Informed, engaged communities for health

Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
codesign
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#Govern4Health
#GreenHealthForum21
#HealthClimateSolutions21
#HealthReImagined
#HearMe21
#IndigenousClimateJustice21
#NNF2021
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
#WCepi2021
#YHFSummit
Croakey Professional Services
#AKctionKidneyCare
#BetterCareCOVID
#CommunityControl
#COVIDthinktank21
#KidneyCareTogether
ACSQHC series
Lowitja Indigenous knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#HealthyCOP26
#HousingJusticeAus
#JusticeCOVID
#LookingLocal
#MRFFtransparency
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVID SNAPS
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Election 2022
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Health workers
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
housing
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
Croakey Professional Services archive
#bettercareseries
#CommunityControl Twitter Festival
ACSQHC series 2019
Croakey projects archive
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Naked Doctor
Poems of Public Health
Summer Reading 2016-2017
Summer Reading 2017-2018
The Koori Woman
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
#HealthElection16
Federal Budget 2009-2010
Federal Budget 2010
Federal Budget 2011
Federal Budget 2012-2013
Federal Budget 2013-14
Federal Budget 2014-15
Federal Budget 2015-16
Federal Budget 2016-17
Federal Budget 2017/18
Federal Budget 2018-19
Federal Election 2010
Federal Election 2013
Federal Election 2016
Federal Election 2019
NSW Election 2015
NSW Election 2019
NT Election 2016
Qld Election 2015
Victorian Election 2014
WA election 2021
Support non-profit public interest journalism
Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
codesign
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#Govern4Health
#GreenHealthForum21
#HealthClimateSolutions21
#HealthReImagined
#HearMe21
#IndigenousClimateJustice21
#NNF2021
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
#WCepi2021
#YHFSummit
Croakey Professional Services
#AKctionKidneyCare
#BetterCareCOVID
#CommunityControl
#COVIDthinktank21
#KidneyCareTogether
ACSQHC series
Lowitja Indigenous knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#HealthyCOP26
#HousingJusticeAus
#JusticeCOVID
#LookingLocal
#MRFFtransparency
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVID SNAPS
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Election 2022
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Health workers
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
housing
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
Croakey Professional Services archive
#bettercareseries
#CommunityControl Twitter Festival
ACSQHC series 2019
Croakey projects archive
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Naked Doctor
Poems of Public Health
Summer Reading 2016-2017
Summer Reading 2017-2018
The Koori Woman
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
#HealthElection16
Federal Budget 2009-2010
Federal Budget 2010
Federal Budget 2011
Federal Budget 2012-2013
Federal Budget 2013-14
Federal Budget 2014-15
Federal Budget 2015-16
Federal Budget 2016-17
Federal Budget 2017/18
Federal Budget 2018-19
Federal Election 2010
Federal Election 2013
Federal Election 2016
Federal Election 2019
NSW Election 2015
NSW Election 2019
NT Election 2016
Qld Election 2015
Victorian Election 2014
WA election 2021

Data and drivers of doctors’ mental health — burnout and #MH4Docs at #RANZCP2019

Marie McInerney writes:

Rates of depression, anxiety and suicide among doctors have made headlines in recent years, underscored by high profile campaigns like #crazysocks4docs, but in ways that might be alarmist and counterproductive, according to a leading mental health researcher.

Importantly, despite the publicity, there is no available evidence on what hospitals and training colleges can and should do at an organisational level to address key risk factors like high workloads, long working hours and fatigue, Associate Professor Sam Harvey told the recent RANZCP Congress in Cairns.

Harvey, who is chief psychiatrist and head of the Workplace Mental Health Research Program at the Black Dog Institute in Sydney, steered a recent systematic review and meta-analysis of interventions to reduce symptoms of common mental disorders and suicidal ideation in doctors – thought to be the first such study in the world.

Published in February in Lancet Psychiatry, the study found “remarkably little” has been published (in English at least) on the efficacy of potential solutions, apart from a handful of studies that found benefits in individual interventions based around cognitive behaviour therapy and mindfulness.

“Stunningly,” Harvey told delegates to the Royal Australian and New Zealand College of Psychiatrists (RANZCP) summit, there were “absolutely no published controlled studies” that looked at organisational-level interventions around workplace issues like working hours.

This was despite evidence captured in a yet-to-be-published study by the Black Dog Institute that “once you had junior doctors working more than 50 hours a week they had more than double the odds of reporting depression and anxiety; and once that is over 55 hours you’ve doubled the odds of suicide ideation”.

In their Lancet review, Harvey and co-authors say their findings should “serve as a call to action” on effective interventions — both at an individual and organisational level — to improve doctors’ mental health, with more rigorous, comprehensive research required to establish an evidence base.

