Doctors’ wellbeing must be safeguarded

Urgent action is needed if we are to avoid doctors becoming burnt out and disillusioned in ever greater numbers, New Zealand’s leading medical protection organisation said today.

In its report – “Breaking the burnout cycle” – the Medical Protection Society (MPS) says every doctor in New Zealand should have access to someone trained to recognise burnout and offer support. It said this could be achieved by all organisations and private providers appointing a role like a ‘Wellbeing Guardian’, with a similar dedicated person working with small clinics in a local area. It also calls on medical schools to do more to help prepare doctors with the training, skills and coping strategies they will need.

An MPS survey of doctors in New Zealand shows that 89% do not have someone at work specifically responsible for staff wellbeing, and 40% do not feel encouraged to discuss wellbeing issues at work. 41% also say they have considered leaving the profession for reasons of personal wellbeing.

The survey follows a recent report from the Association of Salaried Medical Specialists which warned that over half of doctors and specialists across the country were experiencing burnout and said this was affecting the care they can provide.

Professor Dame Jane Dacre, MPS President, said: “Few other professions have the ability to make such a stark difference to people’s lives – being a doctor is incredibly rewarding. But when I talk to other doctors, I see increasing levels of burnout and it is clear that the sense of value that doctors have is being diminished by the environment they work in.

“When doctors feel burnt out it is not only bad for the doctors concerned but also for the wider healthcare team, and patients. Put simply, doctors who are happy and engaged find it easier to be compassionate, provide safer patient care and practise to the standard they are capable of.

“The causes of burnout have been widely debated across the country and include the growing demands and complexity of the job, financial constraints and a relentless pace of work.

“The problem is also not unique to New Zealand - it is a global phenomenon affecting all clinicians. When we talk to our members around the world about their working environment, sadly they tell us loud and clear about the impact their work is having on their wellbeing. I am proud of the work we do at MPS to support those dealing with burnout, but this support is only part of the solution.

“If we are to avoid doctors becoming burnt out and disillusioned in ever greater numbers, we must take collective action. We as individuals can try to identify signs of burnout and find ways to build our resilience, but only with commitment from the whole healthcare community – from large organisations right through to medical schools - can we truly begin to tackle the burnout endemic and safeguard the wellbeing of doctors.

END

Notes to editors

For further information or interview requests please email all three email addresses below:

kate.tullett@medicalprotection.org

gareth.cockman@medicalprotection.org

rebecca.Imrie2@medicalprotection.org

If urgent call T +64 (4) 550 5341 or M: +44 (0)7515 298791.

View an embargoed copy of ‘Breaking the burnout cycle’ - this is embargoed until 00:01hrs Wednesday 11 December 2019.

Anonymous comments from doctors in New Zealand:

“This is going to become an epidemic, and systemic changes are the only way to deal effectively with burnout.”

“I am passionate about health and wellbeing, but that is very removed from my job day to day, so much so that I would leave general practice if/when I can figure out how to share my skills in a more fulfilling way.”

“I know I’m on verge of burnout but I can't see any way out as 75% of my department is in the same position.

“I feel that a source of burnout is often from above (management). Many clinical managers forget how clinical work is done and how difficult it can be and therefore put pressure on us. Managers who were recently doctors tend to be better.”

MPS key recommendations:

• Every doctor in New Zealand should have access to someone trained to recognise burnout and offer support. This could be achieved by all healthcare organisations and private providers appointing a ‘Wellbeing Guardian’ with a similar dedicated person working with smaller clinics locally.
• Corporate objectives should include wellbeing, to demonstrate commitment from the top.
• Doctors should receive training on the risks and consequences of burnout, and how to recognise burnout in themselves and others.
• Medical schools and postgraduate training bodies have an important role to play in instilling the right behaviours; they have a clear responsibility in laying healthy foundations for doctors and other healthcare professionals during their training and supporting them in their professional career development. They should:-
• Establish comprehensive standards for doctors’ wellbeing at every career stage
• Provide scholars with obligatory training in general wellbeing in the workplace, in building resilience, speaking up for safety, and how to develop good individual coping strategies.
• Auckland University medical school are rolling out a scheme to ensure wellbeing in their medical students, and we look forward to seeing how this develops.

References:

• Burnout definition: Burnout is characterised by mental, physical and emotional exhaustion, cynicism, increased detachment and a decline in professional satisfaction caused by multiple factors. These contributing factors can exist at a personal, team and wider system level. Burnout is not the same as depression, they have different diagnostic criteria with different treatment. Burnout improves with a break or time away, depression does not. Burnout is a problem that is specific to the work context, in contrast to depression, which tends to pervade every domain of a person’s life.
• MPS surveyed 300 doctors in New Zealand in June 2019 - which was part of a wider international survey of 1,170 doctors across Ireland, the UK and South Africa.
• Key New Zealand stats:
• 41% of respondents agree to have considered leaving the profession for reasons of personal wellbeing
• 50% of hospital doctors say they are unable to take a short break in between two clinically demanding procedures
• 43% of respondents do not feel like their personal wellbeing is a priority at work
• 89% of respondents say they do not have someone at work responsible for staff wellbeing
• The Hospitals on the Edge report, prepared for the Association of Salaried Medical Specialists was published in November 2019.
• Wellbeing Guardians were initially recommended by the NHS Staff and Learners’ Mental Wellbeing Commission, which was set up by Health Education England. The Guardians would be a board level role responsible for the mental wellbeing of their staff, they will set organisational expectations, monitor performance and reassure their board that their organisation is a wellbeing organisation and a healthy workplace in which staff can work and thrive. MPS believes something similar could be achieved in New Zealand, and that the principle should also be applied in smaller practices/clinics.

MPS runs a Building resilience, avoiding burnout (BRAB) workshop. This workshop helps to recognise the signs of burnout and gives the knowledge and confidence to manage the symptoms to recover as well as prevent reoccurrence.