There is a need for change at a cultural level among physicians. Asking for help contradicts the deeply ingrained idea that physicians are their own caregivers. This is why medical leadership and the existing system must change from top to bottom.
Welcome to the second blog post in our newest series Mental Health in Medicine. The subject matter, while heavy, is incredibly important for physicians to be aware about, for themselves and their colleagues. We’re pleased to present to you We’re Losing Our Colleagues to Mental Health Issues Caused by COVID-19 written by author and guest blogger Catelyn Aliana Jones. Catelyn Aliana Jones is a freelance writer with a strong interest in healthcare. Catelyn is also an advocate for mental health acceptance in the medical community. When she isn’t working on her latest piece, Catelyn practices painting in her free time.
Physicians and other medical professionals have been facing insurmountable risks with regards to mental health recently. In a previous blog post on Mental Health in Medicine, we discussed burnout among physicians and defined burnout as a syndrome linked to exhaustion, depersonalization, and diminishing accomplishment. This condition leaves doctors chronically tired, cynical, and discouraged. A June 2019 study in Annals of Internal Medicine calculated that physician burnout costs the healthcare industry $4.6 billion per year due to physician turnover and reduced clinical hours, much to the detriment of patient care.
Unfortunately, burnout is also a leading factor in developing depression and suicidal ideation among physicians — and this phenomenon has been like a silent epidemic for the past 150 years. Research conducted by Amanda M. Kingston, MD, who is an assistant professor of Psychiatry at the University of Missouri, reveals that mental illnesses are much higher among physicians. However, they seek care for mental health diagnoses nowhere near as regularly as the general population due to the social stigma attached. Moreover, the COVID-19 pandemic has further exacerbated physician burnout and mental illness — with no end in sight yet.
What is Happening to Healthcare Professionals
Many physicians enter a career in medicine because of the benefits, such as high pay, respect from their community and the fulfillment that comes with a solid career path. Practicing medicine, however, comes with a lot of pressure. High levels of stress associated with medical workload create an impact on a physician’s mental health. The culture surrounding medicine includes long hours, neglected self-care, less time with loved ones and financial stress. All have the potential to lead to depression as medical training progresses. Perfectionist tendencies may manifest in anxiety disorders as well.
In recent years, concerns like caseload, number of patients, litigation, third-party documentation systems and insurance companies have likewise put a huge strain on medical professionals. The pandemic has also taken an emotional toll on doctors, who face a high number of patient deaths, increased work hours, a lack of control and so much additional frustration with the existing medical system. Some experts even believe that the stress that comes with the profession can be likened to the stress experienced by people suffering with PTSD, as trauma stacks on trauma.
As a response, some physicians turn to self-medication, either by self-prescribing or using alcohol and illicit drugs to cope. Most of the time, physicians don’t seek any help due to the stigma attached to mental health issues in the field. According to a July 2019 article in Journal of Medical Regulation, physicians have expressed concern that a depression diagnosis could negatively impact their ability to obtain and retain a medical license. Once physicians are licensed, the consequences of reporting stable and easily treatable conditions such as anxiety or depression to a state licensing board can range from a physician simply being required to submit a letter from their primary care provider documenting fitness to practice, to a request to appear before the board, to being required to undergo and pay for an examination by a board-appointed physician. Other consequences can include the required provision of extensive or ongoing medical records, enrollment in a physician health program (PHP), paying for inpatient or intensive outpatient treatment that may be followed by long-term monitoring, or agreeing to practice restrictions as well as exclusion from opportunities for employment and professional advancement.
What Can Be Done to Help
With the stigma faced by medical professionals, many doctors, nurses and other frontliners tend to feel isolated when considering their personal condition and situation. In a write-up on Bustle, Mariea Snell talked about how people who experience isolation and loneliness tend to lack self-care and that the insufficient support caused by isolation could continue to have devastating repercussions on their emotional health. Mariea Snell is the assistant professor and coordinator of the online Doctor of Nursing Practice programs at Maryville University, which helps to highlight the need for medical leaders to approach the system with compassion, preventive care and evidence-based decision-making — not just for patients, but for themselves and each other as well.
So what can be done? It's important for physicians to have a strong support system to fall back on and an even stronger community to make them feel less isolated. According to a paper on ‘Challenges In Treating Physician Burnout’, compassionate leadership is the long-term solution to this problem. There is a need for change at a cultural level among physicians. For instance, going to work despite poor health is standard practice within the medical community. Asking for help contradicts the deeply ingrained idea that physicians are their own caregivers. This is why medical leadership and the existing system must change from top to bottom. Medical professionals should be willing to seek help, accept support and encourage colleagues to do the same so they can save even more lives.
We’d like to send a big Thank You to Catelyn Aliana Jones, our guest blogger for this post. Would you like to share your perspective on mental health in medicine? Just send an email to Kristin at firstname.lastname@example.org for more information.
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