Ironically, people who work in healthcare tend to be unaware of their own health risks. Physicians have lower life expectancies, unhealthy coping mechanisms for stress, and twice the rate of infertility than the general population (Heim). Female physicians have a life expectancy a shocking 10 years lower shorter than the general population (Heim). Stressors for nurses include ethical dilemmas regarding patient care, conflicts among coworkers, workload, and disorganization (Heim). Physicians are more likely than the general population to abuse or self treat with alcohol, benzodiazepines (tranquilizers used to treat anxiety), and opiates (Hughes). Suicide rates are also slightly higher in physicians than the general population (Dublin).
These harrowing statistics speak to a larger need: a reform for healthcare system so that the people who take care of others can also take care of themselves. As Dublin argues, physician death and burnout is also a waste of society’s resources, as medical school requires a lot of time and money to enter. I would argue that physicians would be better able to care for patients, and perform better at work if the medical field demanded less from it’s workers. The demands the medical field begin in undergraduate school, when students often take 18 or more credits in a semester, along with volunteerism, shadowing, and working- all of which comes at the cost of sleep, ability to socialize, and taking time to workout and eat healthy. This creates bad habits which only worsen as school gets more intense in graduate school. Once in the working, people who work in the medical field are expected to take call, work nights, and pressured to see patients with complicated medical histories in 15 minute appointments. On top of that, paperwork and charting is often completed after hours or at home, taking more time away from life outside of work. With more sleep and free time, and less stress at work, doctors and nurses alike would be better able to care for themselves, and their patients. What do you all think is the first step to creating a better work environment for people in healthcare?
Dublin, L. (2019). THE LONGEVITY AND MORTALITY OF AMERICAN PHYSICIANS, 1938-1942: A Preliminary Report. JAMA Network. Retrieved from https://jamanetwork-com.dml.regis.edu/journals/jama/article-abstract/295454
Blanchy, P. (1963). Suicide in Professional Groups. Ew England Journal of Medicine. Retrieved from https://www.nejm.org/doi/pdf/10.1056/NEJM196306062682307
Hughes, P. (1992). Prevalence of Substance Use Among US Physicians. JAMA Network. Retrieved from https://jamanetwork.com/journals/jama/article-abstract/396891
Hein, E. (1991). Job Stressors and Coping in Health Professions. Psychotherapy and Psychosomatics. Retrieved from https://www.karger.com/Article/Abstract/288414
As an aspiring healthcare worker this is a potent issue in healthcare. Doctors are often advising their patients to eat a healthy and balanced diet, exercise for 30 minutes 5 days a week, and to get at least 8 hours of sleep each night when they themselves are not able to follow these recommendations. Additionally, doctors are not able to care for their own mental health as shown by the suicide rates in physicians. It seems as though society expects our healthcare workers to be superhuman. I was interested to know if hospitals and other employers of healthcare workers were taking this data into consideration and creating new policies. In 2003, a law passed mandating that medical residents are not allowed to work for more than 80 hours a week with no individual shift to exceed 30 hours (Joseph, 2019). There was concern in the medical profession that with this cap, residents would not be able to learn everything they needed to learn and would subsequently make worse doctors. There was no significant difference in patient outcomes before the cap and after the cap (Joseph, 2019). Varying studies have produced different results about how this cap has affected the medical system. A different study found that resident well-being improved but their education suffered (Bolster and Rourke, 2015). Additionally, surgeons and other similar specialties are working hours that would have been prohibited during residency. Upon looking at the data, fatigue in attending surgeons did not affect pateint care but did affect the surgeons personal life and level of burnout (Bolster and Rourke, 2015)). Physician burnout is a huge issue, it leads to a shortage of doctors and nurses ultimately leading to worse patient outcomes. It would seem to me doctors would do better if they were to have more work-life balance and improve their self-care especially since it does not negatively affect patient care. It seems like a win-win situation overall.
ReplyDeleteSources:
Bolster, L., & Rourke, L. (2015). The effect of restricting residents' duty hours on patient safety, resident well-being, and resident education: an updated systematic review. Journal of graduate medical education, 7(3), 349-363.
