Medicine is health care. Why aren’t doctors healthy?

I went to a meeting this week and there was a room full of perhaps 100-120 doctors from various different specialties. I looked around the room, and not one person looked well and healthy – apart from myself and the drug rep sitting next to me. Most people looked, grey, tired, withdrawn, inwards, uncomfortable speaking to people, unable to speak without being in ‘doctor’ mode. Nobody looked truly alive, vital, or well, and this is reflective of my more general experience in medicine, where I was shocked and horrified and alarmed at both the state of physical health and well-being of my training doctors as well as their emotional health and well-being.

Over the last 25 years, it has been the rare few who to me appeared to be truly well, joyful and vital. Most of them in my training, were either angry, cynical, withdrawn, stressed out, depressed, anxious, grey, tired unhappy and unhealthy and not coping but doing their best to survive – or any of the above combination! I was terrified that I was going to end up like them.

I have also watched many of the lovely people I have trained with become tired, drawn out and grey over the last 10 years, losing the joy and zest for life they had 10 years earlier.

We are not a healthy group of people.

We know that it is reported that the rates of burnout in the medical profession are nearly 50% with burnout rates being 65% in some specialties. These rates are far higher than any other professional group and the general population.

In my opinion, those rates are likely to be even higher in reality.

It is well recognised that doctors notoriously lack insight into their own health, are not likely to have a primary health care provider, and the questionnaires that assess burnout depend on self insight and self honesty – a feature which doctors notoriously do not have when it comes to their own health.

Burnout alone is a staggering issue facing the medical profession as it is associated with a whole host of emotional and physical ill being, but aside from that it is also reported that the health of the medical profession overall is not good on a number of fronts.

We have high rates of depression, just like the rest of the general population, but higher than the rates of depression in other professional groups.

We have higher rates of high psychological distress than both the general population and other professionals groups.  2 times higher than the general population and 10 times higher than any other professional group.

We have 2-4 times the rate of suicide of the general population with 24.8% doctors admitting to suicidal ideation in the past and 10.4% of doctors reporting to be thinking about suicide in the last 12 months. These figures are staggeringly higher than the general population and any other professional group.

  • You read correctly – a quarter of the medical profession have thought about killing themselves, and 1 in 10 have more recently thought about killing themselves.
  • 2% have attempted suicide because they are so miserable.

There is little data out there on the physical health and well-being of doctors and how that compares with the general population but it is known that at least 60% of doctors don’t have their own doctor, and of those that do it is not known how much those doctors are influenced by the doctor seeing them.

  • 59% of doctors report that being a patient as a doctor is a source of embarrassment. It is known that doctors do not effectively engage in preventive health care measures for their own health care.
  • If it is a source of embarrassment to be seen as a patient as a doctor, then that speaks volumes as to the level of honesty and care that doctors allow themselves when it comes to their physical and mental health and well-being.

There is a large stigma associated with being diagnosed with a mental health disorder such as depression or anxiety – 40% of doctors feel that medical practitioners with a history of a mental health disorder are perceived as being less competent and capable than their peers, and 48% feel that these doctors are less likely to be appointed.

Drug addiction is common: 10-12% will get a substance addiction with alcohol being the most commonly abused drug.

And to cap it all off, the divorce rate is higher than the general population and for those that remain married their rate of marital dissatisfaction is higher than anyone else.

As a professional group, we are in a bad state.
But shouldn’t doctors be healthy?

As health care providers, ought we not ourselves be beacons of glowing health and vitality to give inspiration to our patients who are not doing well with their health?!

Should not a room full of doctors and health care providers be filled with truly healthy, alive, joyful and vital people, committed to looking after their own health and loving life? After all, people come to us for advice on health care…

I don’t know about you, but I’ve personally been frightened at times when I’ve gone to some doctors for advice over the years by their poor state of health and lack of personal engagement! (perhaps this is why so many doctors don’t have their own ‘doctor’….)

To me there is something wrong with the picture here.

To have a room full of experts in health care, looking so unhealthy, and with the statistics of ill health of the medical profession to back it all up doesn’t make sense with the fact that we are the ones who are supposedly experts in health.

None of us would trust a mechanic with our car who couldn’t take care of his own car.

