Viewpoint: Doctors need time to rest, reflect and recover

MDDUS head of medical division Dr Naeem Nazem discusses the need to support doctors' physical and mental wellbeing

RESTAURANTS and shops open, people meeting friends and family, sporting events back on the timetable. Life as we once knew it may be gradually returning. And yet in so many ways it will never be the same again.

It is fair to say the Covid-19 pandemic has had a huge impact on us all. For me, it meant adjusting to a new way of working, accepting that I would not see loved ones for many months, and adapting to a new reality of life under lockdown. For NHS doctors, the impact was far more significant. As the NHS strained under the pressures of the pandemic, doctors stepped up to meet the challenge. For some that meant working well outside the scope of their expertise.

Others were confronted with treating patients with little or no effective personal protective equipment.

In all of the conversations I have had with doctors on the front line, and there have been many, there have been some common queries. Doctors were concerned about how to deliver effective care to their patients within the new way of working. A few worried about passing the virus to their loved ones when they returned home after a long shift.

However, I began to notice one area was rarely mentioned. It was so striking in its absence I began asking a question that often led to silence and sometimes to tears. The question? “And how are you coping physically and mentally?”

Doctors are invariably focussed on everything, and everyone, around them. When they do think about themselves, it is usually to worry about whether their actions may have put patients at risk, or whether they may face scrutiny or criticism for the way they have delivered patient care in difficult circumstances. And these worries come at a time when many are feeling physically and mentally exhausted.

Burnout amongst doctors is a significant risk to the future of the NHS. Rarely does a week pass without another survey indicating that many doctors, across different specialties, have considered retiring early or leaving the profession altogether. The uncertainty of how they will be judged for their actions during the pandemic only serves to increase anxiety levels.

So how do we tackle burnout?

The first step is to acknowledge it exists and won’t resolve spontaneously. Many doctors are physically and mentally exhausted. They need time to rest, reflect, and recover. They also need their voices to be heard and reassurance that we will not forget the challenging environments in which they have worked throughout the pandemic.

Raising awareness of the difficulties in delivering NHS care during the pandemic is essential. I have spoken with doctors who have received complaints from patients that they have failed to prioritise care appropriately. Some patients feel they should have received a face-to-face consultation, others have even suggested that their doctor has used the pandemic to avoid seeing patients altogether.

It is easy to see how such hurtful comments can have a damaging impact on doctors already working under continued stress. In this context it is unsurprising MDDUS has recorded an increased number of calls from doctors concerned that there has been an irretrievable breakdown in their relationship with a patient.

Doctors do not want to practise with immunity. They recognise and welcome the opportunity to address concerns and reflect on how they can improve their clinical care. However, they deserve to be treated sympathetically and in the context of the circumstances, beyond their control, in which they have been made to work.

We have tried to show our appreciation for NHS workers during the Covid-19 pandemic. Many have “clapped for our NHS”, adorned their home windows with NHS rainbows and expressed their gratitude personally. Now that the focus shifts towards a return to life before lockdown, I am reminded of the Hippocrates saying: “Healing is a matter of time, but it is sometimes also a matter of opportunity”.

The time has come for NHS workers to heal. And we must all give them that opportunity.

Dr Naeem Nazem is head of medical division at MDDUS