No single solution to doctor burnout

Doctors’ unions claim that burnout, or physical and psychological fatigue, is caused by understaffing and bad rosters.

In early August the Association of Salaried Medical Specialists (ASMS) published a report showing that half of New Zealand’s public hospital specialists feel burnedout, potentially affecting patient care and increasing the risk of medical errors.

District health boards (DHBs) claim the burnout is overstated but don’t deny it is a problem.

Melissa Dobbyn, an advocate for the New Zealand Resident Doctors’ Association ( NZRDA), said the solution was simple.

‘‘There is going to be a need for more doctors to make these rosters safer, there’s no doubt about it.

‘‘But those doctors are being produced in New Zealand now.’’

She said it required only a ‘‘willingness and commitment’’ from DHBs to make safer rosters a priority.

ASMS executive director Ian Powell said the problem was more complex than that but hiring more doctors was the first step.

‘‘You’ve got to start from somewhere,’’ he said.

‘‘We need to increase the numbers by quite an amount.’’

Powell agreed DHB funding was restrictive, but said hiring more specialists would save money in the long term because they would improve systems.

Julie Patterson, chief executive of Whanganui DHB and lead chief executive for the 20 DHBs’ National Workforce and Employment Relations Programme, said there was not a ‘‘one size fits all’’ solution. ‘‘As you can imagine, the services and training needs vary significantly between hospitals.’’

Patterson said the DHBs and ASMS shared a priority for a workforce that was safe and well.

She said the resident medical officers workforce was a ‘‘workforce in training’’ that made the issue more complicated.

‘‘The issue of hours of work versus training demands is a longstanding and international issue,’’ she said. ‘‘One solution from our point of view is to manage the rosters better. Factors to consider are providing great patientcentred care and also world-class training opportunities which are critical to all doctors’ career prospects.’’

Patterson said the DHBs and unions had agreed on both a fatigue and wellbeing clause, that encourages the employee to put their hand up when they are too tired to work.

‘‘Self-reporting of tiredness is one way we can address the issue.’’

She said the DHBs had invested in a national workforce team to look at how many doctors were needed and in which fields.

Labour’s health spokeswoman Annette King said DHBs need more money.

‘‘The reason why there is burnout gets back to a fundamental question of what funding they have to employ more doctors and to reduce the hours they are required to work,’’ she said.

‘‘You’ve got to put more funding in it, and you’ve got to attract more staff into the areas where they’re needed.’’

King said a tight funding situation did encourage DHBs to become more efficient but there was a limit.

‘‘They’ve been squeezing the lemon down to the pips,’’ she said.

‘‘You end up with inefficiencies if you end up cutting too much.’’

Health Minister Jonathan Coleman declined to comment and referred Fairfax Media to the Ministry of Health.

The ministry would not be interviewed, citing negotiations between ASMS and the DHBs.

The ministry’s chief people and transformation officer Stephen Barclay issued a response saying the ministry was not an employer of hospital doctors.

He said the ministry supported introducing wellbeing and fatigue clauses into the collective agreement for senior medical officers.

‘‘The ministry is supportive of DHB discussions with the ASMS around wanting to have senior doctors included at all levels of discussion within hospitals.’’