Health Professional Wellbeing

A study published in the MJA has found doctors who are involved in medico-legal matters are more likely to suffer from serious mental health problems including anxiety and depression.

The study of 2999 doctors also found that over 65% of doctors in Australia will be involved in medico-legal matters at some point of their career.

Dr Louise Nash, lead author of the study, emphasised that doctors need to look after themselves. “If they are feeling stressed, they should consider options for reducing their hours, and make sure they do not turn to any negative coping mechanisms, such as drinking,” she said.

Dr Nash noted that the study raised questions about the causality of the relationship between medico-legal processes and poor mental health.

From the Medical Observer.

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In Australia, the Bettering Evaluation and Care of Health (BEACH) project was initiated 10 years ago to continuously collect information about the clinical activities in general practice in Australia. The programme is overseen by the Family Medicine Research Centre in collaboration with the Australian Institute of Health and Welfare. A sub-study from the BEACH project, supported by the Commonwealth Department of Veteran’s Affairs assessed the prevalence of stress and anxiety issues among patients of GPs. An analysis of 100 GP encounters with 3,684 patient encounters, found that 40% of respondents (i.e. 1, 470 patients) reported experiencing a period of anxiety or stress lasting 2 weeks or more in the previous 12 months. Of this group, 75% sought help from professionals and 58% from their GP. Similar results were found in a study of Australian patients by Cohen et al. (1983), clearly indicating that medical practitioners need to understand the aetiology and management of this widespread problem.

Dr Ramesh Manocha

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An Australian study by Markwell and Wainer (2009) found 70% of junior doctors surveyed have experienced high levels of stress at work and 56% have been concerned about the wellbeing of their colleagues because of the work conditions.

The survey, published in the Medical Journal of Australia today also found over 70% of the junior doctors met the criteria for low job satisfaction, 69% met the criteria for burnout and 54% met the criteria for compassion fatigue.

The survey of 914 junior doctors recommended that stress management strategies be incorporated into continuing medical education.

From the Medical Journal of Australia.

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Research from the Australian Primary Health Care Research Institute (APHCRI) has found that 64% of GPs have faced violence ranging from verbal abuse to murder in the past year.

The findings have sparked an investigation by the Austrlain Goverment into the matter, including an online survey which will open in four weeks. The survey is expected to take around 10 minutes to complete, and will be organised by the APHCRI.

The APHCRI’s lead research Professor Rhian Parker says the issue must be more thoughroly investigated. “Often GPs, when they’re assaulted, don’t make a huge deal of it – but it’s significant and we need to find out how much it is going on,” she said.

From the Medical Observer.

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A systematic review of studies exploring stress in doctors and dentists by Rutter et al. (2002) found that teaching doctors and dentists experience less stress then their non-teaching counterparts. The review analysed seven studies and found evidence to suggest that a teaching role mitigated stress in doctors and dentists, with the authors suggesting several mechanism for the effect including lessend isolation, increased self-esteem and added interest in patients as a source of teaching opportunities. The authors emphasised that more research is neccesary to confirm and explain their findings.

The study can be found at Interscience.

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A Spanish study by Camps et al. (2008) found that 8 per cent of medical oncologists are suffering from high levels of burnout. The survey of 200 oncologists also found that 21 per cent of the sample showed high levels of exhaustion. The results were consistent with previous international research examining oncologists.

The authors describe the specialty as having its own unique stresses, as it involves much management of pain and death, which often leads to the internalising of painful emotions.

The authors recommend an increase in education to teach oncologists how to manage their emotions, and the establishment of support groups to help oncologists manage stress and burnout.

The study can be found here.

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A Dutch study by Prins et al. (2007) of burnout in medical residents has found the greatest predictor of burnout is the the level of perceived support from supervisors. The survey of over 250 medical residents also found that the residents were significantly more dissatisfied with support received from their supervisors compared with support received from other residents and nurses.

The study recommends support strategies be taught to not only residents, but also supervisors in an attempt to minimise burnout in young doctors.

The study can be found at www.informaworld.com.

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A survey by Surgenor et al. (2009) of 180 medical consultants in New Zealand hospitals investigated burnout and its relationship with demographic characteristics.

The study found 29% of the sample had high emotional exhaustion, 24% had high depersonalisation, and 31% had low personal accomplishment. Twenty per cent of the sample was assessed as having high overall burnout.

Factors which significantly correlated with burnout were longer work hours, less experience and lower job satisfaction.

The authors recommended well researched stress management interventions to target burnt out consultants.

The study can be found at www.ncbi.nlm.nih.gov.

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An American survey by Shanafelt et al. (2009) of almost 8,000 surgeons investigated the incidence and factors of burnout in the American surgeon population.

The study found that 40% of respondents were suffering from burnout, 30% showed symptoms of depression, and only 36% felt surgery left sufficient time for personal and family life. The study additionally found that 28% of the respondents had a mental quality of life score of less then half a standard deviation below the population average.

The study accepted a number of limitations including a low response rate, and highlighted a number of strengths including that it is the largest survey of physician burnout to date.

The study can be found here.

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In a recent survey of hospital doctors by Salaried Doctors Queensland (SDQ), 88% reported suffering dangerous levels of fatigue while working. The survey of 113 doctors also found that 60 per cent had reported making mistakes while fatigued. The study was used as evidence to support the SDQ’s latest push to the Queensland State Government to limit shift lengths to 12 hours with a minimum of 10 hours of break between shifts.

From the ABC.

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