Breaking the job addiction

Just what is the difference between doctors who are workaholics and those who are simply hard workers?

Workaholic doctors tend to build their lives around their work. They may be perfectionists by nature and often deny any health problems. When they do fall ill, they tend to return to work before a full recovery. They often have an excessive workload, which contributes to their compulsion to work more. 

Workaholism, which is essentially work addiction, has become more well-defined as its prevalence increases. In a 2014 study published in Occupational Medicine, physicians practising at a French university hospital took a survey based on their work addiction risk and psychosocial factors. Of 445 respondents, 13 per cent were highly work addicted and 35 per cent were mildly work addicted. 

According to the Harvard Business Review, workaholics report more health complaints, more sleep problems, more emotional exhaustion, more cynicism, and more depression than those who merely work long hours – and they may struggle to psychologically detach from work. 

Is it different for doctors who simply work long hours? Research suggests they are not mentally preoccupied with work, report fewer health complaints, fall asleep easily, and don’t feel restless when not working. 

Let’s be honest, medicine has an implicit bias toward overworking. “When we’re in training we hear a lot about this archetype of the self-sacrificing physician and this is what patients talk about admiringly,” Dr Elisabeth Netherton, a Consultant Psychiatrist and Regional Medical Director at Mindpath Health in Houston, Texas, told Medscape. “‘Dr Smith took such good care of me, and he was always there, and he always answered my phone calls.’” 

She says that work/life balance can be tricky for physicians because, within medicine, there is the idea of the ideal doctor who doesn’t take full holidays, doesn’t go home for dinner, and stays at work for the requisite amount of hours necessary for everything to be completed. 

We don’t claim to be superhuman but, on the other hand, the subculture is that doctors don’t need to sleep or eat; they are there to serve, help people and do everything right. It’s like a badge of honour. 

Is physician workaholism ego-driven? Netherton says while she sees that less commonly, it doesn’t mean it’s not there, but she says there is a lot of reward in medicine. It feels good to put in additional work and effort and have a patient say thank you for making a difference. And if that comes with a rush of adrenaline or a hit of dopamine, well what’s not to like? 

Busyness is a way we can hide and mask ourselves to shield pain from the uncontrollable things, like when a patient dies. And if you have just given someone a cancer diagnosis, the next patient is waiting for your undivided attention. Workaholism can be the key to keep moving professionally. 

There are also other factors like the corporatisation of medicine, the endless documentation that doctors are responsible for, as well as physician shortages. They all contribute to doctors working later and later to catch up. 

If you want to overcome work addiction, here are some steps that might help. The first thing to do is pause. That doesn’t mean going on holidays, but rather assessing how you’re spending your time, and asking yourself if you enjoy what you’re doing. Do you schedule leisure activities as well as work time? 

Are you getting breaks during the day? Try to take a decent lunch break, but at least take five minutes to sit by a window and take a mental space several times a day before running to the next task. The workaholic culture takes away our sense of control, so creating an atmosphere of better work/life balance can help us feel empowered and back in control. 

As a profession we have to take steps to start cracking the façade of the ideal physician that never goes home, never sleeps, and never takes time off. “We have to recognise that’s a recipe for an unwell physician who might develop substance problems and struggle with burnout,” Netherton says. 

And please do seek assistance. If you’re having trouble with work/life wellness, talking to a cognitive behavioural therapist and learning mindfulness-based techniques have been shown to help. A systematic review, published in the International Journal of Environmental Research and Public Health, on workaholism in occupational medicine found that cognitive behavioural therapy and mindfulness-based interventions show promising results for addictions, such as workaholism.