I'm becoming increasingly concerned about occupational health and safety as a public health issue, and a new book has put the focus squarely on healthcare workers' health and safety. The Tyee has published my review of ‘This Is Going to Hurt’: A Grossly Funny Memoir of a Burned Out Doctor. After discussing the book (which is indeed very funny) and the problems in the UK's NHS, I continue:
Canadian and American healthcare systems are unindicted co-conspirators, exploiting their workers in the name of serving patients at a politically affordable price. Search the website of the New England Journal of Medicine for the term “physician burnout” and you’ll get 72 hits. The problem starts in medical school and takes many forms thereafter, from stigma to scheduling to sexual harassment and violence. It means physicians and other healthcare workers must deal with their own depression, emotional exhaustion, and suicidal thoughts while also trying to care for their patients.
Chief cause of death for young physicians: suicide
OMA Insurance, a program run by the Ontario Medical Association, says Canadian physicians face problems as serious as their American and British colleagues:
“The overall physician suicide rate cited by most studies is two to four times higher than the general population. In the United States, this translates to an equivalent of one to two average-sized medical school graduating classes needed every year just to replace the number of physicians who commit suicide… Moreover, studies have also concluded that suicide is the most common cause of death for young physicians (26% of deaths). Male physicians commit suicide at a rate about 1.4 times greater than the general population, whereas female physicians have suicide rates about 3 times higher than the general population. Unlike the general population, where males complete suicide four times more often than females, male and female physicians have approximately equal suicide rates.”
Ironically, the Canadian Medical Association Journal says Ontario doctors who seek counselling through OMA insurance may receive only $350 for counselling, and get nothing for counselling or medication if they have a pre-existing condition of mental health concerns.
A recent article in CMAJ sums up the North American problem: “One in four Canadian physicians reports high levels of burnout and one in three screens positive for depression. South of the border, more than half of physicians in the United States have symptoms of burnout. One in five is thinking about reducing their hours and 1 in 50 is considering early retirement, despite mounting physician shortages. Meanwhile, some 400 physicians and 100 medical students die by suicide each year.”
