AMA VICDOC Autumn 2024 - Magazine - Page 87
DR D OV D EGA N
are not immune to mental
D octors
health issues. In fact, research from
Beyond Blue reveals that the prevalence of
mental illness is higher amongst doctors
and medical students than mainstream
society. Despite this statistic, it is still not
widely discussed in the medical community.
A multitude of factors contribute to the
burden of disease including stressful
careers, unpaid work hours, workplace
bullying, insufficient provision of training
positions and jobs, ‘type A’ personalities
and patient complaints.
“Physician Burnout” has been formally
recognised as a condition by the World
Health Organisation in 2019 and is a state
of mental exhaustion caused by the doctor’s
professional life, characterised by emotional
exhaustion, depersonalisation and reduced
sense of accomplishment of success.
It is not a medical condition but is an
occupational phenomenon. Clinical signs of
burnout include low mood, irritability, lack
of energy, poor motivation and the very
real phenomenon of compassion fatigue.
This can lead to clinician disempowerment
and career dissatisfaction.
A survey in the United States during the
COVID-19 pandemic revealed a burnout
prevalence of 63% with a reported 70%
dissatisfaction in work-life balance. Those
who experienced burnout had a three to
four-fold increase in job dissatisfaction
with intention to leave their jobs. The
cost of burnout is substantial with an
estimated $4.6 billion dollar annual
burden to the US healthcare system due
to factors such as reduced hours, physician
turnover and expenses associated with
hiring replacement staff. Burnout has not
surprisingly been associated with twice
as many patient safety incidents, reduced
productivity, increased absenteeism, and
a rise in doctors wanting to reduce their
work hours or leave the field entirely.
Unfortunately, there have been
numerous doctors, nurses and medical
students who have taken their lives in
our profession. These suicides represent
tragic statistics which are often not widely
nor openly discussed. These are not just
case numbers but represent the tragic
loss of lives of our colleagues and friends.
The COVID-19 pandemic resulted in daily
announcements of mortality figures but
the mental health endemic does not give
rise to media attention. A death by suicide
is no less worthy of substantiation than a
death by coronavirus. The issue of mental
health and its causative factors merits
greater attention and research by the
medical community, just like any other
organic illness.
I have a lived experience of mental
illness which I have openly disclosed in
order to try and reduce the stigma that it
plays amongst doctors. I am in the unique
position of having experienced both sides
of the fence as an inpatient and a medical
practitioner. From the doctor’s perspective,
I am disappointed by the discrepancy with
which patients with mental illness are
sometimes treated compared to those who
are unaffected. The time taken to explore
comorbid psychiatric problems is rarely
comparable to physical issues. In addition,
the training time in medical school dealing
with mental health issues is limited leading
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