Doctors must look after their health too

Short term counselling followed by a modest cut in work hours may help reduce emotional exhaustion (burnout) and sick leave in doctors, according to a study published on bmj.com today.

It is well known that doctors have higher rates of depression and suicide than the general population and are less likely to seek help. There have been calls for early intervention programmes to help doctors with mental distress and burnout before their problems interfere with the welfare of patients.

Although such programmes have been shown to reduce stress and exhaustion, it is not clear what type of intervention is best suited to which individual or personal characteristics, or which factors contribute to positive changes.

Dr Karin Rø and colleagues from Norway examined levels of burnout and predictors of reduction in emotional exhaustion after one year, in 227 stressed doctors who participated in voluntary counselling.

Initially, 187 doctors attended a one day individual session, and 40 a one week group based course. Of the 185 doctors who completed follow-up assessments, 70 returned for an additional intervention during the follow-up year, 51 to a one week course and 19 to an individual session.

They completed self report assessments in the four weeks before and the three weeks after the counselling, and a follow-up questionnaire after one year. The data was compared with data obtained from a representative sample of Norwegian doctors in 2003.

One year after a counselling intervention stressed doctors reported a reduction in emotional exhaustion and job stress similar to the level found in a representative sample of Norwegian doctors.

The researchers also found that the number of doctors on full time sick leave had reduced substantially in the year after counselling (35% to 6%), and that the use of psychotherapy also substantially increased from 20% to 53% in the follow-up year.

Interestingly, they found that reduction in work hours after the intervention was also associated with a reduction in emotional exhaustion.

"Our findings indicate that seeking a counselling intervention could be conducive to reduction of burnout among doctors. Considering doctors' reluctance to seek help…it is important to offer interventions that facilitate access", conclude the authors.

Source: British Medical Journal