Klaudia Kolasa, nazwa.gazeta.pl: Let’s start with statistics. In Poland, 60 percent medical staff see symptoms of burnout. In turn, research conducted by the Nie Widać Po Mnie Foundation shows that over 30% of people suffer from anxiety and depressive disorders. doctors all over the country. What do you think this means?
Marcin Król, resident doctor in family medicine: We cannot lump doctors of all specializations into one bag, but we are united by overwork. In the case of family doctors, I think there is also the pace of work and a definitely excessive number of stimuli.
Can you elaborate?
As family doctors, we should devote a maximum of 15 minutes to one patient. This is what the system requires of us. This is an optimistic scenario. In some clinics, 15 minutes is a luxury. Sometimes doctors have 5 or 10 minutes for a visit. This time must include a thorough interview, examination, recommendations, education, answers to questions…
And when the visit is extended, the patients waiting in line become impatient. The pressure is double…
Moreover, I am the only doctor in the clinic, so the patients who come to us blame me for this system. It often happens that the visit is delayed because I try to devote as much time to people as they need. A queue is generated and the doctor and those waiting are stressed. Everyone makes an appointment for a specific time and would like to enter the office at that time. I understand this anger and impatience perfectly.
On the other hand, I would like patients to also understand my situation. We are not machines. I would like everyone to feel that even if there is a delay, I will still devote as much time as they need. Always.
Does this mean that in such situations your working hours are longer than they should be?
Of course. Many times I stayed at work an hour or an hour and a half longer. As much as it takes. Sometimes it happens that I cannot complete medical documentation within 15 minutes. Each symptom must be described. I make quick notes in the margin, then another patient comes in and a pile of paperwork piles up. I complete them after working hours.
So there is no work-life balance in the medical profession?
We are not ready for this as a country. There are too few of us and too many patients. I once listened to an interview with a doctor from Sweden who saw 10 patients during the same working hours. Perhaps this was the exception. During this time, I take 50. How much time can be devoted to 10 patients in 8 hours, and how much time to 50 patients? This translates into everything: the accuracy of the diagnosis, the risk of making a mistake.
The second issue you mentioned is excessive stimuli. Tell me what you mean by that.
My oldest patient is 102 years old, next to him the patient may be a week-old baby. As a family doctor, I see everyone. Each visit brings different emotions and stories. This is where overstimulation comes from. I can give you an example from today.
During 7 hours of work, I sent two children with shortness of breath to the hospital. Telling a mother about her baby’s serious condition is always stressful. These emotions come out. Then a smiling senior woman comes to buy prescriptions and tries to joke with me. I like such visits, of course, but it’s hard to smile when I’m still going through the previous situation. Even if this is successful, a patient who takes care of her 20-year-old daughter with cancer spread soon arrives. This is a life full of extreme situations and emotions, the experience of which with a patient can quickly lead to burnout.
The most emotionally difficult moments are when a young person is sick. I have some really sick young people in my care. These are difficult visits and many times they bring tears. I would be lying if I said it was just the patient’s tears. Sometimes they are also the doctor’s tears. Someone may say it’s unprofessional. I will say that it is simply human.
During your studies, were you taught mechanisms for coping with stress and these emotions?
Absolutely not. Not even one day of classes was devoted to how to deal with one’s own stress or relaxation techniques. During our six years of college, we had a week of psychology classes. This is a drop in the ocean. The topic wasn’t even broached.
And yet doctors have classes in psychiatry in a psychiatric hospital…
Of course, we had such classes, but all the attention is devoted to the theory from the books, and then to the patients in the ward. We didn’t talk about what should concern us about our own behavior. What are the symptoms that should prompt us to ask for help? Doctors’ statistics are disturbing, but let’s also mention medical students. The situation among students is the same, if not worse. Studying during the day and at night, tests, tests, exams. It’s a stressful life.
Do you take a break at work to breathe, collect your thoughts or at least eat lunch?
Depends on the number of patients. If the schedule is full, I don’t have a break. If I work until the evening that day, I have a break while transporting from one job to another. Unless during the visit the patient only asks me for a prescription. That’s when I have 10 minutes to eat. Or if the patient does not come at the scheduled time and a gap appears. But this does not happen during the infection season.
