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 Most people looked, grey, tired, withdrawn, inwards, uncomfortable speaking to people, unable to speak without being in ‘doctor’ mode.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 Most of them in my training, were either angry, cynical, withdrawn, stressed out, depressed, anxious, grey, tired unhappy and unhealthy and not coping but doing their best to survive – or any of the above combination!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