I’m sitting and thinking about how I should start this. The thoughts emerge on the moment when I understood the concept of the unwell doctor, the impaired doctor.
No one prefers to talk about this. It is not a topic you’ll hear on the radio, or on TV or even in the some hospital boardrooms. In fact, it doesn’t exist. Not important. I realised how much stigma was attached to this issue and the consequences for doctors should they ever vocalise the word ‘unwell’. Some are real, some are perceived.
Australian studies have come out with figures like “71% of junior doctors are concerned about their health” and “71% of doctors have low job satisfaction”, “69% of doctors are burnt out” and “54% experienced compassion fatigue”. The stats are concerning, yet we don’t talk about it. We all know that fatigue, poor mental health, physical exhaustion leads to poor patient outcome, yet we don’t talk about it.
Reasons for this are numerous, but the one thing that stands out is ‘stigma’. Who wants a doctor who is fatigued? Who wants to hire a doctor who is impaired? If we get treated, people may know about it. If we tell someone there could be consequences. So very often the majority of doctors suffer in silence. A few hospitals have recognised this issue and are leading the way of change. But we need to do more.
“Junior doctors do not prioritise their own healthcare and feel pressured not to miss a shift because of ill health”. Let that sink in for a bit. We have a young doctor who is unwell yet is treating unwell patients because of the pressure they experience to attend their shift. Again, let that sink in for a bit.
Even as I write this I am experiencing serious stigma to share my own story of when I had to ask for help. It’s incredible how ingrained this process is within the mind. There is a fear of being perceived as weak, or incompetent. No doctor wants to be seen as incompetent, especially not by their peers. Our peers are the most critically evaluating people you’ll ever come across. So no, we don’t want to appear weak. So we don’t ask for help.
I was encouraged to take a break by a friend, who himself had gone through a tough time by ‘just getting on with things’. He saw that it wasn’t brave at all to just ‘soldier on’ or ‘toughen it out’ but rather support one another and take breaks when we need. It was his care and understanding that made it feel ok to look after myself for a bit. I think if we looked after just one colleague for every 10 patients it would make a significant difference to all our lives.
So now I’m trying to look after my own colleagues in ways which I feel my skills would best serve them. We don’t know the full extent of this issue in Australia, particularly among surgical registrars and residents who possibly experience more stress than other professions. If we can openly discuss our need to look after ourselves and each other better, then we can provide a better service and care to our patients. So I encourage every surgical registrar and resident to support their colleagues and start breaking the stigma and create a new system that is based on compassion, support and care for ourselves and each other.
Until next time.
P.s Help us by completing the Exercise Patterns and Surgical Training Survey which aims to look at the health and wellbeing of surgical doctors. In order to create change we need more data on the extent of the issue. Thank you in advance.