Some have called physician burnout a public health crisis.
Given the rising trend of burnout and mental health problems in doctors, there must be more than simply us as individuals not having sufficient coping strategies, resilience or emotional intelligence.
The challenges facing the NHS
According to this article, some of the key challenges facing the NHS include
- An ageing population
- A growing population
- Evolving healthcare needs, such as the increase in cases of obesity and diabetes, or antibiotic resistance.
- Medical advancements which save lots of lives every year, but push up costs considerably. It is estimated that progress in medical technology costs the NHS at least an extra £10bn a year.
- Closure of local services due to centralization drives
- An increase in reliance on privatized services
In addition to these, there are specific yet different challenges faced by both primary and secondary care. Those facing primary care are well described by Dr Jenny Napier in her article “Preventing burnout for GPs: time is of the essence.”
For both however, the rising complexity and the increasing patient demand and expectations in our fast paced digital world further compound these challenges. The demands of appraisal, revalidation & CQC add yet more pressure.
The importance of social networks
At a recent talk I attended on practitioner well-being at the Royal College of Psychiatrists, Professor Sir Simon Wessely spoke briefly. He talked about health and well-being being related to the individual and their social networks (home /work/social).
He, like psychologist Kelly Mc Gonical (TED talk: How to make stress your friend), suggested that stress is exciting and good for us.
He questioned whether the problem we have now is due to the individual, where stress management and resilience training, healthy lifestyles will obviously all help; or whether it is a social problem, so not just us, but our social networks and the way we work. For example, junior doctors are now working in fragmented teams and are not belonging to a system that values them. I think that many of us feel that we are operating in a system that does not value us. It is widely known that workforce morale is at an all time low.
So, there are clearly issues at a social and an organisational level, issues relating to our social networks and the way we work.
Complaints & litigation
The rising number of complaints, GMC enquiries, litigation and even criminal proceedings is a worry for all doctors. This can contribute to stress, anxiety and a sense of paranoia.
GP Survival are trying to open up “a debate in the national media about the appropriateness of the change in the way doctors are being treated and the impact this has on patient care.”
Loss of the art of medicine
In a much needed effort to standardise practice nationally, practising medicine has sadly become very prescriptive and very much about following pathways and protocols. With this, has been the loss of “art of medicine” and an associated reduced sense of mastery and control, known to be strongly linked with job satisfaction.
I feel that these are all important contributing factors to the rise in burnout and mental health problems that we are now seeing at all stages in a doctor’s career.
When I was training as a junior doctor, we were encouraged by the knowledge that there was light at the end of the tunnel. The sense that things would be better once we became fully fledged GPs or consultants. That hope and that promise no longer seems to be there for those currently in training.
I am interested to hear your thoughts as to why this is happening now.
And more importantly, what can we do about it?
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