The New Statesman held a roundtable discussion at the Houses of Parliament recently, in collaboration with the University of Buckingham, on the subject of how to make a profession in Healthcare more sustainable by altering the university experience for medical students. It was attended by NHS Directors, Professors, Politicians, and Charities, and Breathworks was delighted to be invited to attend; our Business and Research Manager Colin Duff (below) represented Breathworks in the discussion.

The issue of the work intensity for doctors in the UK is hard to overstate; only 1 in 10 Trainee GPs say that they want to work as a doctor full-time when they complete their training, citing, amongst other things, the intensity of the work. Given the eight years of gruelling work it takes to qualify as a GP, this is a shocking figure. In 2011, England lost 13% of its GPs and 22% of its Specialists to Australia, due to kinder working hours (and also probably the sun).

Self-maintenance and well-being strategies are not touched upon as part of a medical degree, despite having a huge influence on burnout rates and time lost to poor mental and physical health, job satisfaction, and basic quality of life for doctors. Higher levels of workplace stress for doctors is also associated with lower quality of care and lower levels of patient satisfaction. The medical school at the University of Buckingham has been an exception, emphasising mindfulness and well-being in the curriculum, thus far with excellent feedback from students and patients.

There is great potential for universities to incorporate a developing understanding of positive psychology into their degree programs. A recent paper(1) from Sir Anthony Seldon and Dr. Alan Martin makes a number of excellent suggestions to this end, proposing that well-being strategies be taught to everybody before they are needed. They make the simile that waiting for an individual to develop mental health problems before helping them is like waiting for somebody to fall off a waterfall, and then trying to fix them, instead of employing prevention strategies which in the long-run would be more economical, effective, and encourage the flourishing of well-being for the whole student body.

A study(2) published in February looked into the effectiveness of interventions for physicians to prevent burnout. It found that interventions targeted at individuals, many of which were mindfulness-based, were significantly effective in preventing burnout in physicians, but that those interventions which were directed at an organisational level were significantly more effective still. The study concluded that “burnout is a problem of the whole health care organization, rather than individuals”.

A letter sent to the committee from a retired GP echoed these findings strongly: “Mindfulness and Compassion training would be very helpful as a part of a bigger package to improve resilience in young doctors, but if the package is used as a sticking plaster for a much deeper wound of a broken NHS, that is to say, if working conditions are not improved, the package will not be effective.” 

The former GP, Dr. Farhad Emad, was himself forced to retire from the profession early due to ill health resulting from chronic physical and mental burnout. He writes of himself and a colleague: "Subsequently we both trained in Mindfulness practice with Breathworks organisation and managed to get ourselves out of our difficulties successfully, and in the process, we helped others including GP’s, by teaching Mindfulness. We are both of the strong opinion that earlier Mindfulness and Compassion training might have averted our premature retirement and that we would still be working as experienced GP’s."

Breathworks runs introductory Mindfulness and Compassion courses for doctors and Healthcare professionals to help with these problems. Dr. Emad noted that  "Many junior doctors are taught empathy but know nothing about compassion and consequently struggle with empathic distress, which can lead to burnout."

It seems essential that organisational changes take place and that aspects of this training become incorporated on an institutional level where they are sorely needed by trainee doctors at huge risk of severe physical and emotional burnout. In the meantime, we can hope that a knowledge of well-being training is spread organically through books, courses, and teachers.

You can find out more about Breathworks courses for Healthcare professionals and book a place here.

Ollie Bray

 

References

Seldon, A., & Martin, A. The Positive and Mindful University. 2017
Panagioti, M., Panagopoulou, E., Bower, P., Lewith, G., Kontopantelis, E., Chew-Graham, C., ... & Esmail, A. (2017). Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis. Jama internal medicine, 177(2), 195-205.