Patients first.

Credit: Mario Sanchez Nevado (www.aegis-strife.net)

When I speak with gatherings of doctors, I often start with asking them to shout out whether they think the statements below are True or False. What do you think?

  • Sick doctors know when they are sick.
  • Doctors are good at asking for help and following advice.
  • Doctors take good care of themselves.
  • Doctors have strong support networks.
  • Doctors are kind to each other.   

Irrespective of which country I am in, without fail the auditoria flood up with a big resounding ‘FALSE’ for each of the above, accompanied with some sniggering. Isn’t it shocking? One would expect that people who work in ‘healthcare’ would know a thing or two about their own health as individuals and as a community.

These are the highlights of a survey conducted by the Royal College of Anaesthetists in 2016-17:

The NHS Sickness statistics consistently show that NHS hospital doctors have the lowest rate of sick leave as compared to any other staff group.  Here is a list of personality traits of doctors (a broad generalization, of course) that might explain this:

  • Perfectionism (I must do this right!)
  • Narcissism (I am good at what I do.)
  • Compulsiveness (I can’t give up till I finish.)
  • Denigration of vulnerabilities (If I need help, I am weak.)
  • Martyrdom (I care for my patients more than myself. Their needs come before mine.)

The very traits that make us good doctors are the ones that may not be very good for us. But our seniors have not been aware of this and hence they have not been able to help us understand ourselves. This tradition has been going on for generations of doctors. There is a nobility associated with such self-sacrifice, which we all have bought into. The fact is that if your own cup is empty, you cannot serve others well.

Things add up – a dysfunctional department, work pressures, lack of support outside work, ill-health, emotional burden of the job, a traumatic adverse incident, lack of sleep, fatigue, a complaint made against you, poor diet and no time to exercise or pursue hobbies, impaired judgement of one’s own symptoms, fear of letting others down, difficulty in admitting that they have a problem.

Burnout among medics is not unusual. It looks much like depression and sometimes ends in devastating tragedies. But help is available. Sadly, unlike other illnesses, for mental health issues, the onus of getting help lies with the sufferer. It takes courage to acknowledge one needs help and seek it out in good time. It might be the best thing a doctor can do for themselves and their patients.

Sources of support:

  1. https://www.bma.org.uk/advice/work-life-support/your-wellbeing/sources-of-support
  2. Doctors in Distress, a charity set up by Amandip Sidhu in memory of his brother Dr Jagdip Sidhu who was an eminent cardiologist and tragically died by suicide on 27th November 2018.

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