C-Force: How Health Risks Affect Our Healers

In America, we place a great deal of weight on the concept of care. As is the case in other developed countries, it's a word that gets thrown about a lot, especially in the context of health care or the idea of being a caregiver. But what of the concept of self-care? "Self-care isn't an indulgence -- it's essential," Palena Neale of the Harvard Business Review reminds us.

"We all have a role to play in promoting and maintaining our own health," a World Health Organization article reads. "Self-care empowers us to be 'active agents' in our own healthcare." This proposition doesn't suffer from a lack of attention, even on a global scale. This year marked the fifth anniversary of WHO's Self-Care Month, which coincided this year with the launching of "the first global Guideline on self-care interventions for health and well-being."

Mounting evidence also shows that many in leadership positions struggle when it comes to personally implementing self-care practices. This includes those we turn to for medical help -- doctors, nurses and staff.

Medscape recently released its 2024 Physician Burnout & Depression Report. Its data shows that, despite slight decreases from 2023, "both burnout and depression remain relatively high" for physicians and other health professionals, according to an Advisory Board report.

The Medscape survey included "9,226 physicians in over 29 specialties between July 5 and Oct. 9, 2023, to assess their current feelings of burnout, stress, and more," the Advisory Board report continued. "Among the respondents, 61% were men, and 37% were women. Overall, 49% of physicians said they were burned out. ... Most respondents said they have felt burned out for at least 13 months or more, with 42% saying that they have been burned out for over two years.

"Among the different specialties, emergency medicine continues to top the list with the highest rates of burnout at 63%. The specialties with the next highest rates of burnout include ob/gyn (53%), oncology (53%), pediatrics (51%), family medicine (51%), and radiology (51%). Job stress is a major contributor to burnout and depression among physicians, with 83% of both male and female physicians saying that it contributed to either most of or all of their feelings of burnout and/or depression."

Nigel Girgrah, chief wellness officer at Ochsner Health, says that "burnout is not the same as depression, but can be a major risk factor for developing it," according to Advisory Board.

"I think of burnout as an occupational syndrome; over time, the resulting exhaustion can lead to depression," Girgrah says.

"When asked about the top factors contributing to their burnout," the Advisory Board report continues, "physicians highlighted too many bureaucratic tasks (62%), too many hours at work (41%), and a lack of respect from others at work (40%).

"Compared to last year, fewer physicians said that depression did not affect their patient relationships (45% vs. 51%). Overall, 40% percent of respondents said they were more easily exasperated with patients."

Recently, a Washington Post story appeared bearing this shocking headline: "A young doctor's final words offer a mental health warning for others."

William West, "a doctor in his third year of ophthalmology surgical training at George Washington University School of Medicine and Health Sciences in D.C. ... died by suicide at the age of 33," according to the story.

"There is no way to know for certain what led Will to end his life," the story continues. "But what is known ... is that despite a growing acceptance nationwide of the benefits of mental health care, barriers persist in residency programs that keep doctors from seeking help during a time when many need it." Medical school graduates "spend three to seven years training in their specialty under the supervision of attending physicians." They "can face grueling 80-hour workweeks on modest salaries. They can also feel compelled to hide their struggles, fearing the repercussions that disclosure might bring. Success in their programs is critical to landing the jobs that will launch their careers."

According to a CNN article, a study published last year in the medical journal JAMA found that "the annual suicide rate in the United States among health care workers is about 14 per 100,000 person-years compared with about 13 per 100,000 person-years among non-health care workers. Person-years means the number of people in a study multiplied by the years following them."

"Health care workers compared with non-healthcare workers have greater risks for mental health problems and long-term work absences due to mental disorders," notes Dr. Mark Olfson, a Columbia University professor and an author of the study.

"We both have burnout driving the health care workforce to leave, and we have this compounding mental health crisis that is making the environment untenable," Corey Feist, cofounder and chief executive officer of the Dr. Lorna Breen Heroes' Foundation, explains to CNN. "The foundation was established in memory of Feist's sister-in-law, Breen, with a goal to reduce health care workers' burnout," CNN notes. "Breen was a frontline emergency department physician who treated Covid-19 patients before she died by suicide in 2020."

The study's researchers report that, "Compared with the general population, physicians tend to live longer and have healthier lives. In their occupational roles, however, physicians and other health care workers routinely engage in stressful tasks of caring for severely ill individuals and managing heavy workloads, with little control over patient outcomes. ... Because health care occupations vary in their emotional demands, they may also vary in suicide risk."

As Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention, explains, according to the Post report, "reforms have been instituted unevenly and stigmas persist."

As the Post puts it, the question remains: "Who cares for the healers?"

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