How do you feel when you come home after your shift at the clinic?
In my case, such an intense day lasts from 7 am to 2:35 pm in the first clinic and from 3 pm to 6 pm in the second clinic. During the infection season, I see about 60 people during these hours. Therefore, I close at 6:30 p.m. Literally and figuratively. I would prefer not to say anything for the rest of the day. Imagine that you talk to 60 people during the day and at 8 p.m. your mother calls. He wants to ask how you are feeling and how you are doing. I say: “Mom, I’m sorry, but I just can’t make it today. We have to postpone the conversation until tomorrow.” I suffer from laryngitis two or three times a year.
At the same time, so as not to draw everything in such dark colors, such an intensely worked day gives a lot of satisfaction at the end. I feel that my work matters. It makes me want to get up for work the next day.
It’s hard to find the strength to talk to your mother, let alone visit a psychologist or psychiatrist…
The doctor should sometimes become the patient. I’ve found that when I’m bothered by a problem and I think about it on my way to work, when I’m at the clinic I get caught up in my duties and simply forget about it. Its solution is delayed, and self-help is also postponed.
I have never told this story to anyone. A few years ago I was in a mental crisis myself. Who knows what would have happened if not for the help I received. It’s not only about family help, but also about specialist help. Thanks to this experience, I am much more sensitive to problems of this nature. I once heard a patient say: “Thank you, you are the first doctor to ask me this.”
I try to notice these disturbing symptoms – anxiety and depression disorders. Even if something is not visible at first glance, and the patient has hypertension, it is worth assessing his mental well-being. If I am concerned, I encourage you to seek treatment.
There is no reason to get tired and not help yourself. Patients postpone treatment for years, and even after a month they see significant improvement. I understand what this fear is about. Something in our heads tells us that we couldn’t cope on our own, but on the other hand, none of us has any doubts that if we have a fracture we go to an orthopedist, and if we have appendicitis we go to a surgeon. Has anyone ever said after surgery: “I wish I could have done it myself?”
I would like patients to remember that you do not need a referral to a psychiatrist under the National Health Fund, and if there are no appointments, the treatment of such disorders is also within the competence of a family doctor.
What prompted you to start treatment?
I was very lucky in this misfortune. I realized very quickly that it would be difficult for me to handle this on my own. They say what doesn’t kill us makes us stronger. I don’t agree with this at all. What doesn’t kill us won’t kill us, but it can traumatize us and leave scars.
There is a myth that once treated, it will last for the rest of your life. Nothing could be further from the truth. Yes, sometimes it lasts years, sometimes 6-12 months. We have really good and safe medicines. They allow you to gain distance from the problem without causing addiction. A well-chosen drug will make us function much better. I have had treatment for a long time. It was the best decision I could have made at the time. Thanks to this, I am doing well today.
My family doctor also shared her experiences with me. It turns out that there are many of us. The sooner we react, the better.
What should change to make everyday life of doctors easier?
I would like to wisely increase the limits for medical studies while maintaining the quality of education. It would be nice if we were relieved of the burden of paperwork and for patients to see a human face in us.
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If you need to talk to a psychologist, you can contact the 24-hour Support Center by calling 800 70 2222. ITAKA Foundation psychologists are available by phone, e-mail and chat, providing advice and directing callers to the appropriate support facility in their region. Relatives of people who require help can also contact the center. Specialists will advise you on what to do to encourage your loved one to contact a specialist.
If you are experiencing difficulties and are thinking about taking your own life or want to help someone at risk of suicide, remember that you can use the free help numbers:
Helpline for Children and Youth: 116 111
emotional support phone number for adults: 116 123
If suicidal thoughts or a suicide attempt is life-threatening, for immediate crisis intervention, call the police on 112 or go to the emergency department of your local psychiatric hospital.
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Source: Gazeta
Bruce is a talented author and journalist with a passion for entertainment . He currently works as a writer at the 247 News Agency, where he has established himself as a respected voice in the industry.
