One-fifth of young doctors suffer mental problems

News in Science ^ | Wednesday, 19 February  2003 | Danney Kingsley

[vannrox]

	The stress of being a young doctor takes its toll, with many suffering mental problems

Two-thirds of Australian medical graduates show obsessive-compulsive behaviour, a fifth are likely to have mental health problems and some face drug issues, according to a new study.

The research looked at 117 students who were the first to complete a new graduate medical program run by the University of Sydney. Many became emotionally exhausted, and suffered burn-out in their first year of work. Some experienced a high level of distress.

"It's a stressful environment - you can't work in acute end of health care, in hospitals, and not get stressed," said Dr Simon Willcock, director of the academic general practice unit at Hornsby Ku-ring-gai Hospital in Sydney, who conducted the study.

"We wanted to measure if with continued exposure to it, they were at risk of poor outcome and burnout," he told ABC Science Online. The research was reported in this week's British Medical Journal.

Subjects were followed in the 2000 academic year until the end of their hospital internship in late 2001. They completed regular psychological assessments and were interviewed on three occasions.

Two thirds met the criteria for obsessive-compulsive behaviour, the authors said. "This tells us that they are obsessive about being hard working and altruistic. The problem for the community is if they burn out, they might leave the profession," Willcock said.

By the end of internship, 40% of the subjects had a significant level of psychological distress. Using a standard measurement technique, the researchers found that 20% of the subjects had met the criteria for psychiatric disorder, usually anxiety and depression.

Doctors are generally physically healthier than the general population, the authors note: they smoke less and are better at looking after their fat levels. But they match the general population in their level of mental health problems, although they have a higher incidence of drug use. Suicide rates in doctors are also higher than that of the general community.

The paradox is that while patients expect their doctors to be empathetic and caring, it is these very traits that cause the mental problems for young doctors.

Doctors who did not show these effects tended to be de-personalised, which was a problem in itself, he explained. "We don't want doctors who are not sensitive," he said. The team is preparing a scientific paper for publication, which is expected later this year.

Conditions for junior doctors working in hospitals have slowly improved over the past 12 to 14 years, said Willcock. There are limitations on the number of hours they can work without a reasonable break before the next shift, for example.

Registrars - the next rung up the ladder towards specialisation - do not have this protection, and are sometimes still subject to extremely long and unsustainable working hours. "While junior doctors' hours of work are significantly decreased, there is no demonstration that they are no fewer stresses," said Willcock. "In some cases, they are more stressed."

The research will likely form the basis of a discussion on how to address the issue. "The results will allow us to go back to the employers of young doctors, in this case hospitals, and ask them how they are ensuring the occupational health of their young doctors," he said.

Universities might be tempted to select medical students who are more tough minded and can handle the stress, he said. "But [these students] may be less sensitive to the needs of the patients," Willcock said. "We probably can't have it both ways."

Danny Kingsley - ABC Science Online

More Info?

It's official: hard work, stress makes you sick, News in Science 4 Feb 2003

Dr Email?, News in Science 7 May 2002

Doctors not keen on discussing death, News in Science 20 Jun 2001

© ABC 2003 | privacy

[vannrox]

Hum. I don't know what to think about this.

[FreeTally]

I always thought that someone who wanted to look up your butt hole, or cut you open and look at your insides must have some sort of mental problem....

Wasn't this obvious?

;-)

[Pearls Before Swine]

Well, doctors certainly undergo a very stressful training program. For my part, I wonder if the data was broken down by specialty. I'd like to know what the percentage of disturbance among psychiatrists was, and if it was higher or lower than that for the other types of doctors.

[ClearCase_guy]

I have noticed some obessive-compulsive behavior in surgeons. Have you ever seen those guys wash their hands? I mean, give me a break! It's like, every time they're going to perform surgery, what do they do? They wash their hands! It's some sort of good luck ritual, I think. And boy, do they go to town! Like they just can't get their hands clean enough. Sheesh! Oh, and afterwards, they won't even open a door -- what are they afraid of? Kooties?

Yeah, doctors engage in some weird behavior.

[Polycarp]

I don't believe this for one minute.

Yes, I do!

No, he does not!

Shut up!

No, you shut up!

Both of you knock it off!.

Ahem...

As I was saying, I don't believe this for one minute.

--Dr. Polycarp

[Alberta's Child]

For what it's worth, I do know that most insurance companies refuse to write disability policies for medical doctors. The number of disability claims filed by these doctors is very high, and while it has not been proven, there is a feeling in the insurance industry that the vast majority of them are fraudulent claims.

[dodger]

The rate of mental disturbance among psychiatrists is not statistically greater than other specialties and the actuarial tables for physician disability are considerably better than the general population.

[Palladin]

I believe it. Did you ever notice how many doctors murder their wives and/or girlfriends?

[Alberta's Child]

Talk to someone in the disability insurance business and ask him or her how hard it is to underwrite a policy for a medical doctor.

[joesnuffy]

Not any more at least among Aussie MD's :)
I've worked around some severely disturbed ones though..but their peers covered for them nicely..

[ofMagog]

WE ARE NOT SCHIZOPHRENIC!

LEAVE US ALONE!

[katana]

I don't know, I haven't worked at a company yet where more than 20 % of my colleagues weren't completely nuts. I think the same thing was true in college and high school.

Of course, there's an outside chance the problem has always been me.

Naaaah!

[Clintons Are White Trash]

My daughter had to go thru an extensive interview process that included a psychiatric review before she was admitted to medical school. It makes me wonder if they are ok when they go in but the process messes them up.

[weikel]

Im surprised its not more you gotta be crazy to go into medicine nowadays.

[weikel]

One in my hometown did( Dirk Grenider) for a doctor he didn't know s*** about forensics typical dumba** academic, he left about as much evidence as OJ Simpson from what I understand.

[2 Kool 2 Be 4-Gotten]

What's so new about this? This has been going on for some time now, IMO.

[Overtaxed]

Paging Doctor Howard, Doctor Fine, Doctor Howard!

[2 Kool 2 Be 4-Gotten]

Dr. Howard's fine, Dr. Howard.

[Overtaxed]

Nyuck, nyuck, nyuck!

[dodger]

I am quite familiar with the business and talk frequently with all manner of insurance people including senior executives of major companies.

Industry trends basically are correcting the lax standards applied to doctors in the past (which have come home to roost as baby-boomer doctors ages). These trends affect some high-income specialties with more restrictive underwriting guidelines, benefit reductions and higher premiums. It is sometimes necessary, especially for physicians with higher incomes, to use a combination of group and individual policies to get the desired level of coverage, although existing group coverage reduces the amount of individual coverage a person can buy in order to prevent overinsurance.

It is, indeed, harder for a doctor to get open-ended disability coverage but physicians as a group remain less likely to become disabled than the general public.