The myth of the superdoctor

The evidence of the rise of burnout among doctors is accumulating

How would you feel about being called a ‘superdoctor’? Uncomfortable? It seems a little dated, does it not? I mean I thought the days of us being considered God-like figures were long gone.

 In the latest MPS report — Breaking the Burnout Cycle — there is reference to an entrenched culture of doctors ignoring their own health concerns and believing in a superdoctor syndrome, in which they set unachievable expectations for themselves.

The Irish version of the report includes a snapshot of 143 doctors in Ireland in June 2019, as part of a wider international survey of 1,170 medics.

A quarter of UK doctors surveyed said they suspect emotional exhaustion has contributed to an ‘irreversible’ clinical error on their part. Almost one-in-two respondents in Ireland considered leaving the profession for reasons of personal wellbeing. And two-in-five are not confident their workplace is a safe environment. Perhaps the most sobering statistic to emerge is that one-in-three GPs feel unable to take a break during the working day to either eat or drink.

It seems that as modern medicine allows doctors to do more for their patients than ever before, there is mounting evidence that doctors feel burnt-out and disillusioned in ever-greater numbers.

Commenting on the report, MPS president Prof Dame Jane Dacre said: “When I talk to other doctors, I am troubled by the increasing levels of burnout I see. The sense of value that doctors have is being diminished by the environment they work in.

“When doctors feel burnt-out, it is not only bad for the doctors concerned, but also for patients and the wider healthcare team. The obvious reality is that doctors who are happy and engaged find it much easier to be compassionate and provide safer patient care.

“The causes of burnout have been widely debated and include the growing demands and complexity of the job, tighter financial constraints and a faster pace of work.”

The latest example of how challenging the working environment has become is that, from this month, GPs and other healthcare professionals requesting emergency ambulances for patients across England will have to provide a clinical ‘score’ as a reason for calling from next month. 

Not surprisingly the British Medical Association has warned the new rules could risk patient safety and has said they “must not” be used as a barrier to accessing an emergency ambulance. The new mandatory emergency assessment is made by scoring six vital signs: Respiratory rate; oxygen saturation; systolic blood pressure; pulse rate; level of consciousness; and temperature. The GP will be expected to give each factor a score, with a higher number reflecting how much the symptoms vary from the norm. The guidance from NHS England says: “This information should be communicated to ambulance dispatch when requesting an ambulance. If possible, the patient’s NEWS2 score is to be calculated, recorded and also handed over to ambulance clinicians.”

A score of seven or more triggers a level 2 ambulance response time, which is 18 minutes. But if the score is less than seven or if the GP hasn’t calculated it, they will be asked to give the clinical reason for calling an ambulance. In other words, they will have to explain themselves to a stick-wielding ambulance controller!

(A level 1 ambulance response time, which is seven minutes, is reserved for life-threatening conditions requiring immediate assistance like cardiac arrest, cardiovascular collapse, and airway compromise.)

The situation is every bit as challenging here in Ireland. A study by the RCPI found that one-in-three hospital doctors working in the health service is suffering from burnout.

We badly need innovative approaches to support doctors’ health and to raise awareness of the importance of caring for them. The MPS says every doctor in Ireland should have access to someone trained to recognise burnout and offer support. It said this could be achieved by all HSE organisations and private providers appointing a ‘Wellbeing Guardian’ by 2022, with a similar dedicated person working with GP surgeries and smaller clinics locally. It also calls for doctors’ wellbeing to become a key performance indicator in all organisations.

Undoubtedly a good idea — but will it ever happen?

And let’s drop the awful ‘superdoctor’ moniker, so Irish doctors can be spared the pressures of that particular chain hanging around their necks.