- The Washington Times - Monday, December 25, 2006

Physician, heal thyself. But do they?

The holiday season can be especially challenging. Think of all the cookies, candy and other tempting offerings from grateful patients and their family members showered on doctors already under stress in life-and-death decision-making specialties.

Dr. Robynne Chutkan, 40, a gastroenterologist affiliated with Georgetown University Hospital, knows about such temptations and avoids them.

“My downfall is sweets. The minute stuff comes into the office, I take them to nurses at Georgetown and fatten them up,” she says lightheartedly. “If I open one up, it is over.”

As director of the Digestive Center for Women in Chevy Chase, treating digestive disorders of all kinds, she is seriously concerned about the effects of stress in society and has taken steps to control it in her own life. One major step: “I started taking Fridays off years ago.” Away from work, she will take a yoga class and, in winter, she often goes snowboarding. In summer or fair weather, she will go running or play tennis. One day a week she goes to a gym before work.

“I decided early on what was important. Isn’t life about living? I thought it would be nice to be chair of a department, but when I look at colleagues — I don’t want their life. They work all the time. Being able to buy time is important,” she says.

It helps, she says, to be a two-income family and have a husband who is just as disciplined as she. She doesn’t drink caffeine but will have a glass of wine with meals at night. She and her husband cook at home and they have a ski house in the country where there is no television, computer or cell phone reception.

“The fountain of youth is eating a healthy diet, and we all know what that is and it isn’t McDonald’s,” she says. “Second, don’t smoke. Third, get as much exercise as you can — one half to one hour five days a week.”

Her only downfall is not getting to her internist for regular physical exams.

“I’m not that good about going. I get there every 18 months,” she says.

Cardiologist David Pearle, 64, also with Georgetown, agrees that his peers are well-positioned to get the best treatment available “and hopefully apply the same standards [of preventive care] they recommend to patients. ? It is a common problem that physicians are cavalier about their own health care,” he says, recalling the saying that “the doctor who takes care of himself has a fool for a physician.”

“I’m not as careful about my diet as I should be,” he admits. “I was a big-time runner for years, and weight has gotten away from me.”

He visits his internist, gets colonoscopies on schedule, takes statins and aspirin and makes sure to keep his lipid levels on target. He finds a major stress-reliever to be owning a second home, which he and his wife bought in the Berkshires, in Massachusetts, two years ago.

“I feel weight off my shoulders when I am there,” he says.

George Washington University Hospital orthopedic surgeon Dr. Panos Labropoulos, 59, a specialist in reconstructive foot surgery, is only half joking when he says he gets his exercise walking in the office: “I’m sure I do more than 40 miles a week going up and down from the operating room and back.”

Dr. Shmuel Shoham, 37, an infectious disease specialist at Washington Hospital Center, is careful to take off his work clothes and put on what he calls “home clothes” and different shoes when he gets home — a preventive gesture to protect his young children whom he says “get their mouths on everything.” In addition, he does some sort of cardiovascular activity several times a week, usually on a treadmill in his house.

At the hospital, he climbs stairs instead of taking an elevator.

“When I’m not getting exercise, I park my car farther away than normal,” he says.

Another special activity, he says, is sharing his own health problems with his patients, even telling them when he has forgotten to take medicine for his high blood pressure.

“I share my successes and struggles, and since I take care of patients with HIV, taking medicines is extremely important.”

Georgetown’s Dr. Aziza Shad, director of pediatric hematology and oncology, who gives her age “in the late 40s,” also says she believes in separating the worlds of home and work. The mother of three boys, she praises an eight-week hospital program that taught techniques of meditation and what she calls “different coping skills.” She goes to a gym once or twice a week, walks as much as she can, and has banned red meat and white bread at meals.

Even so, she admits, “I could easily lose 10 pounds,” and she hasn’t had a mammogram or been to a doctor in two years because “there always is something else pressing to be done.”

Likewise, Dr. Anisa Abraham, assistant chief of adolescent medicine at Georgetown, makes sure she sees her gynecologist and gets a general physical yearly as well as going to the dentist twice a year. She has started doing yoga in a class, and takes a gym bag three or four times a week to be sure she exercises after work.

“Sometimes we [doctors] aren’t so good about listening to our own message,” she says. “My mother is a nutritionist, so I have strong ideas about eating and I even pack my lunch every day so I eat well: chicken breast and spinach that I heat up, and then fruit or yogurt.”

She says she feels strongly about the importance of getting enough sleep, a rule she says physicians notoriously do not observe.

Despite their health-related shortcomings, physicians overall are “60 percent less likely to die [early] than others in the same population, race and age,” and “are better than the general population even in their preventive care,” according to Dr. Michael J. Klag, 54, dean of the Bloomberg School of Public Health at Johns Hopkins University. An internist by training, he says he eats well, but working exercise regularly into his schedule can be a problem.

His information comes from an ongoing landmark investigation, called the Precursors Study, which he now heads. Currently, 1,000 Hopkins School of Medicine graduates from the classes of 1948 to 1954 report annually on their vital signs, yielding a mother lode of data. Findings showed that physicians are 80 percent less likely to get lung cancer and emphysema, but for things like depression, there is not much difference from the rest of the population, he reports.



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