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The National Study of Wellbeing of Hospital Doctors in Ireland

National study of wellbeing of hospital doctors in Ireland finds 50% of doctors are emotionally exhausted and overwhelmed by work

This national study, which commenced in 2014, aimed to assess the wellbeing of hospital doctors across Ireland and get a deep understanding of what it’s like to work as a hospital doctor in Ireland today.

As well as examining the causes of stress in the workplace, we collected data on doctors’ lifestyle choices, interpersonal relationships and rates of mental health problems, including burnout, depression, anxiety and substance misuse.

The study was led by Professor Blánaid Hayes, Past Dean of the Faculty of Occupational Medicine, and was published in BMJ Open in March 2019.

The study entitled Doctors don’t Do-little: A national cross-sectional study of workplace well-being of hospital doctors in Ireland found that hospital doctors across all grades in Ireland have low levels of work-life balance and high levels of work stress. Almost one-third of respondents were experiencing burn-out and 50% of doctors reported being emotionally exhausted and overwhelmed by work.

The study is the first national survey conducted on a cohort of hospital doctors working within the same health system in Ireland.

Hospital doctors in Ireland have higher levels of burn-out measures than their international peers

1,749 doctors completed workplace well-being questionnaires as part of this study. The 55% response rate is considered high in this population, where response rates tend to be low and are declining.

  • Burn-out was evident in just under 30% and was significantly associated with male sex, younger age, lower years of practice, lower desire to practise, lower work ability, higher ERI (Effort-Reward Imbalance) ratio and greater over-commitment.
  • 50% of doctors reported being emotionally exhausted and overwhelmed by work, which is higher than in hospital doctors from the UK, the USA and Australia.
  • 29% of respondents had insufficient work ability and there was no sex, age or grade difference. Work ability measures the degree to which individuals are able to cope physically and mentally with the demands of work.
  • 70.6% reported strong or very strong desire to practise medicine
  • When asked if their work situation left them enough time for their family/personal life, only one in five doctors felt this was the case (22.2%)
  • Occupational stress (ERI) was reported by four out of five respondents (82%), indicating that the perceived rewards for the group and especially for doctors in HST fall well short of the effort exerted.
  • While consultants reported highest levels of effort, rewards were also highest for this group. At the time of the survey, the majority of the consultants were employed on a contract which had been in existence since 1998, with a new, less favourable, contract introduced for new recruits in 2012, two years before this study.
  • Apart from the measures of work ability and over-commitment, there was no sex or age difference across any variable. However, ERI and burn-out were significantly lower in consultants than trainees.

You can read the full study here https://bmjopen.bmj.com/content/9/3/e025433

THERE IS A CRITICAL NEED TO REVIEW THE WORKING CONDITIONS OF HOSPITAL DOCTORS IN IRELAND

Professor Blánaid Hayes, lead author on the paper, said, "These results give great cause for concern. 50% of doctors reported being emotionally exhausted and overwhelmed by work, which is higher than in hospital doctors from the UK, the USA and Australia. There is a need critically to review the working conditions of hospital doctors in Ireland.

"Surprisingly, in a milieu where evidence is the key driver of patient treatment, the evidence on the relationship between workplace psychosocial environment and employee health is paid little attention by those who fund and manage healthcare organisations. It is buried under the constant refrain of ‘putting the patient first’ with little regard for those who are instrumental in providing care.

"When work poses excessive demands with little control and support, its impact on both physical and mental health can be negative, leading to stress-related disorders, depression and other common mental health issues."

Professor Blánaid Hayes FRCPI
Doctor working on computer.

Study Phases

This data collection for this study was carried out in three stages.

1. Delphi study
A preliminary Delphi study sought opinion on the key stressors for doctors within their particular specialty. A ‘shortlist’ of stressors was incorporated into the main study questionnaire.

Read the findings of the delphi study

2. Randomised, cross-sectional questionnaire study
A national, randomised, cross-sectional questionnaire study was carried out in April 2014. Email and postal surveys were circulated to more than 3,000 doctors in Anaesthesia, Emergency Medicine, all internal medical specialties, Obstetrics and Gynaecology, Paediatrics, Surgery, Pathology and Psychiatry. The questionnaire measured the prevalence of stress, depression, anxiety and burnout. The response rate was 57%.

Read the findings of this study here

3. Qualitative data
Interviews were held with trainee doctors and consultants to capture qualitative data relating to stressors, coping strategies, how support was accessed when in difficulty, and preferred pathways to care. This analysis of these interviews is currently ongoing.

National Study of Wellbeing of Hospital Doctors in Ireland

Read the full text of National Study of Wellbeing of Hospital Doctors in Ireland published 2 May 2017

Dr. Blanaid Hayes

Dr. Blanaid Hayes

Consultant Occupational Physician