It’s an obvious statement, but doctors do get sick, just like everyone else. And given the nature of the job – the targets, the paperwork, and the relentless pressure – more doctors than ever before are struggling with mental health.
It’s one thing, as a doctor or consultant, to help an anxious teacher figure out how to manage his workload and develop tools for lessening stress – but it’s a whole other ball game when the patient is yourself. For one, how can you tell if you’re stressed out, or right in the middle of a total burnout? It often takes an outside observer, and plenty of time in reflection, to see the changes in personality that come with a struggling mind.
That’s because the mind in question might be unable to see the problem. And if it does, it may be incapable of recognising the extent to which the problem has grown. Instead, it might identify the cause as a personal failure – typically with self-blame, guilt, doubt, and inner criticism ruling over the strict diagnostic approach one would normally expect.
Another huge, but often undiscussed issue with stressed doctors is self-medication. Coffee. Chocolate. Pizza. Vodka. Cocaine. Diazepam. Morphine. Each individual has a poison of choice, and it’s a sure bet we all know someone who doses themselves up to get through the day. Some choices are, naturally, worse than others – but all can have negative consequences if they become an essential, untempered crutch. Consequences for your career, your body, and your mind.
Why are doctors getting ill?
It might seem like common sense that if you hang around with ill people, then you’re likely to get sick. Fair enough! But that doesn’t explain consistently rising rates of mental illness and cases of burnout. These are not transmittable illnesses. The truth lies in a combination of NHS underfunding, ever-increasing demand, stagnant front-line wages, and excessive expectations placed on practitioners – all of which contribute to a working culture that can’t help but become toxic given its components. Doctors are stressed. They can’t cope.
Health service personnel in England took 16,866,471 sick days off work in 2016. That’s a 6% increase on the previous year.
And who could blame them?
What is the NHS doing?
The NHS Practitioner Health Programme is a free and confidential NHS service for doctors experiencing issues relating to a mental or physical health concern. It also offers support for doctors with an addiction problem – particularly where these might affect their work.
Is it helping?
The NHS has recognised that doctors (as well as dentists, who are also a focus of the programme) tend to manage their own health problems, to self-medicate, and to chat informally with colleagues rather than seek a proper consultation and treatment. This practitioner health programme is an acknowledgement that yes, there is a problem.
And here are some positive stories about the impact of this programme. Allison says:
“For the last 2 years, PHP has supported me more than I could have imagined: through talking sessions, general support and CBT. I have made really amazing progress in my personal and work-life and am continuing to do so thanks to the help of PHP. I really am grateful for all that has been done for me and for the treatment I have been able to access. All that remains is to say that I wish there were more services like this to support healthcare professionals.”
You can read some of the positive stories at http://php.nhs.uk/patient-stories/. What I found most interesting were the background reports on how these healthcare professionals found themselves so overwhelmed by work that they could no longer function – because they mirror much of my own past experience, and those of my clients.
Doctors are fed up with the ‘work smarter not harder’ slogan. It’s a mantra that goes unchallenged far too often, when the truth is not that doctors are working 13-hour shifts because they’re inefficient – but that they’re being backed into impossible corners because the workload is simply unmanageable.
So while the Practitioner Health Programme is a welcome step forward, the powers that be are obviously still well aware that staffing and funding shortfalls will continue to put pressure on those caring for patients. By 2018/19, the CQUIN incentive payment will be paid to NHS providers that improve the health and wellbeing of their staff by 5% (on a 2015/16 baseline), as measured by the staff survey.
Incentivisation is good. It leads to reward and progress, in my view – yet the concern remains that the NHS will continue trying to treat mental health issues in their staff after those concerns have arisen. What if a stressed doctor does not seek help? We already know the internal culture doesn’t make that easy – and approaching a coach like myself can be an extremely daunting decision too.
What if they self-medicate their way to an employment tribunal? What if they quietly suffer and make the worst decision of all?
How can we assess if a trust has improved their staff’s health and wellbeing when the casualties have already fallen by the wayside?
I sense more paperwork on the horizon…
But what do you think? Leave your thoughts in the comments below.
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