance and who were unable-or unwilling-to get public assistance.
In 2008, Albani and a group of volunteer nurses opened the Midlothian Free Health Clinic to provide primary care to low-income adults without insurance. The clinic is open two evenings a month at a local church.
In the nine years since, the clinic has served thousands of patients, expanded services to offer physical therapy and dental care and has grown into an operation with about two dozen other physicians, nurses and volunteers. The clinic providers have caught cancers, diagnosed heart problems and spotted other conditions early, saving the lives of people who would have otherwise likely received care only when it was too late, he says.
“When you watch the impact it has on their lives and you see their faces, the tears and the hugs, it really humbles you and makes you recognize that what we do has a lot of value,” Albani says. “We can truly make a world of difference for people.”
Albani says his work at the clinic leaves him feeling refreshed, partly because it allows him to focus on just one thing. “There is no need to worry about insurance forms and all of the red tape that we deal with in our private practice,” he says. “We can take care of our patients and simply focus on medical care. It takes it back to why you got into medicine in the first place.”
LeRoy gets that same feeling when he volunteers, especially when he’s called upon to do what he calls “instant volunteerism,” from helping sick passengers on an airplane or volunteering at Dayton’s annual air show in the medical tent.
“When I went to medical school, that’s part of why I wanted to be a primary care physician, so I could respond to any kind of situation,” he says. “Sometimes divine intervention happens, and you’re like, ‘This is why I do what I do.’ It recharges your batteries instantly.”
For physicians new to a community or those in solo or smaller practices, volunteerism can have another benefit: It’s great public relations. “People in the community pay attention to these things,” Albani says. “They watch what’s going on in the community. They acknowledge what you do. It’s a thumbs-up sign in the community.”
About two-thirds of physicians do some sort of volunteer work, according to a 2015 survey by the Journal of Compassionate Health Care. Pro-bono medical teaching was the top volunteer activity of doctors (54% said they did it), followed by providing free care at their practice (39%) and volunteer work at a clinic or outreach program (38%).
A 2016 Permanente Journal survey of physicians who volunteered at safety-net clinics in California confirmed that many viewed their work as an “escape hatch” of their regular jobs. The biggest challenge to volunteering? Finding the time to do it. “Time is a physician’s most precious commodity, and they don’t have enough of it,” says Gazelle.
So how can physicians who want to volunteer carve out time in their already packed schedule to do it? One answer seems obvious, says LeRoy: “Make it part of your schedule, so that nobody intrudes on it.”
Albani suggests starting small. “They will be happy to have you come out and help, even if it’s just for a few hours once a month or maybe once or twice a year,” he says. “I have clinic volunteers and physicians who may only be able to come out once every month or two.”
Physicians who already feel that they don’t have enough time for their families, their faith or their community should be strategic about their volunteering, says Vania Manipod, DO, a psychiatrist who specializes in treating burnt-out physicians and medical students in her practice in Ventura, California.
“I have seen physicians who feel like they aren’t getting time for their children or their religion,” she says. “My recommendation would be to volunteer at your kid’s school, go on a field trip with them or volunteer for religious activities to get reconnected with your spiritual place of worship.”
Manipod says physicians, even if they work in a group practice, can easily fall prey to feelings of isolation. “I barely ever get to see my co-workers, because we’re just running back and forth,” she says. Volunteering, however, restores “meaningful connections” with others, Manipod notes.
More often than not, physicians will know where they are needed most in the community, just by listening to their patients, says Karen L. Smith, MD, who has a solo primary care practice in rural Raeford, North Carolina.
In 1989, while getting her medical degree in Philadelphia, Smith was asked to give a talk to her church about the then-exploding AIDS epidemic. “The community was just scared to death,” she remembers. “I was called upon to try to allay the fears of the people in the congregation. So here I was, a semi-health professional who could really talk about the issue that was sensitive to the population and bring it under control so people were not fearful but were understanding.”
She realized the influence, and obligation, she had as not just a healer but an educator. She was hooked.
Today, Smith devotes most of her volunteer activities to education and advocacy, giving health presentations, speeches, even appearing regularly on a Friday morning radio show to talk about health issues. She sees her clinical work as helping one person at a time while her volunteer work helps scores.
Smith suggests physicians find a health issue that they are passionate about, create a speech or presentation and then reach out to local chambers of commerce, civic groups and local libraries. “Ask them, ‘Do you need a speaker on healthcare topics that affect our community?’ I can almost assure you they will give you a yes response,” she says.
Smith, LeRoy and Albani all have children, and they have all seen their volunteer activities make a strong impression on them. LeRoy’s oldest is a medical social worker. Three of Albani’s children have entered medical fields. And Smith’s daughter is getting a Master’s degree in public health.
“Sometimes we think that our children are not paying attention, especially when they’re teenagers and they’re shrugging their shoulders and rolling their eyes,” says LeRoy. “But that stuff we talked about and that she saw, it sank in.”
Perhaps volunteering’s greatest benefit for physicians is both self-serving and world-serving: Volunteering makes the community a better place. And because of their training and education, physicians have an obligation to volunteer, to give back to their communities, LeRoy says.
“You help others in an unselfish way, not for money or fame or recognition, but just because you are living and breathing on this Earth,” he says. “You have a privilege of being able to help others, so that’s what you have to do.”