Monthly Archives: October 2019

Medical industry pressures are placing an intolerable strain on staff

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An overwhelming majority (85%) of Australian medical professionals believe their peers are at a heightened risk of burnout compared to the general population, EKAS Market Research’s latest survey shows.

Complicating the issue is the finding that 84% of the same survey group said there is a strong stigma against those in the medical profession seeking help. 

These recently collated views of Australia’s medical practitioners are corroborated by other sources. A landmark BeyondBlue study conducted in 2013 found one in five medical students and one in 10 doctors had suicidal thoughts in the past year. 

Additionally, the BeyondBlue survey showed more than four in 10 medical students and a quarter of doctors are highly likely to have a minor psychiatric disorder, such as mild depression or anxiety. The study also found 3.4% of doctors experienced very high psychological distress, a rate far higher than the general community. 

EKAS’s own survey of nearly 500 Australian medical practitioners, which delved into a range of issues, revealed several other alarming statistics.

Younger and regional doctors considered at a heightened risk

Although the medical profession at large suffers a greater mental health affliction, its youngest employees are perceived to be at greatest risk. When asked whether young practitioners are at a higher risk of burnout, 44% agreed they were, while 28% regarded the risks as the same irrespective of age. A further 22% said younger practitioners were at a lower risk, while 6% could not decide.

Remoteness was another factor observed as a key contributor to burnout. There were 46% of respondents who rated regional medical practitioners as being at a higher risk, while 31% assessed the risks as the same wherever they practiced. Only 9% rated regionally-based doctors at a lower risk and a further 14% could not decide.

Working with a mental health burden

The attitudes of medical practitioners themselves can be considered problematic, with updated BeyondBlue research from 2019 revealing 40% judged their peers with mental health concerns as less capable. 

EKAS’s survey similarly showed that just 5% of medical practitioners thought a physician could practice competently while dealing with a mental health issue. There were 27% who categorically said they could not do so, while the majority (68%) said it was dependent on the severity and nature of the disorder.

As for whether the current resources were adequate for dealing with physician burnout, the view of the profession was scathing. 

There were 56% of those surveyed who said the channels for help weren’t sufficient, while only 6% felt they were. Another 25% felt there were adequate resources to help but they weren’t being utilised properly and another 13% didn’t know enough about the options to comment.

Causes of burnout

The sheer number of hours that medical staff were required to work was rated as the most significant contributing factor to burnout, with 69% of those surveyed including it. 

This was followed by 57% who cited a perfectionistic, high achieving personality type, 55% who saw a stigma around seeking help, 52% who flagged the relationship between patient illness and death, and 50% who said there was not enough clinical or professional help. 

Almost a third (32%) said there wasn’t enough devoted mental health support, while 27% said there was inadequate resilience support and training from universities.

When asked to pick out the single most significant factor influencing burnout in medical professionals, 24% cited the length of workdays, 17% the effect of patient illness and death and 15% a perfectionistic, high achieving personality type that would not allow themselves the respite they needed.

Why do they suffer in silence?

It is well established that medical practitioners not addressing their mental health is a significant factor in burnout and suicide. It appears the contributing factors are well understood however, with roughly two thirds of respondents citing every one of the survey’s reasons for not disclosing a mental health issue.

All told, the perceived reasons for not disclosing mental health struggles included fear of judgement from colleagues (78%), fear of being deregistered (72%), the high achieving personality type of medical practitioners (66%), confusion around AHPRA reporting guidelines (65%) and the perception that doctors needed to be seen as resilient (64%).

What can be done?

A high number of respondents (83%) said better work-life balance for medical practitioners was required, followed by improved lifestyle factors like diet, health, exercise and meditation (66%) and the need for a reduced stigma around seeking clinical help (56%). 

Interestingly, all three top ranking factors related to either self-care or a perceived need for more understanding among the wider profession. It points to a general insularity, and a sense that if medical practitioners can help others, they can help themselves.

Additionally, there were 53% of those polled who said clarity around AHRPA guidelines was needed and 52% who cited a stronger clinical health system.

As for having the mental health issue dealt with mandatorily, only 28% said there should be required counselling with specialised GPs or psychologists. 

It’s a finding that suggests implementing step change for dealing with mental health in the medical profession would require a hearts and minds campaign of some scale. But, given the stark findings of this and other surveys, now appears to be the time.

 

If you need to talk to someone, you can call Lifeline on 13 11 14 or BeyondBlue on 1300 22 44 36

 

Footnotes

For the purposes of this study, burnout was defined as mental exhaustion and/or mild depression or anxiety. 

