Sick of being a doctor
The stress on over-worked hospital medics and GPs is pushing them out of the industry, says Áilín Quinlan
even a basic chest x-ray, and this is a huge stressor,” he says.
“And there’s no back-up from the hospital system.”
It’s no surprise, then, that so many young GPs are emigrating: a survey published by the Irish College of General Practitioners, in late 2017, showed that almost one in five of recently graduated GPs had already emigrated, while one in three of those currently in training were considering working abroad.
“There is plenty of work for GPs in Ireland, but a lot of my counterparts have decided to emigrate, because the workload is becoming increasingly difficult,” says Kieran, adding that the 38% cut in the income stream from medical-card patients is another major disincentive for doctors considering a community-based medical career.
In contrast, he says, in Australia or Canada, GPs “can get all the back-up and diagnostics you want, plus the pay is better — a career as a GP is now a very unattractive profession in Ireland.”
Another GP trainee, who did not wish to be identified, says “As a GP, you know that a person needs to see a certain specialist or get a certain investigation, but you also know that that investigation or that access to a consultant could take a year or so down the line.
“That’s a source of stress, because when this kind of thing is routine, you end up with a whole cohort of people whom you know need further investigation or specialist review, but the access to these facilities is not timely — for example, in the case of hip replacements or cataract surgery.
“There’s a huge gap between what is needed and available resources.”
Because of the everdwindling number of GPs — the National Association of GPs has warned that the number of GPs in the country has fallen far below international best practice — patients are now experiencing increasing difficulty in even getting a GP appointment, he says. And when they do get to see a doctor, they have less time in the consultation than previously, because of the pressure of numbers.
There is a “huge” issue with burnout among doctors, warns Dr Mark Rowe, a GP of 23 years, lifestyle medicine expert, and author of A Prescription for Happiness. He points to research in the Journal of the American
Medical Association, which shows that about 50% of physicians were experiencing symptoms of burnout, he says.
“Caring is wearing and if you ask any doctor about burnout, they’ll ask you which burnout story do you want to hear,” says Waterford-based Rowe.
“You are dealing with increasingly complex cases — you could have people on up to 20 different tablets daily.”
Then, there’s the long hours, and the rise in litigation, which is another stressor for overworked doctors.
“Systems are far from perfect and mistakes happen, but there’s now a culture of ‘hang the doctor out to dry’, rather than looking at the system around something. This puts a lot of pressure on doctors — the fear of being sued.
“The lack of resources and lack of access to central services is a major issue.
“It’s not acceptable that people in Ireland have to wait so long to get basic tests. This frustration for patients affects the doctors,” says Dr Rowe. “A lot of GPs are going to Australia and Canada — they’re moving there because of money, but the reason a lot of them are staying is because the systems are much better. In Australia, if someone has a problem, they can have their scans done on the same day and the GP will have the results back that evening and get a specialist to see the patient the day after,” he says. Doctors in Ireland work extremely hard and in very difficult conditions, adds Dr Rowe. “A doctor can find himself or herself working all the time and neglecting health and key relationships,” he warns. “At a fundamental level health needs to be valued as a resource rather than as a cost and the people who provide healthcare need to be valued as resources and not just seen as a cost.”
Also Human: The Inner Lives of Doctors, by Caroline Elton, a Heinemann hardback, €23.79 * Names have been changed