Doctors, dentists, vets, and all kinds of healthcare professionals are like everyone else: we encounter all types of health problems.
The difference is that medical professionals have a tendency to try and manage things on their own – to self-medicate, to chat informally to colleagues, and to play down their concerns rather than seek proper consultation and treatment.
If you talk to doctors about their personal experiences with stress and burnout, you can see a common thread. Doctors care too much about others. And they fear that they are not working as hard as they can.
Alice, a GP who was part of the NHS Practitioner Health Programme, explained her opinion:
“I believe it is the ‘good’ doctors who burn out, the ones who try to extract their patients from the avoidable messes caused by the failings of the NHS: abysmal communication, lack of resources, unrealistic targets. These are the doctors who keep on top of the excessive workload. For a while: eventually they break. And let’s face it, we’re all ‘good’ doctors. So we all break. It’s not a question of if; it’s a question of when.”
Many doctors have found support and help through this programme, which focuses specifically on their needs. The thing is, the NHS is big. Huge. Massive. And what works in one department doesn’t always work in another.
Workplace stress has been the topic of a mountain of studies and reviews – but comparatively speaking, there aren’t many that point the magnifying glass squarely on conditions for doctors and surgeons. This seems strange, given a health and safety executive study, using data from the Labour Force Survey and analysing a three-year period from 2014 to 2017, concluded that workplace stress is most common in public sector industries such as education, health, and social care.
Their evidence suggests there are common factors in development of stress and burnout.
According to the survey, which is sent to around 37,000 British households per quarter, the main cause for stress at work is related to workload pressures, or being landed with too much responsibility coupled with a lack of managerial support. Other factors included organisational changes, workplace violence, having a poorly defined job role and scope of responsibilities, and uncertainty over the future of a job.
A major cause of anxiety – at least for me and many of the people I work with and speak to – is awareness of the impact a mistake can have on the life of another. No pun intended, but in the blink of a proverbial eye, I could blind someone. If you’re reading this, you likely deal with life and death decisions on a daily basis.
That’s scary, and it should be – but if you’re regularly flippant about these real risks to others, it’s likely you’re putting some mental barriers in place to help you cope. That’s not healthy.
But even though medicine is in itself a stressful job, that does not mean you have no option but to live a stressful life. One thing that can help is to develop a personalised method, or routine, that helps you separate yourself into two ‘modes’ – work and private. Here’s one I picked up from a friend some time ago.
This friend is a teacher. She works with children within the social care system – some of whom have seen and experienced awful things in their short lives. The sort of stuff that would keep even the strongest of us struggling to close our eyes at night. She never knows if the children she teaches will be safe when they leave school – whether they’ll return the next day with more weight on their minds, with a black eye, or even something worse.
She knows they’re safe at school, but there’s nothing she can do once they walk out those doors at the end of the day. So to help her deal with the swirling anxiety she felt every evening, she went out and bought some teddy bears for the classroom. Each day, just before leaving school, she’d choose a teddy that represented a child she worried about, and she’d place it into a safe bed. She’d tuck it in, and say ‘you are safe.’ Mentally and physically, she would put her worry to bed.
You might think that sounds silly, or even childish, and that’s a natural response. The logical side of the mind knows that the child may not be safe (and the anxiety will insist that they definitely are not). But the logical mind also knows that, as a teacher, she cannot help outside of her school. She must follow protocol, and rely on the state to do its job.
As long as her duties have been fulfilled, it can only be a personal net negative to continue carrying that weight into your down time.
Metaphorically, putting your fear and worries to bed is just as important when you’re a doctor. We’re not just professional empathisers – we’re professional worriers. There may be a patient in intensive care who might not make it through the night, and it can be incredibly difficult not to carry that with you when the day is done.
But it’s time for you to pass over that patient and go home to your own life. You need to relax and recharge, so you can be a good doctor the next day. If you don’t recharge, you won’t be at your best.
Find a way of putting your fears to bed. It works best as a physical act – something that brings together your thoughts and your actions. Teddies aren’t as common in a hospital as they are in a primary classroom, but there are plenty of other possibilities. Write the name of the patient and draw a safe circle around them, for example. They are safe at hospital – at work. You know you’re leaving them in good hands. You have done what you can; now it’s time to go and be present in your own home.
The key to this is finding a procedure that works for you. As I said earlier, teddies might feel completely absurd. That’s fine. Writing a name might also feel empty – and that’s okay. What works for one person won’t work for another, but the concept is the same. Some people might sit down for five minutes of reflection and meditation, bringing the body and mind out of the work state. If meditation feels silly (absolutely, it isn’t for everyone), there’s always a different way to bring this concept to life.
Play with it, and discover what suits your temperament. Make it a habit to put the patient to bed, put your fears to rest, and recharge your own mind. You can’t help others if you won’t help yourself.
And if this article sparked some interest within you, you can find a wealth of strategies that helped me climb from the pit of physician burnout detailed inside my book, Physician on Fire. Packed with 30 days of personal stories, lessons, and activities, it might be just the ticket to help you make a much-needed course correction.
Alternatively, why not book an easy-going and confidential chat with me, and we’ll figure out where you are, where you wish to be, and how you’ll get there.