As revealed by the British Medical Association’s (BMA) recent report into the wellbeing of health and care professionals, being a doctor in 2019 isn’t all that great.
On average, as a doctor, you’re at 80% risk of burnout, you’re more likely to suffer from mental health issues, and you’re at greater risk of alcohol dependency, binge-eating and drug addiction as a result of the mounting stress-levels and emotional exhaustion associated with your job.
With that in mind, you’re probably wondering: why on earth would anyone pursue such a profession? And that is part of the problem. You see, the NHS staffing crisis is both partly to blame for, and a result of, the findings revealed in the BMA report. And, ironically, this is largely thanks to advances in medicine and the unprecedented rise and development of healthcare technology, which has resulted in increased life expectancy in the UK and across much of the Western world.
Compared with 30-40 years ago, many diseases – despite not having been cured – have become more treatable, manageable and, in some cases, no longer life-threatening. People with cancer, AIDS and diabetes, for instance, have an opportunity to grow old – an opportunity they would not previously have been afforded. These people, however, need monitoring and ongoing treatment, additional resources and care. And so, what might once have been considered an adequate workforce is now painfully insufficient.
Burnout is, therefore, an ode to how quickly medicine and technology are advancing and helping to improve patient outcomes. In short, there are more people who need to be treated and a higher volume of people needed to treat them. But, in absolute numbers, we’re seeing the health and clinical workforce decline.
This is a vicious cycle in which the NHS is trapped: an insufficient workforce results in higher workloads, higher workloads result in an increased risk of burnout, an increased risk of burnout results in a health system that struggles to recruit and retain permanent members of staff.
And this cycle is further fuelled by the fact that the social status of health and care professionals has been in decline – publicly undervalued and undermined through poor government policies (think Junior Doctor strike), poor wages and, often, by the very patients they are trying to help.
The rise of the internet has further added to this, with everyone able to turn to 'Dr Google'. Before then, people who worked in health and care were more highly regarded – they knew something the rest of the world didn’t. And this gave them a certain status, a certain power and an impact that no longer exists. Now, with that taken away – and with the grim picture of doctor’s mental and physical wellbeing – it should come as little surprise that people are pursuing career paths less intense, less demanding and better for their health.
So, then, what needs to be done in order for this to change? Well, clearly, the NHS needs more staff and, to get more staff, the role of health and care professionals needs to be made more appealing – and that means paying them a decent wage and empowering them with the type of technology they encounter outside of work - technology that makes their jobs easier.
Now, I’ll leave the good fight for fair and equal pay for all healthcare workers for the trade unions to battle. But what about other solutions that could make a real positive difference to the mental health of doctors? As things stand, NHS tech leaves much to be desired. It’s proven, it works, but most large, existing systems is decades-old – lacking in intuition, and often more time-consuming than paper-based processes.
As a result, health and care professionals are taking it upon themselves to make their jobs easier and more manageable. This is highlighted by the pervasive use of consumer messaging services, such as WhatsApp. With time so precious on hospital wards and with healthcare professionals under more pressure than ever before, it’s hardly surprising to see so many of them turn to consumer messengers – I certainly did.
During my time as a surgery resident, I used WhatsApp prolifically – it was my go-to for communication, it just made sense. WhatsApp made me more efficient, it was clinically useful and freely available. At the time, it was a massive improvement in supporting the daily communication needs of patients.
But things soon got out of control. Aside from the risks and potential consequences associated with breaching patient confidentiality and falling foul of IG Toolkit compliance, I soon realised that, by using WhatsApp in this way, I was putting myself at even greater risk of suffering from burnout.
That is because, despite working effectively as a short-term fix – resolving communication issues across geographical and/or organisational boundaries and networks – naturally, as a consumer messenger, WhatsApp is unable to differentiate between your personal and professional life, thus blurring the lines between the two. For me, this became increasingly problematic. Everything was on WhatsApp: social conversations, private conversations and professional conversations. It got really hard to separate. I couldn’t switch off.
Of course, this is just one example of how tech – if not implemented correctly – risks bombarding staff and increasing the risk of burnout, but it is one amongst many. What about electronic patient record systems, for instance, which are often introduced despite being slow, clunky and difficult to navigate/use? Or the litany of different tech solutions that don't integrate, causing you to log in and out of different systems and inputting the same data over and over again? The list goes on.
Isn’t it about time we learned from our mistakes? When implementing new technology solutions in healthcare, let’s stop just thinking about the needs of the patient and let’s also consider the needs of healthcare professionals. Otherwise, the NHS will continue to struggle to recruit and retain permanent members of staff, and those that remain will continue to suffer, or be at significant risk of suffering, from burnout.
Joost Bruggeman is co-founder of Siilo, the secure healthcare-specific messenger app