“I remember once actually sitting under the desk, hugging my knees to my chest, I was so anxious.” – GP (page 4; Riley et al., 2018) 72
The above excerpt is an immensely powerful and telling image. How many doctors feel like this? How many are close to burnout? Sharon Rea (pictured) explores this issue with Lifestyle Health Hub…
Eleven years ago, in 2009, Dr. Steve Boorman published the NHS Health and Wellbeing Review, at the request of Dame Carol Black’s review of the health of working age people in 2008. One of the most astonishing facts that came out of this review was that there were in 2009, approximately 10 million working days lost in the NHS, the Review published a list of recommendations including an increase in investment into Occupational Health for Medical Staff. Fast forward to September 2018, when the Society of Occupational Medicine published a report which demonstrated that this was and still is a major issue.
One of the most significant and telling pieces of information to come out of all the reports and reviews, is that Doctors have issues in looking for and asking for help when they need it the most. In fact, studies have found that most medical professionals will continue to struggle into work even when they are not feeling physically or mentally fit to do so.
The limited research that is available can be categorised at best as mediocre, because the time pressures involved on Doctors currently is enormous, especially those in primary care.
What it has demonstrated however is that a mixture of approaches is the best method to attack this hidden epidemic. Reduction in work load, sharing of experiences amongst peers, as has been trialled in the United Kingdom following the successful implementation of Schwartz Rounds in the United States, but ultimately ensuring that there is an adequate and healthy level of Work/Life Balance is what effects most change.
Doctors especially those in Primary Care and those that are in Secondary Care who deal with trauma and death on a regular basis, some not all on regularly battle with anxiety, depression, stress, panic all which are morbidly psychiatric, however, they are afraid of the stigma that will be associated with them should they seek intervention from a local source.
This may come from the image that has been portrayed by Doctors over the years, where they were stoic, commanding, all knowing and apparently infallible. This is the amount of prestige that was and is still placed on those that are working in this, the most caring and compassionate of professions. What Doctors, their managers, the Occupational Health Departments, and the NHS need to realise is that Doctors are human beings, with their own, needs, desires and interests. A GP once said to me that I was right in asking for help, that I needed to access the help and support that was available, as in my current situation I was only surviving, existing, not living or thriving. There is an incredibly old saying and that is ‘Practise what you Preach’ It is now time for Doctors themselves to realise that they are human, that they are not infallible as is historically suggested. They need to live, they need to have a healthy, happy home life. They need to have the ability to walk away from work at the end of the day knowing that they have made a difference, but also to walk away eager to begin again the next day.
So how do we get Doctors to openly go and get help? One way is to make it compulsory that every two months, it becomes a requirement for them to go and spend time discussing their thoughts and feelings with a person who is qualified to give them the Strategies and Actions in order for them to be able to not just survive a career, but to live and thrive through it.
Another avenue is that during training it is enforced and reinforced that for to be the best possible version in their chosen field is to always take care of their own mental health. This is not only to the benefit of the Doctor but also to the benefit of the Doctor Patient Relationship
A third option would be to foster a caring and compassionate environment within the NHS, where all Line Managers are made aware of the services that are currently available, but for the NHS trusts to invest proactively in providing for a positive Mental Health Environment within the organisation. To ensure that the introduction of Schwartz’s Rounds became standardised throughout the United Kingdom. To ensure that all Doctors from the most junior to the most senior are all informed fully as to the availability of all the help and support that is and will be available.
Or we could be really radical and look to implement all three, yes it would be expensive, but then so is the amount of sick days currently being accrued in the NHS, the financial burden that this is placing on an already stretched service, it will stop the bleeding out of extremely well trained professionals out of the system to other countries and occupations where the work life balance is in greater proportion to what it is currently in this country.
Many Doctors spend years studying continuously from nursery right the way through to qualification and beyond, it is time that we ensure that they realise that it is time for them to not only survive, but to live and thrive through their careers.