IMG_1721Dr Alice Rutter, anaesthetic doctor in the South East of Scotland and General Medical Council (GMC) clinical fellow, reflects on key findings from the ‘Caring for doctors, caring for patients’ report on doctors’ and medical students’ wellbeing. You can hear more from Alice, along with her colleagues, Dr Catherine Walton and Dr Adam Thomas, in their new podcast ‘Prescribing change – creating healthy workplaces for medics’.

Through my work as a clinical fellow at the GMC, I’ve been in the position to hear the views of doctors across the UK, and wellbeing seems to be at the heart of what matters to us. Professor Michael West and Dame Denise Coia’s recent report hopes to make a real difference to doctors’ and medical students’ wellbeing. So – does this move us forward?

Why does it matter?

Whatever I expected going into medical school, it’s safe to say – this was not it.

I am really proud to be a doctor and of the work that we do to improve the lives of the people that we meet, but it’s not as easy as matching patterns of symptoms to textbook problems. People are complex, with increasing co-morbidity and expectations.

With all the demands we are trying to juggle, wellbeing can seem like a luxury that is difficult to find the time for, rather than a basic human need. Perhaps then it’s no surprise that one in four trainees report burnout, as do one in five trainers (1).

Michael West and Denise Coia’s report tells us that if you’re an NHS worker in England, you’re at 50% higher risk of stress so severe people describe it as ‘debilitating’ (2). It also highlights that half of secondary care doctors want to leave their jobs.

Stressed doctors are bad for patients (2). Stressed doctors have less cognitive acuity, are less able to be compassionate, are more likely to make mistakes, and are more likely to deliver poor care (2). I don’t want to be a doctor that doesn’t have the energy or ability to care, and I definitely don’t want to be treated by one.

Viewing change as impossible resigns us to remaining trapped in a damaging and demoralising cycle, but pockets of great work prove that this is not an insurmountable challenge. This is a problem too big for anyone alone to fix. It requires a commitment from all of us, our leaders and healthcare organisations – the whole system working together.

So – what now?

The groundswell of support for doctors’ wellbeing is reaching critical mass. It is a rare day that I don’t get sent a blog, resource, article or event invitation about doctors under pressure. We need to work out how we will capture and use our energy and this momentum to drive meaningful and lasting change, that protects our healthcare services into the future.

Michael West and Denise Coia’s ‘Caring for doctors, Caring for patients’ report aims to unite us in focusing on prevention. It asked hundreds of doctors and medical students in the UK – what matters? What needs to change? What is important to your wellbeing? The report distils this down and proposes an action plan to help healthcare environments meet the needs of their staff:

  1. Autonomy: The ability to make your own decisions without being controlled by anyone else, through looking at working patterns, being listened to, and looking at the environments we are within. For me, this boils down to the concept of respect. Doctors want their thoughts, feelings, individual lives and needs to be respected in a way that is visible.
  2. Belonging: To be in a suitable or the right place; to feel happy or comfortable in a situation. For me this is summarised as being valued in a culture that is compassionate and cares for us and our colleagues as well as patients.
  3. Competence: The ability to do something successfully or efficiently. Doctors are used to striving for excellence, and helping people develop and improve is important to their wellbeing. We want to feel like we’re good at work that we feel is important and interesting, through great training, flexibility, and quality feedback.

What has struck me reading this report is that there are places all over the UK doing inspiring things to make doctors lives better – with equally inspiring results. What seems to unite these is that wellbeing and staff are a priority, that leaders have invested their time, and that there has been collaborative and creative thinking about ways forward. Wellbeing is like every other challenge we encounter in our health services – it’s multifactorial. We recognise the problem. We know the evidence. But if you prescribe without discussion, involvement, collaboration – the chances are, the remedy will sit at the back of the cupboard becoming slowly covered in a layer of dust. We need to use these principles and start the conversation in our own workplaces and systems. What is our plan for action? And how can we support each other?

References

  1. National training surveys, General Medical Council, July 2019
  2. Caring for doctors, caring for patients, Professor Micheal West and Dame Denise Coia, November 2019