Out for the count: anaesthetists battle burnout
As suicides mount, report reveals 40% of state-sector anaesthetist doctors have reached their limit
Anaesthetists, who patients rely on to keep them alive during surgery, are themselves waging a daily battle, so severe is the pressure of their jobs.
In the past six months, the SA Anaesthetist Society (SASA) has been made aware of three anaesthetists who committed suicide. In 2015, SASA started a wellness group for 2,000 members, including some general practitioners who also act as anaesthetists, after five suicides were reported in 18 months. On Thursday, SASA released new research by Stellenbosch professor of anaesthesiology Johan Coetzee which showed that 40% of state-sector anaesthetist doctors are suffering from burnout.
He found severe burnout in the state sector among 18% of all anaesthetists – much higher than the international average of 6.2%.
Burnout is a risk for depression, suicide and poor-quality work. In the US, the suicide rate among anaesthesiologists is twice that of other doctors.
The implication of high stress on anaesthetists and their high level of burnout could affect the care they provide.
“If we don’t tackle this issue urgently, quality patient care may become unsustainable in the future,” said Dr Caroline Lee, an anaesthetist and founder of the of the SASA Wellness Support Group.
Lee said that, for now, patients receive good care, but she had a message for medical aids, patients and government officials and policy makers: “We need to care for doctors so they can care from you.” Coetzee said the levels of stress and long working hours were increasingly becoming unsustainable, saying many students went abroad after qualifying.
Working as an anaesthetist is highly stressful job requiring intense concentration and extremely quick reactions. It is known to be a risk for suicide.
Lee said: “The actual work alone is stressful. You work long hours in public service. But you are required to work that. You have a patient’s life in your hands. At two o’clock in the morning it is very difficult to keep 100% concentration, but you have to.”
Coetzee said: “A doctor such as a GP sits and consults a patient. He has time with which to decide what special investigations to do. As anaesthetists, if something happens, you have to think on your feet and take action, in seconds or minutes.”
State hospitals need anaesthetists so that surgeries can be performed or the hospital will grind to a halt.
This places more and more pressure on anaesthetist registrars who are specialists in training and work up to 48 hours a shift. Without them many other doctors can’t do their work.
Society schief executive Natalie Zimmelman, at the Johannesburg event, asked registrar Justine van der Westhuizen how she and other registrars coped with long hours and their exams.
Van der Westhuizen replied: “We claw our way through. We survive, but we are not thriving.”
Lee said that what affected doctors the most was not their work or hours, but not being able to give patients the best care.
There were many hurdles, such as some medical aids pushing for the use of ineffective generic drugs, and under-resourced state hospitals.
“You have a value system. You want to give the best possible medical care,” said Lee.
For medical aids, the focus was on cost-effective care. For governments it was about sticking to the budget and meeting the growing needs of patients with diminishing resources – and for the private sector, care was about profit margins.
“It is the moral dilemmas that prey on the heart and soul that cause most severe burnout,” said Lee.