Health Information Management

Stress and the everyday coder

JustCoding News: Inpatient, August 1, 2012

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by Lois Mazza, CPC

There is nothing new about stress; humans have felt stress since the beginning of time. Our ancestors no doubt stressed over different circumstances than those modern men and woman experience, but the psychological and physiological reaction remains the same.

What is stress? Stress can be defined as a reaction to the demands and pressures of everyday life. A certain amount of stress is not necessarily a bad thing. Stress can certainly be a motivator to action. But too much stress can cause mental and physical breakdowns.

Stress can be hard to define as what stresses one person may not bother another person at all. Everyone has different levels of tolerance. Nor is stress inherently a problem. It is the effects of stress that cause the problems. Those who study stress and its effects believe stress can cause a myriad of troubles, both physical and emotional.

Signs of stress

Some physical symptoms of stress include:

  • Pain
  • Digestive upsets such as constipation or diarrhea
  • Nausea
  • Dizziness
  • Chest pain
  • Rapid heartbeat
  • Loss of desire for sex
  • Frequent respiratory ailments such as colds or flu

Some emotional signs of stress are:

  • Mood swings
  • Irritability
  • Short temper
  • Feeling agitated or unable to relax
  • Feeling overwhelmed by life
  • Feeling lonely or isolated
  • Depression
  • General feeling of unhappiness

Some cognitive signs of stress include:

  • Inability to concentrate
  • Problems with memory
  • Poor judgment
  • Negativity
  • Anxiety
  • Constant worry

Finally, some behavioral signs of stress are:

  • Over- or under-eating
  • Insomnia or oversleeping
  • Procrastination
  • Neglecting responsibilities
  • Self-medicating and over use of alcohol
  • Tobacco use
  • Abuse of prescription and recreational drugs
  • Nail biting, pacing, talking to one’s self, and other nervous habits

Many of us do not even realize what stress we are under until a breakdown or illness occurs and we become unable to function.

Causes of stress in the coding world

People who work as medical coders often find themselves in stressful situations, such as:

  • Unrealistic expectations. As coders, we are expected to be perfect. At any rate, most coders I know expect this from themselves. And when coding, perfection is the goal, of course. Mistakes can lead to trouble, both for the patient and the coder. But we must always remember we are humans, not robots. While it is natural to want to always be perfect, it is a completely unrealistic expectation. It is stressful to worry about being perfect and it’s extremely stressful to realize an error has occurred.
  • Office politics. Many coders work in medical offices, which by their very nature are stressful situations. Medical offices are filled with people who are ill, concerned family members, and people who may be experiencing emergent situations. The staff in the office may also be under stress dealing with the many situations that occur in the office. Some coders work in the corporate setting for companies that provide coding and billing services. This can cause friction from others who wish they had the job or who think that, because someone is a coder, he or she has a better work situation than that person. Often times in office settings, there is just friction between individuals regardless of the role they have due to personality conflicts. Some coders work from home and while this situation lessons the stress of everyday human interaction, it presents unique stressors of feeling isolated and having to solve problems on their own. Problem solving is done by phone or email, which is not always the most effective or expedient way to get results.
  • Professional expectations. Coders have stressors when it comes to their professional expectations. Certified coders need to maintain their certification by obtaining continuing education units (CEU). Many coders hold multiple certifications resulting in needing an even greater number of CEUs. There is a lot of competition for jobs in the coding world. Coders need to do everything they can to be marketable. Many coders go to school to prepare for certification and to increase their marketability. School adds to the stress with time needed for classes and studying.
  • • Working conditions. In an ideal work place, coders will have a quiet, well-lit area with minimal distraction. They will have an ergonomically designed work space with everything they need to do their job at their fingertips. In the real world, this is not always the case. Companies are not always anxious to replace old or worn equipment. Office chairs wear out or break, leaving the coder sitting in awkward positions for hours on end. Coders also usually watch a computer screen for hours on end. This can be stressful to the eyes and the mind.

Dealing with stress

If you believe you are under stress and it is having a negative effect on your wellbeing, there are stress management techniques you can utilize for stress relief. Consider the following:

  • Recognize stress. The first step in dealing with stress is to actually realize the effect stress is having on your life and wellbeing. Many websites deal stress and its effects. Look online to learn more to learn more about stress and its effects.
  • Get support. If you are suffering from adverse work conditions, schedule time to speak with your manager and discuss the problems you face. Talk about the impact the adverse conditions are having on your work performance. Be specific and offer solutions that might help to relieve the stress you are experiencing. Talk to a trusted friend or family member about the stresses you are under in your day-to-day work life and consider seeing a counselor for help in forming a plan for stress relief.
  • Focus on good health for stress management. When our health is not at its best, we struggle to cope with even minimal everyday stressors. Consider your health and ways to make improvements:
    • Eat a diet high in plant products (fruits, vegetables, and whole grains) and eat less saturated fats and refined carbohydrates.
    • Get enough exercise. Check with your doctor before deciding on a plan for more physical activity.
    • Get enough sleep at night. Try to go to sleep one hour earlier every night for a week and see if this positively affects your ability to handle stress.
  • Enjoy your life! Make plans to do something you truly enjoy every day. Any hobby or activity you find fun and relaxing would be good to take your mind off work or any troubles you may be experiencing. Plan a few minutes each day to do something you enjoy: read a book or magazine, spend some time visiting websites that address subjects you are interested in, call a friend to chat, spend some time playing outside with your children, or work in your garden, for example. Spend a few minutes considering how you could spend some time each day doing something enjoyable to help with distressing your mind and body.

Coders, along with most other humans, experience stress in their day-to-day lives. But stress can and should be recognized and dealt with in order to improve the quality of our lives.

Editor’s note: Lois Mazza, CPC, is a documentation specialist for a medical management group that provides management services, as well as coding and billing services, for emergency departments, hospitalist medicine and anesthesia groups in 46 states in the USA. She is certified through the AAPC since 2004. She has 16 years experience working in the healthcare industry. Contact Mazza at

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