It would be reasonably expected that a good mechanic would love his own car and take care of it and have it running optimally, in fact, better than the average car! Souped up to The Max so to speak with a super powerful dual turbo charged engine, gleaming wheels and all the best possible accessories! That car would purrrrrrrr powerfully at the traffic lights, and Roooar off with gusto and power when the foot was placed on the pedal (OK, so my love of a powerful engine is coming to the fore here….!) That mechanic would absolutely love his car and be passionate about his (or perhaps her) car.

As doctors, do we take the same care, passion and attention to our own health and well-being? After all, our trade is health care, no different to the way that the mechanic’s trade is cars….

Are we the walking advertisements for good health to inspire trust and confidence in our patients as our mechanics are with their cars?

If not, then how can we expect people to trust us with their health care and listen to our recommendations for health when we ourselves are not taking care of our own health?

And to continue, we as patients, how is it that we are trusting unhealthy doctors with our health care? Would we trust a mechanic with a bung beat up car who put the wrong fuel in the engine? I know that I sure wouldn’t. It simply doesn’t make sense.

I’m not speaking here to undermine the medical profession as I love it and the people in it dearly who are doing their absolute best to care for people and I see that what we offer is immensely important. Medicine and what it offers is fantastic there is no question. If bees had knees, Medicine would be it for illness and disease. But the picture here is revealing of something deeper at play that is affecting us all.

The health care profession is more unhealthy than the general population that they are treating.

Statistically, the doctor you are seeing is more likely to be thinking about killing themselves than you are, is more likely to be anxious than you and more likely to be burnt out than you, and, not willing to admit that they are burnt out and despite exhorting you to seek medical care is unlikely to follow that same recommendation themselves.

Its alarming!

  • How does the health care profession come to such a state of ill health – yet still hold it and the people in it to be the sole arbiters of good advice when it comes to health care?

Clearly Houston – and the world!! – has a very big problem that needs addressing!

Nobody starts out medicine planning to become burnt out and unhealthy, avoiding their own health care responsibilities. Nearly everybody who does medicine does so because they care about other people. Nobody plans to become a write off themselves. It could be reasonably expected that if we were learning about health care then we would learn how to care for ourselves, but none of that happens in medical school.

What goes wrong? How is it that our best and brightest who are trained to be experts in health care are so consistently unhealthy?

It can’t be a case of individuals, because what we have here is a systemic problem with institutionalised ill health of a profession.

Are there cultural matters that need to be addressed? Are we missing something in health care?

Stay tuned for part 2…..

Dr Maxine Szramka
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13 thoughts on “Medicine is health care. Why aren’t doctors healthy?

  1. There is much here that you have shared Maxine that is very similar for nurses. When I moved from Sydney to the country I was blown away with the poor state of health of the nurses I was working with. I put it down to an older population of nurses, but what I have also realised with this (yes we are all getting older) is that it comes comes to the choices we make. So illness and disease does not necessarily need to naturally occur just because we get older. I see my colleagues, doctors and nurses (who I just adore) put everything down to old age. “Well that’s what happens when you get old” and because we believe this so do our patients. I love what you say about should we not be glowing beacons of health (not perfect health, for we do live in a body)? For this is what inspires your colleagues and your patients as it does for mine. Thank you for your inspiration.

    Liked by 1 person

  2. Great blog, Dr Maxine, telling it as it is! The truth about the medical profession is not too pretty, and it good to expose it so that we can all realise that doctors are people too, many of whom are struggling and in need of care. It is a sad indictment of our system that in all our training, we are not trained to truly care for ourselves. Time for true change! Looking forward to part 2…

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  3. Self care should be the foundation subject for all health related subjects everywhere. I totally love working in health, but it never ceases to amaze me how much chocolate, cake, tea and coffee is consumed at every social event in our Hospital. There’s rarely anything else on offer. And it’s usually the senior health professionals who’ll plonk a big box of chocolates or lollies on the table to get a meeting started!? Work that one out! Looking forward to part 2, thankyou Dr Maxine.

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    • I agree Tim, and I also feel it needs to be more than a few lectures, it needs to be a way of life and a culture in health care that permeates the entire educational and working system. If we just do a few lectures for medical students, and then tell them to ‘suck up’ everything that we throw at them, it becomes just lip service. We need to value our doctors and health care providers as people, and not as ‘professionals’ to do a service.