Speaking ahead of Saturday’s federal election, when Australians voted to return the Liberal-National coalition for a third term, Harvey said government leadership may be required on the issue.

The mental health of medical practitioners was on the COAG agenda in 2018, with a push to end mandatory reporting of doctors ultimately falling short with the passage of Queensland legislation in February.

Watch our interview with Harvey below:

What happens in the darkness

Harvey’s was one of a number of packed sessions over the four-day RANZCP congress that explored wellbeing issues, including bullying and burnout, for junior doctors and other at-risk occupation groups like first responders, military personnel and military veterans.

One session, titled ‘Telling Our Stories’, heard a graphic account of systematic bullying by a senior registrar when the presenter was in his first year of training.

“I felt my heart start to race when I entered the building. My confidence was being eroded, and I was being paralysed by my doubt and fear,” he told the session.

He went on:

I never pursued a formal complaint, I couldn’t tolerate sitting in a room with him and listing all the micro incidents that were making me feel stupid and afraid – I didn’t think people would believe me.

Each interaction seemed like nothing, but when taken as a whole this man was bullying me, he was systematically undermining and intimidating me.

This ‘telling’ is exactly what is needed to shed light on these shadows in our profession and to process what happens in the darkness.”

Bullying and burnout in medicine has come under increasing scrutiny in recent years, with trainee doctors blowing the whistle on cultural issues within the profession, prompting internal reviews by groups including the Royal Australasian College of Surgeons and Australasian College for Emergency Medicine (ACEM).

Burnout, and the factors underpinning it, was a hot-button topic at last year’s annual meeting of emergency doctors, with bullying and discrimination featuring in the program the previous year.

An online movement, #MH4Docs, has gained momentum following several highly-publicised trainee suicides, spawning a popular awareness-raising campaign, #crazysocks4docs, that has gone global. This year, the event will be held on Friday, June 7.

Not without consequence

Harvey opened his keynote address by challenging the value of reports that young doctors in particular have much higher rates of anxiety and depression compared to the general population.

In Australia those figures largely come from the 2013 National Mental Health Survey of Doctors and Medical Students conducted by Beyond Blue, which found significantly higher levels of very high psychological distress in doctors aged 30 years and below compared with the general population – 5.9 percent versus 2.5 percent.

“The conclusion is: ‘Oh my God, doctors are more than double the rate of depression and anxiety than the rest of the population, what the hell is going on!’,” Harvey said.

But he pointed to UK research suggesting that occupational studies return higher reports of psychological symptoms compared with population-based research, with a possible “framing effect” from research questions exploring ‘work stress’ in the occupational setting.

The UK study also made some unexpected findings within occupational groups: among professions predicted to have a higher level of trauma, such as the military and police, common mental disorders were not more prevalent compared to academia, teaching, white collar employment and the social services sector.

Questioning the statistics was not just “academic navel gazing”, Harvey said.

“I think it is a risk to us as an industry, going out and telling medical students that they’re at increased risk and perhaps should have chosen another occupation,” he said.

“Those messages are not without consequence,” he added. “It’s anxiety-provoking for them and has an impact on their perception of their symptoms and their resilience, which has knock-on consequences that may not be helpful.”

Harvey’s verdict?

Describing doctors as being at substantially increased risk of  mental health issues compared to other occupational groups “may not be accurate”, though they are by no means immune to the kinds of mental health problems seen in other populations.

What is clear, however, is that doctors are at increased risk of suicide, with Harvey nominating two key factors.

First, doctors often find it “very difficult” to seek help – for a range of reasons including the threat of mandatory reporting and loss of their medical licence. Secondly, they have access to and knowledge of highly lethal means.

“This points to one of the key issues in rates of doctor suicide, and why you don’t need to have doctors have higher rates of depression and anxiety than other occupations to explain high rates of suicide,” Harvey said.

Sleep deprivation and work-life balance

Beyond Blue has kindly given the Black Dog Institute access to its raw data from the 2013 survey, allowing Harvey and his colleagues to crunch the numbers on work-related risk factors for about 3,000 interns, junior doctors and registrars, across all specialties.

The original survey asked respondents how stressed they felt by a variety of workplace factors.

While the stress impact of some factors like bullying were lower than expected, two stood out in terms of frequency and impact: the conflict between work and personal life, and sleep deprivation.

Both will require rigorously researched organisational and individual interventions to address, Harvey said.

“And this is not just an Australian problem, this is an issue for health services around the world. It seems to me unimaginable that we can’t find the resources to actually study some of these things and to know which things work and which don’t,” he said.

