Unhappy Doctors

Dr Kauser Mansoor
MRCOG,FRCOG
Consultant Obs& Gyn & HOD AlQasimi hospital,Sharjah
 Headlines
“Frustrated physicians find careers outside of
medicine”
“Suicide rate of women doctors in US is twice
that of other working women”
“Suicide rate high in female doctors”
“Many doctors prone to stress”
 What is happiness
• Emotional state
• Feelings of enjoyment and satisfaction
• Pursued and commented on extensively
throughout world history
• “Happiness is a choice that requires effort at
times” (Anon)
 We All

– want happiness
– need appreciation
– crave for recognition
– want to be applauded
– desire to be called as good humans
– are looking for certificates from our
institution,friends, family & colleagues.
 Are doctors unhappy?
• Unhappy is a crude word

• “Happiness is essentially a state of going

somewhere, wholeheartedly, one directionally,
without regret or reservation.”
William H Sheldon
 Physician Dissatisfaction:

• Study in 1997 revealed physicians were less

satisfied in every aspect of their professional life
compared to 10 years prior.

• 40% of practicing physicians in 2005 would not

choose to enter the medical profession if
deciding on a career again
– Higher percentage would not encourage their
children or highly qualified college graduates
to pursue medicine
Source:1Sullivan P, Buske L. Results for CMA’s huge 1998 physician survey point to a dispirited profession. CMAJ. 1998;159:525-528.
2
Massachusetts Medical Society. “Physician Workforce Study.” 2005.
 Dissatisfaction
• Dissatisfaction has been reported in diverse groups of
physician
– Primary care
– Surgery
– Infectious disease
– Anesthesiology
Large study revealed lowest dissatisfaction in primary care sub-
specialists and highest in surgical subspecialties such as
gynecology, ENT, and plastic surgery

Increasing unhappiness among physicians has led to job changes,

non-clinical work and early retirement

Source: 1Leigh JP. Kravitz RL. Schembri M. Samuels SJ. Mobley S. Physician career satisfaction across specialties. Arch Intern Med.
2002 Jul 22;162(14):1577- 3Leigh JP. Kravitz RL. Schembri M. Samuels SJ. Mobley S. Physician career satisfaction across specialties.
Arch Intern Med. 2002 Jul 22;162(14):1577-84 84.
 League of unhappiness
Country Very Unhappy Neutral Happy Very happy
unhappy

UK 23 43 17 14 2

US 14 45 10 19 11

NZ 8 25 30 25 11
Why might doctors be unhappy?
 BMJ Survey

• Poll---- May, 2001

• 1400 doctors voted
• 90 countries
• Level of unhappiness
• The reasons of unhappiness
Work pressure
 Negative media
• “Negative media coverage might represent
the world's waking up to the limitations of
doctors and medicine, and it's
uncomfortable .
• newspapers sometimes do influence by
highlighting negative trends and emphasizing
scandal.
 Junior Doctors
• House officers syndrome:
• - long training hours
• - excessive work loads
• - sleep deprivation
• - changing work conditions
• - peer competition
• - self denial
Junior doctors training
..
What’s wrong with these guys?!! Med reconciliation—Harder, faster!!
 Senior Doctors
• Senior Physician find new stresses waiting for
them:
• - work faster and longer hours
• - mountains of paper work and threat of
malpractice suits –
• challenge to explain and defend work
• - daily confrontation with sickness and death
 Problems

• Dysfunctional relationships
• Boss Unappreciative , Climate of criticism…. no
feed back
• Colleagues blaming each other, hostility and
oppositions ,hospital care blaming primary
care, nurses blaming doctors & docs blaming
politicians.
• Patients Demand???
“Sorry boss I was
doing my best”
 Patients’ s view
• Modern medicine can do remarkable things: it can
solve many of my problems

– Doctor can see inside me and know what's wrong

– knows everything it's necessary to know
– can solve my problems, even my social problems
• So we give you high status and a good salary
 Help
• So often we buy into fallacy that something or some one is
going to come along and make us happy
• Hope is a powerful influence in our lives.

