Stress – GPs and other Physicians

When, for GPs and other physicians, daily work decisions can easily kill or save lives, handling stress is an essential skill.

Sadly, many of the people who spend their lives helping others do not themselves fare well in the stress, physical or mental health stakes. Physicians are nearly twice as likely to commit suicide as other professions. Twice!

The GMC cites evidence that physicians have higher rates of mental illness than the people they serve: the general population. The BMA evidence is that nearly a third of physicians have some kind of mental disorder (http://careers.bmj.com/careers/advice/view-article.html?id=20002383).  A third!

What could explain such poor health outcomes for our best health care providers?

Is an explanation necessary?

Hmmm… that may seem an odd question until you ask the related question: are physicians any less vulnerable to the range of human afflictions than the rest of the population? No. Then the question is probably better phrased as: what causes health professionals to have considerably more afflictions than the people they treat?

Are physicians simply more exposed to illnesses in the line of work, and thus get ill more often? Or is it overwork? Or is it over-conscientiousness? Or is it more psychologically complicated?

It is more complicated. It seems that physicians do suffer more stress, not because the job is any more demanding than any of the other top professions, but for reasons, not experienced elsewhere.

Physicians are expected to be the person who knows the answer to all the common health problems.

That expectation is self-directed, too. What does that mean? When a physician gets ill in some way s/he expects to be able to self-diagnose, to self-treat. It seems that most do. Why? Possibly for fear of being thought weak by colleagues. If the condition is physical and serious enough the physician may “give-in” and consult a colleague.

What if the symptoms are mental health related? What is a physician to do then? Risk being deemed unfit to practice? It seems that for most, that is too big a risk. Another route is easily taken: “Even if it is a mental health problem, it will pass in a few weeks, and if I keep quiet my career will remain intact.” Before long a few weeks has become years and the problem is worse, and now fully embedded in the person’s mental behaviour patterns. If the physician does come forward now, suspension may be inevitable until recovery is achieved.

Physicians who seek help early are most likely to deal with the problem, recover completely, and recover quickly. Those, as is the case with the general population, who try to mask, deny or ignore their problems, or put off getting the needed help, soon find that a rapidly treatable problem has become much more difficult to handle.

For those who are concerned about getting help within the NHS, with the almost daily breaches of client confidentiality, another option is available: private psychotherapy.

The great news is that most physicians recover from psychological problems, with the right early help, and become very effective at helping others who suffer the same problem. In other words, the problem may turn out to be a blessing.

If you wish to make an appointment call

Prof Nigel MacLennan on

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