Friday, 23 October 2015

How important it is to ensure physician’s wellbeing

For doctor’s cause: How important it is to ensure physician’s wellbeing and what can be its impacts on their patients?
Dr K K Aggarwal

The importance of physician’s wellbeing was the centre of discussion of the delegates at the annual General Assembly of the WMA in Moscow, which was held from 14th to 17th October. The expert panel saw the active participation of around 60 countries, stressing on how a few factors including biological, psychological and social problems experienced by physicians including mental illness, disabilities, occupational stress, burnout and any other chronic ailment can affect the efficiency of the doctor and as well as their patients.

As often discussed, a physician’s wellbeing is one of the most prominent factors contributing towards successful treatment of a patient. However, there is still not much clarity on this subject, but still this topic has been going back and forth in the discussions of the medical experts. They have spoken about the medical industry of each country needs to focus on encouraging ongoing research on physician’s health. Government should start supporting the conclusions based on the estimates and evidences that we already have. While it is always believed that physician’s follow the nitty-gritty of a healthy lifestyle, but some of them still suffer a lot of stress due to different reasons.

Reportedly, it has been observed that the highest rate of suicide is found amongst the medical professionals, especially physicians. Additionally, female doctor suicides significantly outnumber male doctor suicides.  The major factors accountable are the stress and strain one has go through in order to be a doctor and carry on in the medical profession. Due to the workload, doctors often end up getting managing and multi-tasking consistently. As a result, they get inadequate sleep, are forced to social isolation and are overworked. The government needs to take a step and start working on framing the necessary policies that will ease up the whole crisis for physicians and their patients as well.

Setting all the reasons aside, physicians tend to avoid seeking help in case they feel ill because they are concerned about the confidentiality of the information pertaining to them. They are seen as the role models by their patients and hence, they hesitate in opening up about their health problems. To eradicate this fear of information breach and excessive burden of external expectation on them, government should ensure that the physicians get the same right of confidentiality as any other patient when seeking and undergoing a treatment. The health care system may need to provide special arrangements for the care of physician-patients in order to uphold its duty to provide privacy and confidentiality. Prevention, early assistance and intervention should be available separately from any disciplinary process for them.

WMA states the factors that hinder the wellbeing of a physician:

·         The medical profession often attracts highly driven individuals with a strong sense of duty. Successfully completing the long and intense educational requirements often confers upon physicians a high degree of respect and responsibility in their communities. This external expectations burden often ends up burdening them with a lot more than an individual can take, hence, leading to stress. Also, the doctors, who are always looked up on as the ideals and role models prioritizing the care of others over care of self. And missing out on expectations often given them a feeling of guilt and selfish nature

·         Working conditions, including workload and working hours, affect physicians’ motivation, job satisfaction, personal life and psychological health during their careers. Sometimes, due to the extended working hours, they miss out on required sleeping hours and this eventually leads to their health deterioration

·         Physicians are often perceived as being immune to injury and diseases as they care for their patients. Physician who are employed by small organizations or who are self-employed may be at even a higher risk for occupational diseases and may not have access to health and safety programs provided by relatively large health care establishments. So, despite the size of a hospital or a clinic, the basic healthy practices and hygiene should be adopted for the help of both patients and doctors

·         Physicians in postgraduate education often confront emotionally challenging and traumatic situations including patients’ suffering, injury and death. Physicians may also be exposed to physical hazards like radiation, noise, poor ergonomics, and biological hazards like HIV, TB and hepatitis. All of this makes them more prone to the diseases which can degenerate their health both mentally and physically

·         Additionally, some of the physicians in postgraduate education and medical students, especially women can be victims of harassment and discrimination during their medical education.  And due to their position within the medical hierarchy, they may feel powerless to confront these behaviours. This leads to the frustration building up in their minds and causing a mental outbreak

·         Medical industry runners should work on potential obstacles, which restrict an ill physician from seeking care including denial, confidentiality issues, aversion to the patient role, practice coverage, fear of disciplinary action, potential loss of practice privileges, loss of performance based payment and the efficiencies of self-care.

·         Illnesses can include mental and behavioural health problems, burnout, communication and interpersonal issues, physical and cognitive problems and substance use disorders

According to WMA, a few steps immediately need to be followed including improved wellness promotion programs, prevention strategies and earlier intervention of symptoms in physicians can help mitigate the severity of mental and physical illnesses and help reduce incidence of suicide in physicians and medical students. 

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