-Work does not have to be merely a domain of energy

expenditure but also of energy renewal

-Learn to receive support, healing and meaning while giving

– A new job
– More Money
 New job
• Changing jobs/ career may not be a option
• Small town
• Not very many opportunities
• Inadequate openings in the job market
• Less money offered
Money
 Search for happiness
“Happiness sneaks through the door you
didn't know that you left open”
John berry Moore

IS IT WORTH PERSUING?
 YES…
“There is only one way to happiness and that is
to cease worrying about things which are
beyond the power of our will”
Epictetus
“The Grand essentials of happiness are
something to do, something to love and
something to hope for”
Allan K Chalmers
 How to find happiness
• Deep Relaxation, help combat depression
• Make list of blessings you can be thankful
• Compile a collection of Inspiring thoughts
• Keep Your mind focused on positive things
• Stop sneaking consolations with complaints,
sighs, sad looks and crying
• Social interactions more positive
• Develop interests & activities
 Count blessings

• Appreciate Blessings
 What You Can Do ?

• Identify your main goals

• Do relaxation activities
• Organize time and set priorities
• Maintain a good diet
• Exercise
 What You Can Do ?
• Leave your counseling at work
• Pursue a project or hobby
• Don’t feel that you must do everything
• Keep a “things to do” list
• Social calls, showing warmth to friends
• Try to eat out
• Music/dance
 Relax !
• Psychological studies—every individual 60,000
thoughts/day…57,000are same the day before!
• Do you watch same TV program every day over &
over again?
• Emotional Toxins

“Its neither wealth or splendor but tranquility

and occupation which give happiness”
Thomas Jefferson
What difference does
humor make in
relieving stress?
Laughter is positive
stress.
When we laugh, we
are stimulated and
then we relax
relieving the stress.
IF YOUR WORKLOAD GETS TOO MUCH...

THINK OF HOW TO BALANCE YOUR LIFE!

 Stop complaining !
• Stop being miserable at work.
• Unhappiness & criticism are contagious move
on to avoid catching the bug
• When frustrated with small issues, consider
channeling the energy to solve
• Use Erect posture rather than dropping
• Don’t use slow, quiet & monotonous voice
 Re-framing
Re-framing is a technique to change the way
you look at things in order to feel better about
them.
There are many ways to interpret the same
situation so pick the one you like.
Re-framing does not change the external reality,
but helps you view things in a different light
and less stressfully.
 Be- Assertive

Being assertive involves standing up for your

personal rights and expressing your thoughts,
feelings and beliefs directly, honestly and
spontaneously in ways that don’t infringe the
rights of others.
 Ventilation
‘A problem shared is a problem halved’
Develop a support network through friends or
colleagues to talk with. It’s not always events
that are stressful but how we perceive them.

Writing a diary or notes may help release

feelings but do not re-read what has been
written.
 Time Managing
• Organize the Day
• Delegate amount of time to activities
• Make a daily list
• Set or identify priorities
• Know your peak time
• Remember there is 24 hours in a day
• Create a time and place for private time
 What Your Employer Can Do?

• Provide more clerical assistance

• Provide more educational opportunities to learn about
counseling
• Provide more social activities and “retreats”
• Establish a Physician Health Committee
• Mentor program
• Provide more workshops, in-services, advanced
courses, etc.
• Provide more verbal praise & reinforcement for the job
Creating new contracts for doctors

• Work within guidelines

• Be accountable for key objectives and
improving quality
• Actively support and contribute to achieving
the goals of the organisation
• Work within resource constraints
• Engage in team and collaborative working
 Conclusion
• Unhappiness &burnout among physician is a
serious problem, with a risk for suicide.
• Programs and conferences are needed to alert
physician against this issue.
• Medical training should be re-evaluated and
restructured to prevent burnout.
• Physicians suffering of burnout need to learn
new adaptive coping mechanisms.
Any Questions ?

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