Senior NHS doctors face huge burden of work related illness, researchers find

Authors: Matt Limb 

Publication date:  26 May 2017


Senior UK doctors have disclosed a huge burden of work related ill health and feelings of being unsupported by the NHS, a study has found.

Hundreds of doctors near the end of their careers reported experiencing chronic physical or mental stress, and many said that the NHS did not respond well when they became ill.

The researchers said that more GPs than hospital doctors reported problems and that older doctors in particular “need support to be able to continue successfully in their careers.”

The research was carried out by the UK Medical Careers Research Group at Oxford University’s Nuffield Department of Population Health and was published in the Journal of the Royal Society of Medicine.[1]

The researchers analysed the responses of 3550 doctors who graduated in 1974 and 1977 to a survey on work’s effects on their own health and wellbeing. The authors wrote, “Their comments reveal a huge burden of ill health which many respondents attribute to aspects of their work, the working environment, or the difficulty of achieving a sustainable balance of work and home commitments.

“Many doctors felt that the health services as an employer had, in their own experience, not been good at responding to doctors who became ill or who were subject to difficult and demanding personal circumstances.”

In response to the question, “Do you feel that working as a doctor has had any adverse effects on your own health or wellbeing?” 44% of doctors answered yes. More GPs (47%) than hospital doctors (42%) said that this was the case. Three quarters of doctors who answered yes cited “stress/work-life balance/workload” as an adverse effect, and 45% mentioned illness. Adverse effects cited included problems such as sleep loss, weight problems and heavy drinking, and adverse effects on relationships and family life.

Episodes of burnout and depression were often attributed to the stress and workload that doctors faced.

Doctors also complained that frequent policy changes and increased bureaucracy added to the pressures on them, citing NHS cuts and repeated reorganisations in the 1980s and 1990s.

Doctors often believed that physical illness such as stroke, heart disease, hypertension, and migraine were caused or aggravated by stress.

Some doctors said that they had received good support when they needed it, but many did not.

In response to the statement, “The NHS of today is a good employer when doctors become ill themselves,” 28% of doctors agreed, 29% neither agreed nor disagreed, and 43% disagreed. More women (49%) than men (40%) disagreed with this statement. More GPs (49%) disagreed than hospital doctors (37%).

Doctors also reported specific job related physical illnesses, such as repetitive strain injuries from carrying out procedures.

Many doctors who had since retired reported that their health had then improved substantially.

The researchers said that though some of the reported comments related to the past, there are lessons for the present and future about the need for better support for doctors.

A small number of doctors reported adverse effects on the quality of their work and care of patients. The authors said that these unprompted comments suggested an unacknowledged problem: that some doctors may acquire problems over time through their work that adversely affect the care they provide.

They wrote, “This is worthy of further investigation and planning. In the context in which medical careers are getting longer and retirement ages are increasing, doctors in the latter stages of their careers may have to adapt the make-up of their work to reflect the best use of their skills, experience, and abilities.”

References

  1. Smith F, Goldacre MJ, Lambert TW. Adverse effects on health and wellbeing of working as a doctor: views of the UK medical graduates of 1974 and 1977 surveyed in 2014. J R Soc Med  2017;110:198-207. [Link] [Link] .

Matt Limb freelance journalist BMJ Careers

Cite this as BMJ Careers ; doi: