If you get treated by a young doctor in NSW, chances are they are overworked, not getting paid for the extra hours they’re pulling, and are worried about making errors on the job due to their fatigue - according to preliminary findings from an Australian Medical Association report that will soon be released.

So if you expect your doctor to be in great shape - so they can take care of you - should doctors be allowed to take “mental health” sick days, and talk openly about their mental health?

According to doctor-in-training Roly Stokes, a “don’t ask, don’t tell” culture around mental health in the medical profession is causing harm to young doctors.

Last week on his Facebook page, Dr Stokes wrote about how he “neglected 30 patients” and took a day of sick leave without having any physical health symptoms. It didn’t go down too well with his bosses, Dr Stokes said.

NSW doctors-in-training are under the pump 71% say they have been concerned about making a clinical error due to fatigue caused by their hours worked

68% say they have been concerned about their personal health or safety due to fatigue caused by their hours worked

Only 3% say they work their ‘standard’ hours of 38 hours per week

47% say they work more than 90 hours a fortnight

89% say they are not paid for all the unrostered overtime work Source: Australian Medical Association, supplied

“My batteries were flat from months of overtime and very emotionally full days… the emotional energy burden was in unsustainable debt,” Dr Stokes wrote.

“I justified my one day off with all sorts of soft factors but only in retrospect, with my emotionally energy recharged, can I see how much work weight I was dragging.

“My senior doctors overtly and covertly said I was weak for taking a day off without explicit physical symptoms of illness. I'm proposing this is representative of the culture that needs to change to prevent young doctors' suicides.

"I'm really writing this to the one or two of my mates, or their mates, who err on the side of looking after the hospital before themselves, and one day forget who they are, and why life is vibrant.”

When we talked about this issue on Hack’s program yesterday, the response was massive.

“I’m completely supportive, but I’ll admit I’ve never been brave enough to take a mental health day,” one doctor said, adding, “How can you dump your workload on a colleague who is going through much the same things as you are?”

31-year-old doctor Yasmin told Hack that the issue was bound to get a mixed reaction in the medical community.

“While [Dr Stokes] may be hailed a hero by some, widely most people in our profession will look down upon him, largely because of the stigma still attached to mental health issues…” Yasmin said.

“There is an obligation among most [Junior Medical Officers] to not be a 'shit bloke' who dumps stuff on other people. Therefore we put up with crazy hours and crazy overtime because it's our responsibility to help these patients, not someone else’s.”

“The pressure that we are faced with is enormous,” someone else texted Hack.

If we can't help ourselves how are we meant to help others?”

Dr Tessa Kennedy, a pediatric registrar and chair of the Doctors in training committee with the AMA said the pressure on young doctors wasn’t new, but a string of recent deaths by suicide of young doctors in NSW had put the issue on the agenda.

“It’s tragic, but it’s a thing that we know about. And I guess the biggest tragedy for me is the fact that we have known about it for so long and yet we haven’t succeeded in making any change,” Dr Kennedy told Hack.

“We as a profession are a very highly-motivated, perfectionist set of people who challenge ourselves and push ourselves to be the best we can be for our patients.

But sometimes it’s at the cost of ourselves.”

Share Facebook

Twitter

Mail

Whatsapp

Pulling a “mental health” sickie

The NSW Minister for Health Brad Hazzard told Hack that there was a “huge problem” for young people working in hospitals.

“There’s a whole lot of pressure on them. Let’s face it, it’s a high pressure job.”

Mr Hazzard said that doctors - and people working in every profession - should take a sick day for mental health reasons if they need it. Mental illnesses are just as legitimate as physical illnesses, he said.

“I don’t think there’s a problem with [taking a sick day for mental health reasons] now. I think you can take a day off. The problem is that the doctors feel under a lot of pressure. If [they] feel sick or run down or it’s mentally getting to them, they feel that they can’t take the day off.

“Medicine is not a career for the faint-hearted. They do work their butts off, but they need to know that we back them,” Mr Hazzard said.

Doctors being reported for mental health issues

Some doctors may delay seeking help for their mental health issues due to the fear of being reported to the Australian Health Practitioner Regulation Agency (AHPRA) - and “affecting the rest of their career” - Mr Hazzard said.

If a doctor is treated for an illness, and the doctor treating them believes the illness impairs their ability to do their job or poses a public risk, they are required to report this to AHPRA.

In Western Australia, there is an exemption for doctors presenting with mental health issues.

But how a doctor decides if their patient is too impaired to do their job isn’t totally clear.

For 29-year-old doctor Andrew*, being reported to AHPRA at the beginning of his career meant being blocked from working and caused him further mental health issues.

While studying medicine, Andrew was hospitalised for an “episode” while suffering from Bipolar disorder, Andrew told Hack.

Andrew recovered and successfully finished his medical degree, but was then reported to AHPRA for his mental health episode two years before.

“My whole life ended up being judged on one event,” Andrew told Hack. It took about eight months of paperwork, complaining and reaching out to the Human Rights Commission for Andrew to have the decision reversed.

It threw me into a depression again and I basically sat on my couch for months at my parents house, where I had to move back home.”

Eventually Andrew was able to practice as a doctor, but had conditions placed on his work due to being reported to AHPRA previously. The fact he had conditions placed on him was required to be known publicly, and was listed on his profile on the AHPRA website - where you can look up any registered medical professional in Australia.

Removing those conditions on his work so he wasn’t stigmatised as a doctor was “another battle” that took years, Andrew said.

Andrew says the fear of being reported to AHPRA and being suspended from work means doctors either don’t seek help, or they lie about who they are when going to the doctor.

But the fear embedded among doctors for seeking help might soon lessen. Today, Federal Health Minister Greg Hunt said the Federal Government will work to "establish a common national standard to protect the mental health of doctors", and will make changes to the law around mandatory reporting of doctors with mental health issues.

If you or someone you know needs help for mental health issues, there's always someone you can talk to at Lifeline on 13 11 14.

*Not his real name.