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  4. A great blog, Maxine, and quite an expose of how the medical profession do not know how to really look after themselves. I know they have very little exposure to good nutrition in their course, which is quite incredible when we think of that. Good nutrition is a very important key in good health. And yes, there needs to be an inclusion of how to look after themselves, how can they look after others if they are not looking after themselves. I look forward to part 2.

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    • Thank you Beverley. No, we’re not taught how to look after ourselves. There might be a few lectures on ‘work life’ balance, but then the entire training and work environment is so intense and focussed on marks and study and then work and study, there is very little time to balance anything with anything else! I remember doing all of my intensive training, working full time, working 12-14 hour shifts and night shifts, and then studying for 3 hours a day when I got home.And this was not for a few weeks, like an intensive short period studying before exams, this went on for literally years! I remember looking around frantically going ‘I don’t have time to balance anything with, if I stop studying I will fail and lose my job!!’ ‘How can I balance intensive work and study with 1 hour of exercise a few times a week?!’ ‘if work is not life then why am I spending so many hours working instead of ‘living’ ?’ Like many doctors, I was on the brink of quitting for years, simply as many doctors say ‘to survive’.

      For me, work life balance didn’t make a difference, it was learning how to be with myself every day that got rid of my burnout. Stay tuned for more!!

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  5. ‘We know that it is reported that the rates of burnout in the medical profession are nearly 50% with burnout rates being 65% in some specialties’. – This is a most staggering statistic, I did not know the rates of burnout were so hight within the medical profession, this is very concerning. It makes total sense though as doctors are expected to be super human. First to become a doctor, one is required to put themselves through torturous expectations to deliver academically, working very long hours in stressful circumstances. This does not encourage a loving way of looking after themselves but rather ‘a push through and do what ever it takes to get through’ approach. Many succumbing to often drinking between 4 to 12 cups of coffee a day, and consuming sugary foods to compensate for the stress and lack of sleep. Doctors are expected to be super human throughout their training and beyond as patients most often come to appointments expecting them to be able to ‘fix’ all their symptoms rather than working along side doctors and taking responsibility for the life style factors that are generating the ill health/symptoms. This is a big ask from one person let alone patient after patient day in and day out. Doctors are expected to cope regardless of what is presenting, to show no emotion and to soldier on. Doctors are very human and just like everyone else. The more we all start to honour how we are feeling, start to deeply care for ourselves first, look after our bodies in relation to rest, exercise, and being loving to ourselves in thought, expectations, and action, then we begin to fill ourselves up from the inside out. Able to support others and deliver a high level of service and care without detriment to self in way of burn out.

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  6. Great account of a sad state of affairs – how horrendous is it that doctors fear seeking medical support lest they’d be seen as wanting and somehow less competent; it just doesn’t make sense but it is the system that we have all created, the medical fraternity on one side and the patients on the other. It’s time for a change and it has to come from both sides: patients who take responsibility for their own wellbeing as a foundation of life and medical intervention and doctors and nurses who don’t regard themselves as superhuman and infallible.

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  7. Pingback: Are you a doctor, or a person? continued…. | Dr Maxine Speaks

  8. Pingback: Are you a doctor, or a person? | Dr Maxine Speaks

  9. Great question – why aren’t doctors healthy? (or any healthcare worker for that matter?) One of the greatest changes to the NHS in UK could be to put all 1.3 million staff on a self-care programme. The potential ripple effect with NHS staff as true role models of health and wellbeing (not perfection) is immense. This is a much needed article, and a much needed conversation. Only yesterday I was in contact with a psychologist who said 50% of therapists are stressed and a number of them are needing to go part time to deal with stress.

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    • I agree Jane. Self-care for health care workers is just the beginning. I see it with starting to value and see our health care workers as people too, worthy of and deserving of feeling well. Well workers makes for a healthier system and a more efficient and proficient delivery of true health care. Did you know that it has been shown that burnout in health care workers leads to lower patient satisfaction scores? I our health care workers value and appreciate themselves and ‘the system’ values them then it would make sense to provide well-being and self-care courses for them and develop a system that supports the health and well-being of both carers, doctors and patients.

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