Dr. Craig Newgard is an emergency physician from Portland, Oregon. When he is not in the ED, Dr. Newgard can be found on his mountain bike, conquering the unpredictable trails of his community. Although it can be challenging to incorporate a routine schedule into life as an emergency physician, he has found that it helps him achieve balance and avoid burnout. Here’s how he stays healthy in EM!

• Name: Craig Newgard, MD
• Location: Portland, OR
• Current job(s): Attending Physician, Professor of Emergency Medicine – Dept of Emergency Medicine, Oregon Health & Science University
• 1 word that describes how you stay healthy: It’s hard to use just 1 word! I would say “Integrating health into my daily/weekly routine.”
• Primary behavior/activity to help de-stress: Mountain biking

What are the top 3 ways you keep healthy?

Exercise is my #1. I have been developing this strategy since I was a resident (1997-2000). I’ve commuted to work and school by bike for over 30 years – including time in Sacramento, Chicago, New York, D.C., L.A., Buenos Aires, and now Portland. This is my time to exercise and let my mind relax or wander (active meditation). It also helps ensure that I keep my roots as a kid on a bike. In addition, I take one day a week to ride mountain bikes in the forest – this is a sacred day that I have preserved for over 20 years in different cities, along with several other emergency physicians. I also lift weights 3-4 days per week. This is my composite exercise regimen. Other ways I stay healthy are diet (fresh food, lots of vegetables; no fried food, fast food, or dessert) and listening to hard rock and metal – unhinged music for the soul!

What is your ideal workout?

I have several of these, but my favorite is free-ride mountain biking deep in the forest with a few friends. This is a type of riding that involves a combination of trail, big jumps, elevated beams, tricks, and various combinations of speed and technical skill. It is dangerous for sure, but it is also amazing and intense, plus involves riding up mountains to get to the descent. Riding some big lines with friends for 3-4 hours and seeing huge smiles on sweaty faces at the end is my ideal workout.

Do you track your fitness? How?

I don’t use a heart rate monitor or apps, but instead prefer to keep it simple with a mental log. This ensures that the activities remain fun and enjoyable. I weigh myself most days to keep my weight within +/- 2 pounds of what I think is my ideal body weight, and I adjust my intake accordingly. I generally stick with the same composite routine each week, so I know my weekly miles and stats. My gains are usually measured in speed and time, weight and reps, and the complexity of free-ride lines I can pull off.

How do you prepare for a night shift? How do you recover from one?

I’ve been at this job for 18 years and still don’t have this question figured out.

Pre-shift: I generally work in the office during the day (the research part of my job), work out, leave a little early, eat dinner with my family, try to sleep 2 hours, drink a pot of mate, then ride back to the hospital. The ride at night helps and I’m definitely awake by the time I get back there.

Post-shift: For recovery, I eat breakfast and sleep on a cot in my office after the shift, trying to secure some ‘anchor sleep’ that (might) partially overlap with my normal sleep hours. This said, night shifts wear me down and take me several days to recover – they get harder as you get older. My resting heart rate is higher for 1-2 days after a night shift. This is a downside to our job.

How do you avoid getting “hangry” (angry due to hunger) on shift?

I mainly try to drink water and eat an energy bar if I can. I’d rather eat a meal after the shift, when I can relax a bit. This isn’t usually possible on-shift.

How do you ensure you are mentally in check?

Exercise, diet, sleep, and time management. My ways to stay healthy keep me mentally sane. I consider exercise and my one day in the wilderness each week part of my mental health program. I would have burned out long ago if not for these activities. For time management, I try to focus my work time and play time (including family). I try not to work from home and really be present for my wife and kids when I’m there. I also do a lot of building, projects, and landscaping at our house – working outdoors. This separation of work and home helps keep me mentally in check.

What are the biggest challenges you face in maintaining a longstanding career in EM? How do you address these challenges?

I believe that burnout is our number one challenge in EM. There are many reasons why we are susceptible, which has been demonstrated in several high-quality research studies. For me, the antidote to burnout is a composite regimen of exercise, diet, sleep, perspective, time management, occupational diversity (integrating non-clinical aspects to your job), and nurturing the many non-work aspects of our lives (family, friends, non-work activities). EM is a hard job, particularly if done over 30-40 years, so having a recipe for maintaining balance, physical, and mental health is crucial.

Best advice you have received for maintaining health?

Continuity and consistency with diet and exercise. This includes not only regular activity, but having specific days and times each week that you engage in it. These items should not be sporadic or done when we have time. They should be part of our regular routine, integrated to the daily work flow.

Who would you love for us to track down to answer these questions?

Alex Lapidus
Jeff Kline
Josh Lupton

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