Why is the healthcare system so bad at looking after its own?

Right now, there are a lot of medical practitioners struggling to deal with the aftermath of the global pandemic.

The 2023 Medscape Physician Depression and Burnout Survey found that 53% of the 9100 US physicians surveyed reported they were burned out, compared to 42% in 2018 while 23% reported being depressed, compared to 15% 5 years ago.

Of those reporting depression, 64% had colloquial depression (feeling sad, down or blue) while 24% had clinical depression.

Clearly, things are heading in the wrong direction. Sure, the global pandemic added to the amount of stress being faced but the main issue other than excessive workload is the additional burden of documentation that currently adds an extra 1.84 hours per day beyond work hours, is the lack of support by management.

It’s about having your request for leave repeatedly refused.
It’s about putting in many additional hours that you don’t get recompensed for.
It’s feeling that you’re just a cog in the system, that’s being run without any thought to your humanity.

You’re left wondering, “How much longer can I keep going like this?”

This is leading to overwhelm, a sense of hopelessness and despair that nothing is going to get better any time soon.

Doctors and other healthcare workers are a hardy bunch. They are passionate, dedicated and care deeply about their patients and their work. It’s frustrating battling a system that lacks a clear vision for how to make things work better or a willingness to consider change.

Many of the doctors I’ve spoken with freely admit that their perfectionism, being prone to worry and need to always deliver the very best of care to their patients takes a toll on their energy and wellbeing and puts a strain on relationships with colleagues, other health professionals and partners.

They also don’t like to be seen as weak and so remain in denial that anything is wrong and are reluctant to ask for help choosing to try and sort it out themselves. The stigma around burnout and depression is strong.

But that doesn’t mean that practitioners aren’t taking steps to look after themselves. A growing number are taking regular positive steps to improve their health and wellbeing.

The most common positive coping mechanisms include exercise, talking with family or friends, getting enough sleep, and spending some time alone. While a few also report maladaptive behaviours such as alcohol or binge eating.

What can help?

This is a systemic problem that requires a holistic and integrated approach.

Improving the workplace environment begins by getting a clear understanding of the main points of tension so that the most appropriate and effective changes and be implemented.

Improving communication between management and healthcare workers is a must, to restore trust and mutual respect.

If you feel no one cares about you or notices your level of fatigue and any admission of struggle is treated with derision, it’s demoralising.

This is where creating a safe environment with high psychological safety can enable the robust and candid conversations needed to eliminate the “them and us” situation.

The benefit of this is not only happier and healthier doctors, but a better care environment and outcomes for patients and their families too.

Individual approaches include changing jobs to a role with fewer hours, taking leave when due and working hard to reach a better work-life balance.

But it’s hard to achieve.

The saddest thing about this situation is many are voting with their feet to leave the profession altogether at a time when we as a society can ill afford to lose any of our precious healthcare professionals.

Burnout is a waste of human potential.
It damages people, their health, wellbeing, and relationships.
It can destroy lives.