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Doctors are facing a mental health crisis, driven by long hours, moral injury, and rising public hostility.
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It is estimated that 80 to 90% of doctors experience some form of burnout at some point in their careers. This can affect their ability to practise optimally and to connect with their patients with empathy and care.
The consequences are serious, as burnout and depression are major risks for doctors, threatening their well-being and the quality of care they provide.
On the first Friday in June each year, everyone is encouraged to wear colourful, mismatched or attention-grabbing socks to mark Crazy Socks 4 Docs, an international awareness movement aimed at increasing the visibility and support for mental health for medical professionals, who are at especially high risk for depression, burnout and suicide.
It is deeply concerning that at least 50 to 60% of health care professionals will experience depression at some point during their working lives.
Junior doctors are particularly vulnerable and their risk for depression and burnout seems to be increasing. One of the factors that contributes to burnout is work overload, as doctors are expected to do more within the same amount of time.
Beyond patient consultations, they face a growing mountain of paperwork – from medical aid forms and insurance requirements to documentation and providing clinical feedback on patients with complex medical needs.
People may ask why doctors do not take on fewer patients – the need is simply too great and the resources too few.
Even in the private sector, if you, as a doctor, decide to see fewer patients, this means longer waiting times for people who need treatment from the few specialists in the field available in their city or province.
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Very often, patients just cannot wait months for an appointment. As caring health care professionals, we often squeeze more urgent patients into our days, often at the expense of a much-needed break.
Doctors often find themselves in a situation where they are constantly putting their patients’ needs before their own basic needs.
In the short term, a person may be able to handle this intense pressure but, in the long term, we know it’s not sustainable and will affect their physical and mental health sooner or later.
Some 20 to 40% of doctors’ time is spent on tasks they are not remunerated for, such as writing scripts, completing documents, making phone calls, following up and speaking to patients’ families.
While we do this caringly and in the “always on” culture of social media and digital technology, health care professionals are expected to be available and responsive around the clock.
Not only are these additional tasks time-consuming, but they are often expected outside of normal consulting hours. This can add to feelings of losing control, a major factor in burnout.
While doctors are looked up to as healers, they themselves may experience “moral injury”, which is one of the greatest contributors to burnout.
This refers to a situation where they are forced into doing something they may not agree with, often made necessary because doctors work within the parameters of funding constraints, managed care and patients’ medical scheme benefits.
These limitations mean that we, as doctors, may not always be able to prescribe the ideal treatment that we feel would be most beneficial for our patients – simply because many of the drugs are grossly unaffordable.
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This places health care professionals who have their patients’ best interests at heart in the very difficult position of sometimes having to make compromises on the treatment they can prescribe.
Doctors are sometimes mistakenly perceived to be omnipotent and we are expected to never get ill ourselves, including both our physical and mental health.
Many don’t seek mental health care, often because they are afraid this reflects negatively on their competence or ability to practise.
Tragically, doctors therefore often wait until they really can’t cope before seeking mental health care and by then, it becomes more difficult for us to help, where earlier intervention could have prevented such a serious decline that it may affect all areas of their lives.
Another contributor to doctors’ burnout and depression is the worrying rise in antimedicine culture globally, such as the anti-vaccine movement and anti-pharma beliefs.
As doctors, we bear the brunt of this as individuals who take these beliefs to heart may need our help, but express such distrust, often founded on baseless online conspiracy theories that are counterproductive.
We health care professionals are placed in the invidious position where patients come to us and want us to help them, but they do not want the help we are able to give.
Very often, doctors and their receptionists are on the receiving end of verbal abuse. Even threats and physical violence are not uncommon, particularly in the public sector.
Recognising the immense pressures doctors work under, shifting the narrative from silent endurance to proactive selfcare is essential. Just like their patients, doctors must feel empowered to seek help early.
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