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Getting to the bottom of physician anxiety

What is it about the ‘physician personality’ that makes doctors reluctant to seek help for ill health?

Minnesota professor of medicine Tait Shanafelt says the general public could be forgiven for being slightly baffled by concerns about physicians’ health.

After all, he says: ‘We are highly educated, universally employed, well compensated, and we engage in work that society values and we find meaningful.’

Yet anxiety, stress, dissatisfaction, burnout and thoughts of suicide seem to plague the profession. And high levels of burnout and stress will lead to medical errors.

In his conference speech yesterday, Dr Shanafelt asked the question which the Journal of the American Medical Association has delved into in studies over the past nine years: do errors lead to distress or does distress lead to errors? It is a bit of a chicken-and-egg argument.

In the past, the culture of medicine has perhaps been guilty of priding itself too much on a survival-of-the-fittest approach. The feeling may have been that those who couldn’t hack it just weren’t cut out to be doctors. That culture is now changing.

As for the physician personality type, this is typically described as driven, high-achieving, intolerant of errors made by themselves and others. There is also a tendency to delay gratification, to the extent that physicians under the age of 40 are ‘looking forward to retirement’ as an ‘essential wellness strategy’ or a way of coping, according to Dr Shanafelt.

One tragic fact to emerge from Dr Shanafelt’s research is that doctors are at higher risk of suicide when their youngest child is aged 19-22. This could be because they realise they have missed their childhood, he suggests.

And that might explain why doctors are so protective of their pensions.

Mike Foster is a writer for BMA News

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