High patient loads, understaffing, shift work and red tape are all compiling to negatively affect doctors’ mental health, new research has found.
A study on work-related impacts on doctors’ mental health, published in the BMJ, found system-level changes are needed to protect the wellbeing of the medical workforce, including restructuring leave provisions and addressing staff shortages.
Doctors Health Advisory Service Western Australia (DHASWA) agreed that doctors could benefit from resolute displays of support across the profession, but cautioned not all doctors are in a position to make changes.
Australian doctors at all career stages have higher rates of depression, anxiety and other mental health concerns than other professionals, made worse by the COVID-19 pandemic, the research noted.
While programs encouraging personal resilience are helpful, researchers found organisational approaches to improving mental health may be more beneficial.
“An obvious inlet to change would be to ensure doctors can take sick leave if needed or plan holiday breaks into a year, rather than being paid out for their leave at the end of contract years because they are unable to take it due to staff shortages,” researchers wrote.
Researchers interviewed and shadowed 14 doctors while they were on shift in a South Australian public hospital in 2021. They were asked about their roles, the pressures they face, training requirements and hospital regulations that affect their work.
One doctor described high workloads becoming an expected “part of the job”.
“It just makes this horrible feeling of injustice. Which is why I think doctors just feel burnt out, tired, frustrated, because they’re trying to do the right thing, and they’re trying to be better and the system just doesn’t allow it,” they said.
“We just keep taking it, keep taking it, keep taking it, keep taking it …until we can’t. And I think, particularly doctors who don’t want to be seen as causing trouble or rocking the boat… or seen as weak. You don’t want to be the one to admit that, actually, this is impossible for one person to do.”
Another spoke about not being able to adjust their hours to reclaim some personal time.
“My colleague and I are full-time but want to be part-time, and have applied to be part-time and then have been told that it might not be possible,” they said.
“To be honest, things probably aren’t going to change. There is a bit of like, ‘okay, I guess we’ll just keep going’. And this is how it’s been… it’s not going to change, this is the career I’ve chosen.”
While the research was conducted in South Australia, the findings indicate a clear link between doctors working conditions and poor mental health. High patient loads, short staffing, an inability to take leave and administrative burdens are not unique to the southern state.
DHASWA medical director Dr Helen Wilcox said the workplace pressures doctors are facing are unacceptable.
“Neither is it acceptable to suggest that burnout is a reflection on the individual’s inability to tolerate stress,” she said.
“This research discusses the extensive competing pressures that doctors experience and this is certainly true of most doctors with mental health challenges.
“They have excellent clinical abilities and may be highly resilient, but acute-on-chronic organisational and systemic issues or unforeseen personal and clinical stressors can trigger distress and decompensation.”
She added that doctor wellbeing is not only important to the individual practitioner but can have a wider impact on patient safety.