Joseph, L., Bowman, R. C., & Gregg, J. T. (2019, July 11). Study says limits on residency work hours didn't affect doctor performance. Retrieved from https://www.statnews.com/2019/07/11/medical-residency-hour-limits-new-doctors/.
As an aspiring healthcare worker this is a potent issue in healthcare. Doctors are often advising their patients to eat a healthy and balanced diet, exercise for 30 minutes 5 days a week, and to get at least 8 hours of sleep each night when they themselves are not able to follow these recommendations. Additionally, doctors are not able to care for their own mental health as shown by the suicide rates in physicians. It seems as though society expects our healthcare workers to be superhuman. I was interested to know if hospitals and other employers of healthcare workers were taking this data into consideration and creating new policies. In 2003, a law passed mandating that medical residents are not allowed to work for more than 80 hours a week with no individual shift to exceed 30 hours (Joseph, 2019). There was concern in the medical profession that with this cap, residents would not be able to learn everything they needed to learn and would subsequently make worse doctors. There was no significant difference in patient outcomes before the cap and after the cap (Joseph, 2019). Varying studies have produced different results about how this cap has affected the medical system. A different study found that resident well-being improved but their education suffered (Bolster and Rourke, 2015). Additionally, surgeons and other similar specialties are working hours that would have been prohibited during residency. Upon looking at the data, fatigue in attending surgeons did not affect pateint care but did affect the surgeons personal life and level of burnout (Bolster and Rourke, 2015)). Physician burnout is a huge issue, it leads to a shortage of doctors and nurses ultimately leading to worse patient outcomes. It would seem to me doctors would do better if they were to have more work-life balance and improve their self-care especially since it does not negatively affect patient care. It seems like a win-win situation overall.
ReplyDeleteSources:
Bolster, L., & Rourke, L. (2015). The effect of restricting residents' duty hours on patient safety, resident well-being, and resident education: an updated systematic review. Journal of graduate medical education, 7(3), 349-363.
Joseph, L., Bowman, R. C., & Gregg, J. T. (2019, July 11). Study says limits on residency work hours didn't affect doctor performance. Retrieved from https://www.statnews.com/2019/07/11/medical-residency-hour-limits-new-doctors/.
This is a great topic to shed light on, especially for pre-med students. When I worked in a clinical setting, the staff had weekly rounds to address one issue. One week, it was addressing burnout and the staff was contributing to how they deal with burnout. I remember fondly one nurse said that she makes herself take a week vacation during every quarter and it was this quarterly vacation that kept her from experiencing immense burnout. There are so many overlooked factors to healthcare workers in general. I think that sometimes, people tend to forget that healthcare workers are human too whose health should also be considered. I found an interesting article about how human error can impact providers, such as the unintentional medical error that's directly affecting the patient (Robertson & Long, 2018). The authors highlight that the providers feel guilt, shame, anxiety, fear, and even depression when they don't adhere to being the "perfect physician" (Robertson & Long, 2018). This can be seen even right now among pre-med students who also feel the pressure to have the perfect transcript, resume, extracurriculars and even the perfect MCAT score. There's also a lack of support for providers who experience this (Robertson & Long, 2018), which raises interesting questions like who does the provider go to when they are the ones who need to be provided? The lack of support for physicians really shows how much they are overlooked in the healthcare community (however this does not mean that they are the only ones who are overlooked) and makes their burden even heavier. Not only do they have to make the decisions, they have to carry that with them without any sort of relief. To answer your final question about improving the work environment, I believe it's multi-faceted. The entire healthcare system has to transform the power dynamics to offer more support to everyone involved in the medical decision. That's a really daunting task, but it could start with establishing a work environment that is not hostile or intimidating, and exchanging words of affirmation among everyone in the healthcare team. Even in my small role in the hospital, to hear that I did good work that day reminded me of why I want to be in this field.
ReplyDeleteSources:
Robertson, J., & Long, B. (2018). Suffering in Silence: Medical Error and its Impact on Health Care Providers. The Journal of Emergency Medicine, 54(4), 402-209. doi:10.1016/j.jemermed.2017.12.001.