Cape Town – Medical education needs to put more emphasis on doctors realising their limitations and recognising their humanity and fallibility, says past president of the South African Society of Psychiatrists (Sasop) Professor Bernard Janse van Rensburg.
The suicides of prominent medical professionals and university students in the past year have turned the spotlight on mental wellness and the need to remove the stigma from mental health conditions, particularly among medical professionals themselves, said Van Rensburg.
Doctors were two and a half times more likely to commit suicide than the general population, while physician burnout was a leading cause of medical error.
This is not unique to South Africa - studies in the US, UK and Australia have all shown that doctors, specialists, nurses and other medical professionals were at higher risk of burnout and suicide, and they were also less likely to seek help.
Van Rensburg said burnout was not a medical diagnosis in itself, but was a combination of conditions such as stress, anxiety and depression, signalled by emotional exhaustion, detachment or lack of empathy with patients, and a reduced sense of job satisfaction or professional achievement. He has called for mental awareness to be promoted at student level.
“Burnout is a very real state that has a significant impact on sufferers and their productivity and performance at work, as well as on their personal lives and relationships, heightening the risk of drug or alcohol abuse as a coping mechanism, and sufferers experiencing suicidal thoughts,” he said.
Burnout can lead to errors of judgement and affects doctors’ prescribing habits, test ordering and overall professional behaviour.
“Doctors and other medical professionals who are highly critical of others and themselves tend to blame themselves for their own illnesses, and are more at risk of major depression and other mental disorders that can lead to suicide.
"They tend to be reluctant to approach their professional colleagues for help and rather ‘self-medicate’ for symptoms such as anxiety or insomnia. They also slip into risky coping mechanisms such as alcohol and drugs,” Van Rensburg said.
Doctors needed to be self-aware and vigilant on their own vulnerabilities and possibly risky coping mechanisms, and not “suffer in silence”, Van Rensburg added, referring to the self-administered Maslach Burnout Inventory questionnaire as a simple means for practitioners to check in on their own health.
Professional bodies, including Sasop and the South African Medical Association, have also turned their spotlight inwards, he said, raising awareness among medical practitioners to check their own mental health and self-care, and working to reduce the stigma that can delay seeking help.