Julia Patterson recalls clearly the moment she decided she had to quit two things she treasured – practising medicine and working in the UK's National Health Service (NHS) – in order to safeguard her own mental health. “I loved my job,” she said. “I love psychiatry, but I could no longer go to work every day without tackling what was happening.” The Guardian reports that she broke down to her husband: “I told him I just couldn’t send another homeless mentally ill patient out on to the streets after they’d arrived in A&E at 3am, suicidal and alone.”
It was a huge decision – to take a break from the career she had wanted to pursue for so long. She was halfway through her psychiatrist’s training and had passed all the exams young doctors have to sit when starting out on their careers. Patterson left behind a service that she says has been left “cut back to its very bones” after nine years of austerity funding.
“This is felt every day on the NHS frontline and in every patient encounter. Trying to give care when you don’t have ‘enough’ is heart-breaking. There is no longer enough time, enough staff, enough resources. It chips away at you daily: and your morale becomes broken. Doctors are stretched because so many of our colleagues have left – left the country for places that support them better or left the profession altogether.”
According to research published earlier this year in the BMJ, British doctors are turning to drink, binge-eating and prescribed drugs to cope with the mounting stresses of their jobs, research reveals.
Large numbers of doctors are troubled by sleeping problems, fatigue and headaches because workloads have become so heavy. And more than half of all medics (55%) are suffering from burnout, from the emotional exhaustion of their jobs.
The research shows how hard doctors find it to switch off from the responsibilities involved in caring for patients. Six in 10 (61%) think about work when they go to bed, while 49% have trouble sleeping if they postpone tasks.
Academics at Birkbeck College in London and University College London found that one in three medics used alcohol to feel better, and one in five to cope with a stressful event, while 5% were dependent on drink.
The results are based on questionnaires completed by 417 UK doctors, which reflect the makeup of the country’s 251,000 practising medics.
More than two in five (44%) respondents said they used drugs, though they were mainly antidepressants and painkillers and herbal, homeopathic and over-the-counter medications rather than illegal substances such as cocaine.
Many doctors have dysfunctional eating habits too. A third (35%) said they ate large amounts of food even when not feeling physically hungry, while 28% felt disgusted, depressed or very guilty about overeating.
The Guardian report says in Patterson's new role as a co-ordinator of both campaign group EveryDoctor, which works to improve doctors’ working lives, and The Political Mess, an online forum run by the Doctors’ Association UK, Patterson, who is 33, hears daily about the pressures medics are under. “Stress is endemic and burnout is common. Our more experienced doctors report that things have never been worse.”
The NHS in England alone is short of almost 10,000 medics. The result of all this is that worryingly large numbers of doctors are giving up either during their training or after experiencing the realities of working in an NHS that is visibly struggling to cope, or are retiring early. GPs and hospital doctors alike feel forced out or are glad to have left their jobs at a time when the health service needs them more than ever. Some, as Patterson adds, kill themselves.
The report says new findings shared by legal support service the Medical Protection Society (MPS) confirm the deep discontent in Britain’s medical profession. Professor Dame Jane Dacre, who until 2018 was president of the Royal College of Physicians (RCP), which represents many hospital doctors in England said: “They tell us that the human impact of all these things – rota gaps, austerity, low morale, working in hospitals with paint peeling off the walls and equipment that doesn’t work, and not feeling that you can do your best for patients – is becoming disproportionate and is undermining doctors’ sense of vocation.”
Dacre visited 80% of England’s hospitals during her time at the RCP. “At each hospital,” she recalled, “we held open forums for doctors to come and talk about things that were on their minds. But very often open forums became like open season. The picture that emerged was of an unhappy and frustrated medical workforce.
“It was heart-breaking to see these articulate, intelligent, empathic and skilled people feeling undervalued, under-resourced, demotivated, crushed and wanting to leave – despite medicine being the thing they loved doing. Burnout was endemic.”
The report says details of the government’s NHS People Plan for England are due in the next few weeks. But with staff shortages now so routine, easing doctors’ burden may not be simple. “These are people that deal with death, emergency situations, other people’s misfortunes on a daily basis,” said Dacre. “They save lives. Somebody needs to start thinking about saving them.”
[link url="https://www.theguardian.com/society/2019/sep/29/doctors-quit-nhs-austerity-stress-staff-shortages"]The Guardian report[/link]