When we’re feeling low and in need of support, we are encouraged to seek professional help, often in the form of medical help – but what about the doctors? Where do they go for help? In the four years from 2011 to 2014, the Office for National Statistics reported that 430 healthcare professionals took their own life with doctors being one of the most vulnerable groups within the healthcare profession. I caught up with Dr Abeyna Jones to explore this further.
Abeyna is an Occupational Health Practitioner and founder of Medic Footprints – a social impact for profit business which leverages the talents of doctors by supporting their wellbeing and connections with diverse career opportunities. After working in the NHS for a number of years, Abeyna found that like many of her colleagues that she was suffering from worsening mental health and low job satisfaction to the point that she sought help from a psychotherapist and decided that she needed to get out of the NHS. She went to work in South Africa as a trauma surgeon dealing with a variety of your-not-so average illnesses and conditions such as snake bites as well as stabbings and gunshot wounds – regrettably something that NHS staff are now dealing with on a more frequent basis but thankfully still not on a daily basis. The change in environment coupled with living on the beach, game drives, wonderful food and wine proved instrumental in Abeyna falling back in love with being a doctor and she came back feeling revitalised and enthusiastic again about her career.
Medic Footprints is a great idea where those in the healthcare profession can go and seek out opportunities to do something different – either still within the profession but equally something totally different. From Abeyna’s own experience it was the feeling of making a real difference to people away from the confines and rigours of the almost suffocating rigidity of the NHS that led to her realisation that she did want to continue in the medical profession – but not necessarily in same capacity as she had been previously. She opted to trade in being a surgeon and retrained as an occupational health physician, meaning that she has a better health/life balance and also allows her to work on Medic Footprints.
In an article written for the Huffington Post, Abeyna said: “My ambition is to promote talent retention, not by boot strapping desperately unhappy doctors to the wards, but by allowing them to openly seek career and wellbeing opportunities for themselves.” It seems perhaps counter intuitive but with the NHS haemorrhaging doctors and the success that Medic Footprints is having, there is clearly a demand for the service. According to Abeyna: “For a lot of the doctors, it is about giving them the means and opportunity to rebalance their life by allowing them to explore their other passions and it doesn’t matter it is in healthcare or not”. Medic Footprints has found that those doctors who do something alongside their day job, report they enjoy medicine more and some that had previously expressed a desire to leave the profession came back having realised they were just under pressure or stressed and in need of a break.
Poor mental health is not without cost – both to the individual but also to business and the economy. A recent study by BHSF “Hiding in Plain Sight” reports that the average employee takes 8.4 sick days each year due to a mental health problem and that 42% of employees in their study admitted to calling in with physical illness rather than admit they were struggling mentally to cope.
Abeyna confirmed that even within the medical profession, there was a reluctance to admit to having any mental struggle – anxiety, stress, depression – for fear that it will be seen as a sign of weakness and might have a negative impact on career progression. It is important that doctors can feel able to admit they need help so that something can be done before they become they take their own live – statistics show that doctors are up to 5 times (2 to 5 times) the risk of suicide compared to the general population. I asked Abeyna why the instance of suicide among doctors is so high: “Doctors have to be very talented; you have to be very academic and you have to have a certain personality to succeed and get through the training. They are very high achievers and if something goes wrong, then they feel terrible about it. They tend to be perfectionists so if they don’t feel that they’re valued or they’re worth anything or they make mistakes, then it’s catastrophic for them and the irony is that we, as doctors, are very reluctant to get support for ourselves simply because we feel we should be able to cope… and we simply don’t have time to look after ourselves because we’re busy treating everyone else!” Doctors are also very well qualified to be able to take their own life – they have expert knowledge and access to medication with anaesthetists being at particularly high risk of being successful in committing suicide according to Abeyna.
When asked if long shifts and intense pressure are a contributory factor to the poor mental health of doctors, Abeyna commented that it wasn’t necessarily the length of the shifts in isolation but it is the ever-increasing amount of pressure that they have to cope with within the shift that is becoming telling which can, and has, led to fatal errors. The recent case of Dr Hadiza Bawa-Garba has angered many in the medical profession – they feel that she was thrown under the bus when being struck off for medical negligence when in reality she working under extreme pressure because the system is at breaking point. Many doctors recognise that the tragic error could easily have been made by any of them and that rather than examining the failings in the system, it seems that the GMC have made an example of Dr Hadiza Bawa-Garba. There is a danger that rather than sharing experiences in order to prevent similar incidences in the future, that Dr Hadiza Bawa-Garba’s own written account of events served her ill as it was used by the GMC as evidence of her culpability. Doctors will be less inclined to share or document accounts in the future thereby storing up further anxiety and pressure, which will inevitably add to poor mental health.
We now live in a highly connected society with an abundance of technology which is supposedly designed to make life easier and we all expect to have access to everything whenever, where ever we believe we need it – a truly global, 24/7 world. Yet what about those that are expected to deliver the service – GPs particularly are feeling the strain. In an article written by Elisabeth Mahase in August 2018, for the GP magazine Pulse, a recent survey by Mind, revealed that in a survey of over 1,000 GPs, 2 in 5 recorded that they have suffered from a mental health condition. With a figure of 40% admitting that they had experienced mental health conditions such as depression, anxiety, bipolar disorder and ptsd, the worry is that their workloads are now such that it is becoming unsafe – not only for the GPs themselves, but surely a worry for the people they are treating? The Practitioner Health Programme is an NHS funded organisation for doctors and dentists within the UK where they can self-refer in order to get help with a variety of mental health issues but despite being founded some 10 years ago, Abeyna believes a lot more could be done to promote its existence within the profession and she feels strongly that the mental well-being of the doctors and staff within the NHS should reside with the NHS as the employer and they should be doing more to look after and promote the well-being of their staff.
It is timely therefore that just before World Mental Health Day that Simon Stevens, NHS Chief announced on 05 October at a conference on “Wounded Healers” that there would be national funding for a new scheme for all NHS Doctors in England which will cover approximately 110,000 additional doctors as well as those already being covered. The aim of the new funding is to build on the success of the current nationally funded scheme for GPs and trainees which has seen it the treat over 1,500 doctors since its launch in its current format in early 2017. With the results of a survey of those who have used the system showing that 93% of patients were likely to recommend the service to others; 88% said it had a positive or very positive impact on their wellbeing and 78% of doctors said it had a positive or very positive impact on their ability to continue working, it is good to see that they appear to have got something right in the NHS!
We must build on people being more open and willing to talk about needing help when it comes to their own mental health – particularly for those in the medical profession because it can be a matter of life or death – not only for the doctors but also the patients.
For more information on Medic Footprints and their crowdfunding for doctors initiative, which launches this Friday. Please visit Crowdfundingfordoctors.org