By: Dr. Coker Ayodele Olurotimi
RIGHT from Medical training at medical schools and during residency programmes, doctors were found to be alienated from the society. They concentrate mainly on their studies to the detriment of living healthy lifestyle.
These men and women acquire the skills of becoming workaholics during training. In times of stress, they may adopt maladaptive ways of coping such as drinking alcohol, smoking cigarettes and other illicit drugs.
This is because they were trained to believe that they were superheroes with superhuman skills and they were also told they could act or take serious decisions alone.
They often lack adequate communication and interpersonal relationship skills which further alienate them from the society which they live. It is in this light, when they become ill, they hesitate to ask for favour due to shame and guilt feelings.
Upon graduation, medical doctors believed that the remuneration and gratification for their long and hectic training that spanned almost fourteen years would be sudden. However, many feel disappointed when the expected financial break fails to occur.
In addition, they get extended work load, with long working hours, several days of call duties, hospital professional rivalry and litigations.
All these factors make the medical doctor vulnerable to mental health challenges. Common among such challenges is depression.
Depression was found to be common as far back in medical schools and during residency training. Two to four out of ten resident doctors were reported to also suffer from depression. Some actually contemplated suicide while in training. In times of psychological distress, medical doctors too abuse cigarettes, alcohol and other illicit drugs similar to other users in the community.
They have access to dangerous addictive drugs, they also self-medicate and because they are more knowledgeable about the exact lethal doses of dangerous drugs that they sometimes use these to commit suicide.
There are strong relationships between drug abuse and suicide among doctors. Studies have shown that between 2 and 4 out of ten doctors who commit suicide used and abused alcohol.
The profession is not also kind to women. The hectic nature of medical training in medical schools was found to affect women in initiating and sustaining mutual satisfying relationships as adults. This could play a negative part in marriages. Female medical doctors are just as busy as their male counterparts but may not advance and be promoted like their male counterparts.
Likewise, additional family and social programmes may bring about psychological distress for the female physicians. Female medical doctors commit suicide four times that of women in the general population.
With regards to divorce, medical doctors because of their hectic work schedule were also found to have higher separation and divorce numbers when compared to other professional groups and general population.
Suicide among medical doctors has been reported to be common much more than people in the general population. They tend to commit suicide twice as much as people in the general population. They commit suicide more than other professional groups. Doctors who treat difficult and un-cooperating patients, who had fewer friends, who live alone, single separated or divorced, were observed more to attempt or commit suicide.
To prevent psychological distress, depression and other mental health diseases among medical doctors, psychosocial interventions such as socials skills training, acquisition of stress management coping skills, management science skills, leadership skills, time and personal management and enhancement of interpersonal communication and relationships, regular appraisal of performance of medical doctors, and formal support through frequent feedback of performance even in the absence of identified stress or depression may go a long way to prepare the young medical doctors to face stress of medical practice.
However, hospitals that expose medical doctors to motivating factors such as job satisfaction, appreciation for work done well, responsibility for the welfare of doctors by management, opportunity for personal advancement and salary enhancement can also reduce the effects of psychological distress and depression among medical doctors. The acquisition of these survival and management skills was observed to make medical doctors to be maximally productive, improve quality patient care and also enhance their quality life. Hospital managers should make policies to encourage physicians to seek for necessary medical help when troubled emotionally and also remove discrimination and punitive actions that may prevent medical doctors from seeking for help when psychologically challenged.
Dr. Coker is a consultant psychiatrist @ the Lagos State University Teaching Hospital, Ikeja, Lagos.