The epidemic of physician burnout is an issue I care deeply about – as it is for anyone who has been through it themselves, or watched friends and colleagues suffer.
Doctors are caring people, and working in healthcare is a stressful career (to put it lightly). Combining these two facts makes for a storm of potential anxiety. While you care about people’s wellbeing, management also have targets that must be met. This, stacked on top of the growing pressure on an underfunded system from an ageing population, leaves it of little surprise that so many doctors feel like they’re sprinting just to stand still.
Since working in healthcare can regularly throw life and death situations at you, it often takes a heavy toll on conscientious workers – and that toll is frequently paid on the work-life see-saw. Whether it’s a missed birthday, anniversaries neglected, relationships becoming distant, or a more general feeling of isolation, we’re used to consistently seeing conscientious healthcare workers figuratively – but also functionally – sacrifice their own lives for those of their patients.
One method some doctors, especially GPs, have used to redress the balance is to make the change from full-time to part-time hours.
A recent survey suggests that over 90% of training GPs plan to work part-time once their accreditation is complete. That’s just one in ten who actively plans on working full hours! Almost half of those polled intended to take up locum work as soon as they qualified.
We also saw feedback from a think tank that found UK family doctors were turning away from full-time clinical work because of the ‘intensity’ of their workload, and a stated fear of burnout.
The theory is that if you work part-time, say on a 0.5 contract, you will have half the workload. Unfortunately, reality (as it often does) has its ways of stepping in to change that. Let’s say you job-share with another GP, for example. You’ll split the caseload and paperwork, but it can rarely be divided half and half and completed within time, simply owing to sheer volume.
The true insanity of a doctor’s workload becomes apparent when two GPs sharing one full-time job between them both need to work extra time to fulfil their roles. If one were working full time, she would need more than a full-time job’s worth of hours to fulfill expectations.
That’s a pain I know many, many teachers also share.
So what is the verdict of think tanks on this unmanageable workload, and the stress it generates? Joyce Robin, of Patient Concern, said GPs were lucky to be able to afford to work part-time.
“It’s extraordinary – all this money pumped into training them and then so many of them go part-time. Obviously, it’s good money, so they can afford to go part-time, and I can see why that appeals, especially for people bringing up families. But it’s disastrous for patients who can’t get to see a GP.”
It would be unkind not to see Joyce’s point, especially given she’s speaking from the perspective of patient advocacy – but within such a response, there’s a sense of denial of how highly doctors advocate for patients. Going so far, in fact, that they strip their own lives bare and are eventually forced to retreat.
Here we have clear evidence that doctors are struggling to live happy lives – but instead of finding ways to help them manage work-life balance or reduce the pressure of their workload, we see a deferment to guilt-pushing remarks on wages. How dare they try and have a life outside the general practice?! What, you would like a happy family life alongside reward for socially crucial work? Disgraceful!
(Another sly wink coming your way, teachers.)
But, moaning aside, I did pose a question earlier. Will going part-time help improve your work-life balance? The consensus among GPs would appear to be ‘yes’, but I think the answer is more fluid.
The workload will not reduce in line with the reduction of your hours, and you will have to deal with people judging your choice to prioritise your own mental health. For conscientious people, that can hit particularly hard. In other cases, stepping away from the work you do love so much can cause listlessness and disconnection – feeling just as bad as the stress you’re tackling while there.
It isn’t a catch-all solution – but personally, it was one of the best decisions I made following my own burnout collapse. It helped me to recover perspective, reconnect with family, rediscover outside passions, and spend more much-needed time recognising, and understanding, what had happened to me.
And what I could do to help others in the same situation.
Hopefully, in time, these think tanks will start to think about physicians as humans who are trying to be healthy and happy, just like the patients those same physicians treat day in, day out. We are not machines – and in the face of no alternatives, if taking our own steps to snatch wellness from the jaws of a system that seems determined to stamp it out is what we need to do, then so be it.