Survey numbers: This EKAS survey polled 474 medical professionals across all Australian states and territories. There were 51% who identified as GPs, 44% who identified as specialists and 5% who identified as surgeons. Of the total survey group, 4% identified as registrars. The average time practicing was 22.1 years.

If you are seeking content for an upcoming event or would like some preliminary information (short poll) for a client proposal, please reach out to EKAS and we’d be happy to help. EKAS received 377 responses for this survey within the first seven business days and respondents went into a draw to win a $100 prize.

Could regulatory measures help prevent physician burnout and suicides?

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Australians have laws in place to protect the welfare of unionised workers, but could a legal approach be the positive intervention we need to protect our doctors against burnout and suicide? 

Sharona Hoffman, a professor of Health Law and Bioethics at Case Western Reserve University in Ohio, argues that regulations similar to those that govern the rights of pilots and flight attendants could help combat the high rates of stress, depression and emotional exhaustion among doctors. It’s an approach that is also gaining a following on our shores.

So how is burnout characterised and what legal steps can be taken to address the key risk factors? Read more here.

Suicide rate for young doctors remains unacceptably high

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In 2016 a junior Australian doctor exposed a ‘disgusting’ open secret about the spiralling suicide rates among younger medical practitioners, owing to the immense workplace pressures they faced.

Physical and mental well-being were suffering, the author wrote, because doctors were operating in an environment where showing the strain of the job was seen as a sign of weakness.

Three years on, that doctor has now revealed her identity. She stresses that little has been done to improve workplace conditions, providing some insight into the exploitative nature of the system in a novel titled Going Down Under.

So what has been the response from the medical industry to address the ‘brutalising culture’ and working conditions? Hear from the doctor who exposed it all here.

Hummingbird Insight’s deep dive into financial and medical probabilities

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Hummingbird Insight asked two separate groups of medical practitioners a separate but related series of questions on financial and medical probabilities. The questions and voting are recorded below. 

Question 1

Group One were asked if they would prefer to receive $50 today or $100 in six months?

Group Two were asked if they would prefer $50 in six months or $100 in 12 months? 

The results found that 39% of Group One preferred $50 today, compared to 61% who said they’d rather $100 in six months.

For Group Two, 25% preferred $50 in six months while 75% would rather $100 in 12 months. 

Researcher and expert in consumer, cognitive and organisational psychology, Adrian Camilleri, said, “Question 1 showed that people were much more willing to wait six months for an extra $50 when all the payoffs were far into the future compared to today.”

Question 2

Group One were asked if they would take this bet: We flip one fair coin one time. If it lands on heads you gain $110 but if it lands on tails you lose $100?

Group Two were asked if they would take this bet: We flip one fair coin 100 times. Each time it lands on heads you gain $110 but each time it lands on tails you lose $100?

In Group One, 80% of respondents said they wouldn’t take the bet, compared to 20% who would. In Group Two, 46% said no, while 54% would take the bet.

“For Question 2, respondents were much more willing to gamble when the bet was to be played many times. But if the one-off single bet was bad, isn’t this just 100 bad bets?” Camilleri said.

Question 3

Group One were asked if they would prefer: An option offering a 100% chance of $30 or an option offering an 80% chance of $40, otherwise $0. 

Group Two were asked if they would take this bet: An option that has recently paid out the following outcomes: $30, $30, $30, $30, $30, $30, $30, $30, $30, $30? Or an option that has recently paid out the following outcomes: $40, $40, $0, $40, $40, $40, $40, $40, $0, $40?

In Group One, 91% voted for the first option with just 9% opting for the second option. In Group Two, 48% voted for the first option and 52% voted for the second option.

“Question 3 showed that people were much more willing to choose the riskier option when the probabilities of each outcome were not explicitly described,” Camilleri said.

Question 4

Group One were asked if they preferred: An option that could lead to a $150 loss with a probability of 19%? Or an option that could lead to a $30 loss with a probability of 98%?

Group Two were asked if they preferred: An option that could lead to memory loss with a probability of 19%? Or an option that could lead to fever with a probability of 98%? 

In Group One 60% voted for the first option and 40% voted for the second option. In Group Two, 11% voted for the first option and 89% voted for the second option.

With Question 4, we observed that respondents were much more willing to choose an option with a very bad possible outcome when considering options with financial (rather than medical) consequences,” Camilleri said.

 

If you are looking for some content for an upcoming event or would like some preliminary info (short poll) for a client proposal, please reach out to EKAS and we’d be happy to help.