Doctors in danger of work burnout

More doctors-in-training are being compelled to work excessive hours in hospitals, despite the potential risks to staff and ­patients.

A new survey reveals an alarming increase in the proportion of doctors who routinely work long hours.

More doctors-in-training are being compelled to work excessive hours in hospitals, despite the potential risks to staff and ­patients, according to a survey of nearly 9000 health professionals.

Amid an ongoing debate over safe rostering, the latest results from the long-running University of Melbourne survey reveal an alarming increase in the proportion of doctors who routinely work long hours.

The 10th MABEL (Medicine in Australia: Balancing Employment and Life) survey was undertaken by 8937 doctors, including 1153 participating for the first time. It found hospital registrars working, on average, 43.6 hours a week and hospital medical officers (HMOs) 44.2 hours a week.

The proportion working 50 hours or more — which the Australian Medical Association has set as a notional safety threshold — increased to 38.27 per cent of registrars and 39.98 per cent of HMOs in 2017.

The Australian commissioned the data after Yumiko Kadota gave an account of her time as a plastic and reconstructive surgery registrar at a Sydney hospital last year. In a 4000-word blog, she chronicled her physical and mental deterioration as a result of working long hours — up to 140 hours a fortnight at the hospital but also on call — with little support from senior staff.

“The 1st of June was my 24th consecutive day of work, 19 of which were 24-hour on-call days,” Dr Kadota wrote of the day she ­resigned. “I knew what it would mean to resign — I would be black-listed and never get a job in plastic surgery again in Sydney. But I couldn’t keep going. I crashed my car on my way home.”

Doctors have rallied around Dr Kadota, and the ensuing ­debate has exposed the range of experiences, and expectations, in the sector, and differing opinions as to what should be done to ­ensure safe rostering.

Some doctors-in-training want more clinical time, particularly in theatre, and the Royal Australasian College of Surgeons has suggested “a 55 to 65-hour working week, spread across a seven-day period, with sufficient uninterrupted breaks during that time, is appropriate for trainees to gain the knowledge and experience required”.

But other groups worry that young doctors are left unprotected in the public hospital system, exposed to bullying and at risk of burnout, and argue governments have a responsibility to ensure ­adequate staffing levels.

Researchers from the Appleton Institute at Central Queensland University have warned that fatigue “carries an invisible cost to clinicians and patients”.

“At one end of the spectrum, we have the increased risk of death or serious injury as a consequence of unintended sleep onset while commuting,” the researchers will tell a South Australian inquiry. “At the other, we have long-term impairment in the mental and physical health of workers. Between these extremes we can see the corrosive effects of fatigue on positive work cultures.”