A 25% of healthcare practitioners in South Africa are considering leaving the medical profession or retiring early due to mental wellbeing concerns.
According to the Medical Protection Society (MPS), more than a third of healthcare practitioners in SA (35%) say their mental wellbeing is worse now than it was during the Covid-19 pandemic.
Commenting anonymously, doctors who participated in the MPS survey said: “I cannot do my job correctly and safely in a way that is best for the patient. We are always making a plan because of shortages. Patient safety and care, unfortunately, bear the brunt of these shortages.”
“I no longer enjoy what I do. It no longer gives me joy. That is a tragedy.”
Another doctor said burnout is a serious and silent problem among all health professionals.
“There is no support, everyone is just trying to get through the day. Patient loads and responsibilities are high, little personal reward, not enough timeout,” said the doctors.
Another doctor said: “We do not want to leave, we do not. But it is all connected. Political, financial, economic instability, disrupted infrastructure and so on, with increased anxiety, decreased wellbeing and social unrest.”
The MPS survey findings, revealed at MPS’s annual Ethics For All conference last week, showed that 55% of the more than 650 respondents said political, economic and financial concerns are affecting their mental wellbeing, while about a third cited the impact of exhaustion, burnout or staff shortages on patient safety as affecting their mental health.
“Clearly many healthcare practitioners in SA are becoming increasingly exhausted and disillusioned due to the variety of pressures and challenges they face daily, and some uncertainty about the future direction of healthcare,” said Dr Volker Hitzeroth, medicolegal consultant at MPS.
I fear SA may face an exodus of healthcare practitioners. More than half of the practitioners surveyed tell us they plan to emigrate or leave the workforce due to wellbeing concerns.
— Dr Volker Hitzeroth, medicolegal consultant at MPS
MPS, which protects the professional interests of more than 300,000 healthcare professionals around the world, including more than 30,000 in SA, said central government, state hospitals, private providers and professional societies all have a part to play in improving mental health awareness and support.
Hitzeroth said when mental wellbeing is poor, it is worrying for the individual practitioner, but it can also jeopardise patient care.
“Without support, mental wellbeing issues canget worse and result in doctors needing extended periods of time off work or even contemplating leaving the medical profession,” said Hitzeroth.
While the majority of practitioners surveyed feel the government should do more to support the profession with mental wellbeing issues, Hitzeroth said this is not just a challenge for central government.
He said public and private hospitals, professional societies and medical aid funders and administrators all have a part to play.
“Many professional societies have, since the pandemic, stepped up with dedicated colleagues looking after the wellbeing of their members. We would like to see more local mental wellbeing resources established, so those doctors struggling with a range of issues can access appropriate support, as well as measures to ensure the system has capacity so those needing time off to recuperate can take it without adding to staff shortages or detracting from patient care,” he said.
Hitzeroth believes central government could do more to increase awareness and research into mental health and its impact on healthcare, through a nationwide campaign.
“If this issue is not properly addressed, I fear SA may face an exodus of healthcare practitioners. More than half of the practitioners surveyed tell us they plan to emigrate or leave the workforce due to wellbeing concerns, which will place even more pressure on the strained healthcare system and those doctors who remain,” he said.
Past president of the South African Society of Psychiatrists (SASOP) Prof Bernard Janse van Rensburg said doctors are two-and-a-half times more likely to commit suicide than the general population, while physician burnout is a leading cause of medical error.
Janse van Rensburg said awareness needs to start at student level, calling for medical education to “put more emphasis on doctors realising their limitations and recognising their humanity and fallibility”.
He said doctors needed to be self-aware and vigilant on their own vulnerabilities and possibly risky coping mechanisms and not “suffer in silence.
“Those in the medical profession need to know that a mental health condition not dealt with is more likely in the long run to negatively affect their practice and professional reputation, and that it’s best to rather ask for help early in their career,” he said.
Van Rensburg said there was also a responsibility at an organisational level for management in the healthcare system to acknowledge the existence of the problem, to develop targeted interventions and to promote resilience and self-care.
“Leaders and managers of medical teams should also show that they are open to feedback, respect the opinions of others, including less-experienced colleagues, and to empower team members to do their work and advance in their careers,” he said.
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