I am Dr. Richard Bounds, Associate Program Director: How I Stay Healthy in EM
Dr. Richard Bounds is an emergency physician from Newark, Delaware. His habits and beliefs definitely resonate with the philosophy of maintaining every day wellness. Despite being the Associate Program Director, Dr. Bounds uses the strategy of prioritizing to still make time for himself and his family. Here’s how he stays healthy in EM!
- Name: Rich Bounds, MD, FACEP
- Location: Christiana Care Health System, Newark, DE
- Current job(s): Associate Program Director, Emergency Medicine Residency, Co-Director, Medical Education Fellowship
- One word that describes how you stay healthy: Priorities
- Primary behavior/activity for destressing: Trail running
What are the top 3 ways you keep healthy?
- Relationships. My wife and 3 kids come first, and it’s a constant challenge when you’re in an academic career with shift work and seemingly endless demands for your time. But I know that making time for them and keeping my family as the top priority will make me a better person and a better physician.
- Exercise. I try to do something just about every day, no matter how busy things get. I’ll get up before sunrise to get a run in with my headlamp, or I’ll just hit the gym for 20 minutes after work. Sometimes all I can do is squeeze in 50 push-ups before my shower. I find that I just feel so much better if I’ve done something active each day.
- Sleep. I used to live by the “sleep when you’re dead” philosophy, usually getting 5-6 hours per night at most, so that I could get more done. As I’ve gotten a little older, and wiser, I’ve realized how critical good sleep is for overall health. And it’s not just quantity, but also quality. I follow the 10-3-2-1 rule for better quality sleep: no caffeine for 10 hours before bed, no alcohol for 3 hours before bed, no food for 2 hours, and no “screen time” (computer, TV, iPhone) for 1 hour before bed.
What’s your ideal workout?
Depends on the purpose of the workout. Every workout for me has a goal/purpose to it. If I need to just unwind and shake out some stress after a shift, I love to head out for an easy run on the singletrack. I don’t look at my watch to follow my heart rate or pace, and I just enjoy being in the woods. For actual training, my ideal workout is 4 to 6 intervals of 8-12 minutes each at threshold on my road bike through the rolling hills of Amish country.
Do you track your fitness? How?
I use a GPS device that tracks heart rate, pace, power on the bike and routes, and I upload my data to Strava. I enjoy the social component of the online software to see what my friends are doing with their training and find new routes on the roads and trails.
How do you prepare for a night shift? How do you recover from one?
The best way to prepare for a night shift for me is to try to switch out of it! Nights crush me. I don’t sleep well before or after them. My kids always wake me up despite two white noise machines and earplugs. I now ask the scheduler to never schedule me for more than 1 or 2 at a time, and that helps. My wife does everything she can to stay out of the house and let me sleep. When I work weekend overnights, she actually takes the kids and goes out of town! Night shifts are the absolute worst part of our job, in my opinion, and I think that we under-appreciate the detrimental effects nights have on our health.
How do you avoid getting “hangry” (angry due to hunger) on shift?
I used to eat and snack constantly, unable to go more than 3-4 hours without eating something, and I was always getting “hangry.” In the past year, I’ve actually gone somewhat “paleo” or at least “primal” with my diet. Basically focusing on a high fat, high protein diet with lots of fresh fruits and vegetables, cutting out most processed foods, grains, and sugar as often as possible. With a family and the challenges of my schedule, I’m not strict about it, but I stick to the diet about 80% of the time, and cheat 20% of the time. Can’t pass up pizza and beer with the neighbors on a Friday evening, and I always eat whatever my wife puts on the table. But since adopting this way of eating, I don’t get the highs and lows, or hunger pangs, anymore, and my metabolism is much more even keel.
How do you ensure you are mentally in check?
My wife, Lily, really keeps me in check. I am very “type-A” and am always looking to be the over-achiever in all that I do, whether related to work projects, athletics … really anything. Last week, I started a jigsaw puzzle with my daughter, and I was sneaking into the family room every chance I could get, just to find a few more pieces that fit! She is very honest with me and lets me know when I am out of balance, or over-doing it in some aspect of my life. Otherwise, I try to take one day totally off per week to do something with the family. I get outside as often as possible. I really try to prioritize my spiritual life, and almost never miss Mass on Saturday night or Sunday.
What are the biggest challenges you face in maintaining a longstanding career in EM? How do you address these challenges?
Honestly, with three kids, the biggest challenge is the shift work and the erratic schedule. The shifts combined with all the administrative work as an APD just makes it more difficult to carve out family time. It’s really tough working every other weekend when you have school age kids. When I work all weekend, I try to take off Friday or Monday, or both, but the kids are in school then, so I still miss out on time with them. Our scheduler puts us in as working the whole weekend or off the whole weekend. Lately, I have started swapping one weekend shift, either Saturday or Sunday, with other colleagues, to split it up. That way, I work just about every weekend for one day, but then I am off one day to spend time with my family.
Best advice you have received for maintaining health?
Best advice I have received was from one of my colleagues, Heather Farley. (She has actually just taken a new role as the director of provider wellness for our hospital system.) As I was moving up the ranks rather quickly, taking on a greater load of tasks and leadership roles, she told me “every time you say YES to something, you are saying NO to something else.” For example, if you are going to join this committee that just requires 2 hours per month of your time, that’s 2 hours per month you have lost with your kids. I’m a very “service-oriented” person by default, but that advice has helped me to say “no” to things that are not advancing my career goals or bringing me value in other ways.
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