What healthcare can learn from Olympians

2013-02-03 Aquathlon - Sangudo

Blog post by Colin Hung

Rio - Ismael CellsThis week marks the start of the games of the XXXI Olympiad in Rio de Janeiro. Over 11,000 athletes from 206 nations will be competing for top honors in their sport. Collectively these elite athletes represent the pinnacle of their respective sports.

In honor of the Olympics I thought it would be interesting to discuss four key elements to becoming an Olympian – training, talent, focus and support. It’s no coincidence that these elements are also key to becoming a medical professional.

Training

Olympic athletes train daily over years to compete in their sport. Take a look at this example schedule from Natalie Coughlin, a 12-time Olympic medalist in swimming:

  • 7am Wake-up. Oatmeal breakfast #1
  • 8am Swim #1
  • 9am Recovery & smoothie
  • 10am Breakfast #2
  • 10:30am Nap
  • 11:30am Lunch
  • 12:30pm Gym & Swim #2 (3hrs!)
  • 3:30pm Recovery & smoothie #2
  • 5:30pm Dinner
  • 8:30pm Bedtime

Back in 2014, I had the privilege to listen to Sky Christopherson talk about how he used detailed biometric tracking to help the 2012 US women’s cycling team achieve amazing results. Each cyclist kept meticulous records of what they ate, when they went to bed, how they trained, etc. Christopherson crunched that data (with some help from a big data Silicon Valley startup who donated their processing time) to build customized training programs for each athlete.

What was fascinating was that Christopherson’s analysis found that some athletes did not require the 10-12 hours of sleep that was the commonly accepted best practice for elite performers. For one cyclist in particular sleeping more than 9 hours had a detrimental effect on their performance.

With the rise of personal health trackers and wellness apps, I wonder how long before this type of sports science is applied to the healthcare profession. In fact, I wonder if there isn’t a surgeon out there who is using data tracking of their diet, health and wellness to help them perform at a high level. It might be far-fetched today, but I can totally foresee a day when a hospital offers performance bonuses to nurses and physicians in return for tracking their fitness.

Back to reality.

Like elite athletes, doctors and nurses go through years of training. This training is intense and is focused on the clinical fundamentals of the profession. There is little time dedicated to teaching non-clinical skills like how to establish a relationship with patients, how to run a financially sound medical practice or how to take care of yourself as a medical professional. Should more emphasis be placed on this aspect of medical education? Should we not take a cue from Olympic athletes who do more than just train their bodies?

Talent

Despite what Malcolm Gladwell wrote in his book “Outliers”, more than 10,000 hours of practice is needed to become an Olympic athlete. Innate talent is also required – talent that can now be quantified thanks to the advancements in sports science.

Athletes can now be tested for lung capacity, maximum muscle exertion and fast-twitch response rates. Based on these types of tests, athletes can track their progress in great detail. Kate Carter a writer for The Guardian put herself through some of these tests back in 2013 and wrote an excellent piece about her humbling experience.

With this type of testing it is also possible to identify high-potential athletes in their earlier years – which makes me wonder, could the same be applied to healthcare? Can we quantify healthcare talent and somehow design a test for it? Is talent a critical factor in healthcare hiring? Should it be?

Focus/Mindfulness

One of the most exciting areas of advancements in sports has nothing to do with physical conditioning. Mental and cognitive training has become an important part of every Olympic athlete’s regimen. Consider this story about soon-to-be 39 year old Merrill Moses of the US Water Polo Team:

After speaking with Moses, and figuring out what accounts for his longevity–aside from his hard work ethic and stellar genetics–it turns out that meditation and mindfulness, in his view, explain his success over the years. “I visualize a set of moves in my mind, taking myself through a sequence and feel that it helps to boost my confidence,” said Moses.

Later in that same article the importance of mindfulness is highlighted:

“Mindfulness can play a key role in harnessing this excess energy, ” explained Dr. Amy McGorry, a physical therapist practicing at Thrive Integrated Physical Therapy in Manhattan. “Yoga can help an athlete achieve this state of mindfulness, and has even helped many of my patients eliminate the ‘noise in their heads’ when facing competition, including their fear of not performing at 100% or fear of re-injury. “Certain types of yoga can help the athlete focus on the present moment and their breathing, and help them gain that body awareness so they can trust moving again,” added McGorry.

Focus and mindfulness in healthcare can have tremendous benefits for doctors and nurses. Suzanne Beyea published a piece for the Agency for Healthcare Research and Quality on this very topic:

The clinician who is mindful of the negative impact of interruptions and distractions may react with increased attention, focus, and concentration on his or her work environment. For example, a physician or nurse might go to a quiet space to review orders or complete other high-risk functions such as calculating a medication dose or writing and reviewing orders. Another strategy in mindfulness is to stay calm and regulate one’s emotions. When clinicians are distracted or interrupted, becoming distressed could further contribute to making an error. Being present consists of putting aside external worries, distractions, and interruptions and centering one’s concentration on a particular work task. Being present for a particular work activity in a busy intensive care unit might be as simple as preparing medications in an NIZ, turning one’s personal cellphone off, and asking others to minimize distractions.

