Dr Volker Hitzeroth, Medicolegal Consultant at Medical Protection.

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In late 2023, Medical Protection undertook a survey of its members in South Africa.

The purpose of the survey was to better understand the key factors impacting mental wellbeing and identify how Medical Protection – as South Africa’s largest medical defence organisation – can assist both its members and the wider medical profession.

Unfortunately, the survey findings made for sombre reading, painting a picture of a medical profession grappling with serious mental wellbeing concerns.

These concerns were primarily due to the immense pressures and challenges doctors face on a daily basis, many of which are far too common across all facets of society in South Africa.

More than half (55%) of the 662 respondents said political, economic and financial concerns were impacting their mental wellbeing, while around a third cited the impact of exhaustion, and burnout on patient safety as affecting their mental wellbeing.

Meanwhile, 75% said load-shedding was impacting their mental wellbeing, with respondents raising concerns about delayed tests, surgeries and prescriptions, failing or unreliable systems, machinery and phones lines, and treating patients in the darkness when inverters or generators fail.

In addition, more than 90% said medication, medical equipment and staff shortages were affecting their mental wellbeing. Doctors working in state healthcare facilities in particular spoke of their distress at seeing patients suffer due to the continually dwindling supply of staff, medication, and equipment.

Respondents also spoke of the impact that abuse from patients and their family members had, with a quarter (24%) of doctors saying that such behaviour was affecting their mental wellbeing.

Notably, one third said their mental wellbeing was worse in October 2023, when the survey was conducted, than it was during the Covid-19 pandemic.

‘Exodus’

It is clear from our survey findings that many doctors in South Africa are becoming increasingly exhausted and disillusioned due to the variety of challenges they face daily. Throw in the uncertainty about the future direction of healthcare and these challenges are understandably taking a significant toll on their mental wellbeing.

When mental wellbeing is poor, it is worrying for the individual practitioner, but can also jeopardise patient care. Without support, mental wellbeing issues can also get worse and result in doctors needing extended periods of time off work or even contemplating leaving the medical profession altogether.

Without any meaningful action to support doctors with their mental wellbeing, I fear South Africa may face an exodus of doctors. This fear is reflected in our survey findings.

Almost half of the practitioners surveyed tell us they plan to emigrate or leave the workforce due to wellbeing concerns.

This will place even more pressure on the strained healthcare system and those doctors who remain.

Possible solutions

It is imperative that doctors who are struggling with their mental wellbeing have access to the support they need. But how do we achieve that?

While the majority of practitioners who took part in our survey feel that the Government should do more to support the profession with mental wellbeing issues, this is not just a challenge to be met by central Government. Public and private hospitals, professional societies and Medical Aid funders and administrators all have a part to play. It must be said that many professional societies have recently stepped up with dedicated colleagues looking after the wellbeing of their members, but far more needs to be done.

At Medical Protection, we would like to see more local mental wellbeing resources established so those doctors struggling with a range of issues can access appropriate support. We also need 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.

In addition, the central Government as well as medical organisations and educational facilities could do more to increase research into mental health and its impact on healthcare and, by doing so, increase awareness of the issue. Medical Protection members can also access counselling as part of their membership for work-related issues or stress that could impact their practice, such as burnout, anxiety and conflict. This service is provided by ICAS who offer a personalised and professional service tailored specifically to individual requirements and delivered by experienced qualified counsellors.

If we don’t all do more to tackle this issue, sadly we may lose many more healthcare workers at a time when the profession can least afford it.

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This article was originally published in Medical Brief and is republished with permission.