Urgent action is needed if we are to avoid doctors becoming burnt out and disillusioned in ever greater numbers, Ireland’s leading protection organisation said today.
In its report – “Breaking the Burnout Cycle” – the Medical Protection Society (MPS) says every doctor in Ireland should have access to someone trained to recognise burnout and offer support. It said this could be achieved by all HSE organisations and private providers appointing a ‘Wellbeing Guardian’ by 2022, with a similar dedicated person working with GP surgeries and smaller clinics locally. It also calls for doctors’ wellbeing to become a Key Performance Indicator (KPI) in all organisations.
A snapshot survey of MPS members in Ireland showed that 91% of doctors do not have someone at work responsible for staff wellbeing, and almost 60% do not feel encouraged to discuss wellbeing issues at work. 46% also say they have considered leaving the profession for reasons of personal wellbeing.
The survey results support research by the Royal College of Physicians in Ireland that over half of practising physicians report at least one symptom of burnout, and this number is growing.
Professor Dame Jane Dacre, MPS President, said: “Being a doctor is incredibly rewarding - few other professions make such a difference to people’s lives. But when I talk to other doctors, I am troubled by the increasing levels of burnout I see. 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 patients and the wider healthcare team. The obvious reality is that doctors who are happy and engaged find it much easier to be compassionate and provide safer patient care.
“The causes of burnout have been widely debated and include the growing demands and complexity of the job, tighter financial constraints and a faster pace of work.
“The problem is also not unique to Ireland, to the HSE or to any one specialty. 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 in ourselves and others and work to develop strategies that enhance personal resilience, but only with organisation level interventions - from healthcare providers and government - can we truly begin to tackle the endemic of burnout in healthcare.”
Notes to editors
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Anonymous comments from doctors in Ireland:
“I have worked in many different healthcare systems. A few colleagues are very supportive, but we are constantly undermined, dismissed or ignored when we bring serious issues about staff and patient well-being to the table.”
“I didn't realise I was 'burnt out' until the last 2 or 3 months but looking back it was coming for about 2 years. I realised one day a patient was giving me a terrible history/crying and I didn't feel anything, no emotion at all. I realised the patients didn't deserve that so I decided I needed to leave. I was gone from clinical practice about 2 months later.”
“Burn out needs to be addressed in a more tailored and structured manner. It is rife in professional practice, without being identified at an individual level.”
“This is not the job I originally started in. I am nearing the end of my career and none of my 4 children would even consider general practice as a career. My husband says it is all about work/home balance. My two older children are already earning more than me and with the hours I work many of my colleagues have experienced burnout. I am counting the days to retirement.”
MPS key recommendations:
- The Department of Health should require all HSE organisations to appoint Wellbeing Guardians. These should be in place in every HSE organisation by 2022 and should report their progress to the leadership board. We would also encourage private providers to establish Wellbeing Guardians.
- Work would need to be undertaken to consider how such a role would work for GPs and other doctors who work in smaller clinics, but MPS would like to see those in local areas work together to ensure each GP has a dedicated person who makes their health and wellbeing a core priority and is trained to recognise and support them when they are experiencing difficulties.
- The Department of Health should also ensure that funding is available to provide confidential and easily accessible counselling service for all healthcare professionals across the country experiencing burnout.
- 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 a snapshot of 143 doctors in Ireland in June 2019 - which was part of a wider international survey of 1,170 doctors across Ireland, the UK, New Zealand and South Africa.
- The Royal College of Physicians in Ireland study into burnout and interventions was published in September 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 this should be achieved by 2022, and that the principle should also be applied in GP/smaller practices.
- 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: https://www.medicalprotection.org/ireland/education-and-events/workshops/workshops-display/building-resilience-and-avoiding-burnout-ire
The Medical Protection Society (“MPS”) is the world’s leading protection organisation for doctors, dentists and healthcare professionals. We protect and support the professional interests of more than 300,000 members around the world. With more than 16,000 members in Ireland our knowledge and experience of the medicolegal environment globally puts us in a strong position to advise and inform policy makers. Membership provides access to expert advice and support together with the right to request indemnity for complaints or claims arising from professional practice.
Our philosophy is to support safe practice in medicine and dentistry by helping to avert problems in the first place. We do this by promoting risk management through our workshops, E-learning, clinical risk assessments, publications, conferences, lectures and presentations. MPS is not an insurance company. All the benefits of membership of MPS are discretionary as set out in the Memorandum and Articles of Association.