Support

Olympic athletes need a tremendous amount of support, especially financially. It’s a common misperception that Olympians are fully funded by governments and sponsors. Jeremy Taiwo, a US decathlete at Rio, is one such example as reported in this Fortune post:

“he’s been living below the poverty line, sometimes struggling to pay his rent. (He lives with his girlfriend, the French track Olympian Justine Fedronic, in Seattle.) These financial restrictions have also limited his ability to compete this year, he says…Among Taiwo’s costs are plane tickets to get to competitions, weekly physical therapy, and of course fees for shipping all of his athletic equipment to meets.

In Canada it is estimated that Rio athletes, as a group, spend $27.5M more than they earn (about $14K per athlete) from sponsors and the Canadian government. Much of this debt is covered by the parents and family members. In fact, parents compare taking care of their elite athletes to caring for toddlers – cooking, clothing and cleaning so that their son/daughter can pursue their gold medal dreams. It takes upwards of 10 years for an Olympian to reach a competitive level.

The debt per Olympic athlete is remarkably close to that of medical students ($140K vs $166K) with the same burden placed on the family for that debt. The debt load on medical students is concerning. Already I suspect that the debt-to-payoff is affecting enrollment in lesser-paying specialties, like OBGYN. #hcldr friend Dan Munro wrote about this topic back in 2014.

Please join our #hcldr tweetchat Tuesday August 9th at 8:30pm ET (for your local time click here) when we will be mimicking Olympic TV coverage and touching on four different topics in our hour together:

  • T1 What areas of healthcare would you like to see greater training emphasis?
  • T2 In clinical care, do feel talent over or underrated? If not talent, what else should be used to judge people?
  • T3 How might leaders set an example for mindfulness and focus in healthcare?
  • T4 What financial, emotional, or physical support could we give to medical/nursing students that isn’t given today?

References

“Can Mindfulness Help Stop Health Worker Burnout”, Emily Nauman, Greater Good, 17 March 2014, http://greatergood.berkeley.edu/article/item/can_mindfulness_help_stop_health_worker_burnout, accessed 7 August 2016

“How can health and care professionals use mindfulness?”, Sarah Johnson, The Guardian, 7 June 2016, https://www.theguardian.com/healthcare-network/2016/jun/07/health-social-care-professionals-use-mindfulness, accessed 7 August 2016

“Interruptions and Distractions in Health Care: Improved Safety With Mindfulness”, Suzanne Beyea, AHRQ Perspectives on Safety, February 2014, https://psnet.ahrq.gov/perspectives/perspective/152/interruptions-and-distractions-in-health-care-improved-safety-with-mindfulness, accessed 7 August 2016

“How Mindfulness Meditation Can Transform Health Care”, Charles Francis, Huffington Post, 11 December 2015, http://www.huffingtonpost.com/charles-a-francis/how-mindfulness-meditation-can-transform-health-care_b_8494900.html, accessed 7 August 2016

“How Mindfulnees Propelled USA Olympic Water Polo Player Merrill Moses to the Olympics”, Robert Glatter MD, Forbes, 4 August 2016, http://www.forbes.com/sites/robertglatter/2016/08/04/how-mindfulness-propelled-usa-olympic-water-polo-player-merrill-moses-on-his-roadtorio/#39c0ad8e16ee, accessed 7 August 2016

“The 10,000 Hour Rule”, Malcolm Gladwell, Gladwell.com, http://gladwell.com/outliers/the-10000-hour-rule/, accessed 7 August 2016

“Can 10,000 hours of practice make you an expert?”, Ben Carter, BBC News, 1 March 2014, http://www.bbc.com/news/magazine-26384712, accessed 7 August 2016

“Malcolm Gladwell got it wrong: Deliberate Practice not 10,000 hours key to achievement, psychologist says”, Tristin Hopper, National Post, 12 April 2016, http://news.nationalpost.com/news/canada/malcolm-gladwell-got-it-wrong-deliberate-practice-not-10000-hours-key-to-achievement-psychologist-says, accessed 7 August 2016

“Here’s What an Olympic Athlete’s Training Schedule Looks Like (Hint: It’s not easy)”, Dominique Astorino, Pop Sugar, 22 April 2016, http://www.popsugar.com/fitness/Olympic-Swimmer-Natalie-Coughlin-Training-Schedule-41038115, accessed 7 August 2016

“Have you got what it takes to be an Olympic Athlete?”, Kate Carter, The Guardian, 28 January 2013, https://www.theguardian.com/lifeandstyle/2013/jan/28/got-what-it-takes-olympic-athlete, accessed 7 August 2016

“Rio 2016: Canada’s athletes indebted to the tune of $27.5 million a year”, Brian Hill, Global News, 29 July 2016, http://globalnews.ca/news/2854091/rio-2016-canadas-athletes-indebted-to-the-tune-of-27-5-million-a-year/, accessed 7 August 2016

“What it takes to feed a Canadian Olympic athlete”, Kenneth Chan, Daily Hive, 5 August 2016, http://dailyhive.com/vancouver/what-it-takes-to-feed-a-canadian-olympic-athlete, accessed 7 August 2016

Image Credit

2013-02-03 Aquathlon – Sangudo https://flic.kr/p/dSX77w

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