In the absence of health sector-specific responses, other occupations are showing the way.

The Black Dog Institute has been working with Fire and Rescue New South Wales on training managers to better respond to mental health issues experienced by fire fighters and other emergency employees that it says has led to a significant reduction in sickness absence.

The Institute is now working with the Royal Australasian College of Physicians on modifying the training for doctors, with plans to conduct a randomised control trial.

It’s an approach that was welcomed at congress by public health physician and health lawyer, Dr Marie Bismark, who told Croakey that other industries have addressed issues like safe working hours and shift work much better than the health sector.

Bismark highlighted research by her colleague Associate Professor Allison Milner that found elevated rates of suicide among those employed in male-dominated professions such as construction compared to other occupational groups.

“It’s easy for doctors to feel that their workplace stressors are unique,” she told Croakey.

“What I really like about Sam (Harvey) and Allison Milner’s work is that they also work with other occupations and remind us that many of the problems – and solutions – to workplace stress are not unique to medicine,” Bismark said.

Andy Teodorczuk, Associate Professor in Medical Education at Griffith University, agreed it was “refreshing to have a psychiatry perspective on the wider wellbeing and resilience discourse that is one of medical education’s current hot topics”.

“I think that in medical education we often focus on burnout and distress. However, considering wellbeing in terms of depression and suicide lends itself to more holistic broader approaches in line with how we manage psychiatry disorders.

“For me Sam’s take-home was that it’s not system OR individual interventions that will make a difference but the need to focus on the system AND individual to tackle the complexity of the issue. Also there are some exciting studies in the pipeline…” he told Croakey.

Systemic risks and the administrative burden

The Black Dog Institute research says it is “incumbent” on colleges and hospitals to lead the way in addressing systemic risk factors, including work hours, workplace culture, regulatory requirements, ongoing training and the delivery of care to patients.

Organisational-level interventions also need to consider how recent trends in health care such as increasing administrative burden “might have affected the values, work-life balance, spirit and dignity of doctors”, it said.

The spirit-sapping toll of “paperwork load and clunky systems” was highlighted in another session on managing burnout, which psychiatrist Tessa Cookson from the RANZCP’s Member Welfare Committee said is expected to affect up to 50 percent of doctors through their careers – at “great cost” to themselves, patients and services.

Cookson said burnout was defined as a syndrome comprising emotional exhaustion, depersonalisation and reduced personal accomplishment in response to chronic stress in the workplace, much of which is seen in medicine as “rites of passage” – whether punishing exam schedules, exhausting patient loads and shift work, or instruction by humiliation.

While the impact of burnout on doctor welfare and performance had won increasing attention in recent years, evidence for practical strategies that can be taken up by individuals, in supervision, and by organisations, “is less clear”, she said, echoing Harvey’s sentiments.

One interesting insight for health services was to “get to know your doctor”, said Cookson, citing evidence showing that “if you give a doctor one day of work that holds intrinsic value they will work the other four days in something they do not particularly like, and do it happily.”

It was also vital to recognise that there was no point reducing work hours without a commensurate reduction in workload, said Cookson, with every one point increase on a ‘burnout scale’ generating a 30-40 percent likelihood that the person would reduce working hours over the next two years.

Again, the message was clear on where action was needed, with Cookson quoting US expert Dr Tait Shanafelt, director of Mayo Clinic’s Program on Physician Wellbeing.

Though it “is a system issue”, Shanfelt warns that “most institutions operate under the erroneous framework that burnout and professional satisfaction are solely the responsibility of the individual physician.”

He and his team have come up with nine strategies to help.

We’ve captured some of the Twitter discussion below:

This is the latest in our #RANZCP2019 series: bookmark this link to read our coverage to date, with more to come.

If you are a medical professional or student experiencing difficulty, the Doctors Health Advisory Service Helpline is available seven days a week.

Help is also available, round the clock, to members of the public at the services below.


Related Posts

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Search by: Categories or tags

Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
codesign
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#Govern4Health
#GreenHealthForum21
#HealthClimateSolutions21
#HealthReImagined
#HearMe21
#IndigenousClimateJustice21
#NNF2021
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
#WCepi2021
#YHFSummit
Croakey Professional Services
#AKctionKidneyCare
#BetterCareCOVID
#CommunityControl
#COVIDthinktank21
#KidneyCareTogether
ACSQHC series
Healthdirect Australia series 2019
Lowitja Indigenous knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#HealthyCOP26
#HousingJusticeAus
#JusticeCOVID
#LookingLocal
#MRFFtransparency
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVID SNAPS
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Election 2022
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Health workers
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
housing
justice
Justice Reinvestment
NBN