Wellbeing must become embedded in the core business of our profession | AMA (WA)


AMA (WA) | Working Towards Change

Wellbeing must become embedded in the core business of our profession

Monday July 6, 2020

Dr James Caudle, Doctor in Training, Sir Charles Gairdner Hospital

The mental wellbeing of doctors is, and will remain, a persistent concern. Great strides, however, have been made to progress awareness through projects including R U OK, Project Pow Wow and Crazy Socks4Docs.

Anecdotally, there has been a marked cultural change towards mental health. Colleagues and seniors both speak more openly now with increased awareness within themselves and those they work with. These projects are having a positive effect.

However, despite improved awareness, we must remain mindful that mental health will always be an issue in our profession wherein we recruit driven, competitive, academic achievers with obsessive personality traits. We do so acknowledging such personalities make excellent doctors who the community can entrust to ensure the best care.

Yet we must understand that these traits mean our workforce is more likely to struggle with depression and anxiety.

While raising awareness and increasing support is improving the situation, doctors’ wellbeing is an issue that won’t be fixed by one or two projects. Wellbeing must become embedded in the core business of our profession through means such as reflective practice and debriefing.

Culturally we are a competitive workforce. There is competitiveness in each of us, and this has likely driven us to achieve thus far. This trait is also reinforced and fostered through workplace culture. It is this drive and pressure to “be best” both intrinsically and extrinsically that can push us, and prevent us from acknowledging our own limitations and making changes to ensure our own happiness.

If our colleagues are working 60+ hours per week, skipping meals and are obsessively focused on the next training goal then through a variety of factors such as peer-pressure, competitiveness and fear of social isolation, we fear to craft a different course. We dismiss the signs of burn-out and instead dig deeper and soldier on. As for most of us, it is this coping strategy that has gotten us to the position we are today.

However, there are long-term implications of this coping strategy if left unchecked. This competitiveness and peer pressure can lead to us to burn out, become hardened, neglect our friends and family and forget about why we initially wanted to practise medicine. Concerningly, this situation can persist through training and consultancy – only becoming apparent later in one’s career, leading to regret.

Most of us didn’t pursue medicine to work more hours, perform more operations, see more patients per hour or compete for that one training spot. The majority applied for medicine to sit with an elderly lady, take time to explain the problem to her and reach an outcome that she wanted within the limitations of the health system in which we work.

Too often, however, time pressures, peer-pressure and burnout prevent this from happening; sub-consciously threatening our own values, what is important to us and further undermining our mental wellbeing.

We must remain mindful that we are making great strides in awareness of doctors’ mental health. However, there are inherent attributes in our workforce that need longitudinal support tailored to our profession rather than just short-term projects.