Unhealthy Work Habits

As a GP I work every day to improve the health and wellbeing of my patients. My colleagues do the same, in fact I haven’t met a GP yet who isn’t interested in preventing disease and improving patient wellbeing. Where we fall down though, is in looking after our own wellbeing. You see, we are particularly guilty for working long hours, in a high stress environment. We often skip lunch, more than ever we are sedentary at our desks, fielding huge numbers of patient calls and admin work. Many of us don’t have time for exercise or are too exhausted to contemplate it, and we often opt for convenience foods due to our hectic lifestyle.

Sadly this makes US pretty unhealthy.

One of the things I struggle the most with at work, is preparing my GP trainees for the work in general practice. You see they come to my surgery with set ideas about the workload they will endure; and are well versed in the rules on how many hours they can work, how much rest time they need between sessions and even how much of a break they need at lunchtime. I admit that I am a bit long in the tooth now, having graduated as a doctor in 1999, but whilst I want my trainees to get this time off, it doesn’t surprise me that so many drop out of general practice, when they realise the reality of life as a GP.

General practice is in the middle of a workload crisis. A BMA survey in April 2021 revealed that half of GPs plan to reduce their hours while 25% plan to take a career break, sadly the number of GPs considering early retirement has doubled recently.

The latest BMA survey on the health of GPs (31st Oct 2021) has revealed that 51% of GPs are suffering from mental health disorders including burnout, and 23% feel worse than they did pre-pandemic. 16% plan to leave the NHS. Furthermore, in a BMJ article in 2021, the high levels of stress and burnout in the profession were highlighted to MP’s and according to the article “GPs are leaving at a rate of three per day”, “over 20% more GPs are reporting burnout than a year ago and GP suicide rates are up to four times the national average”.

The reality is that our job is stressful and never more than now. We are fielding a higher workload than ever before due to higher patient demand, an increasingly sick population and to make matters worse, the level of complexity of our work has increased dramatically, due to the lack of secondary care appointments.

As a GP, I find this is all rather frightening, my friends and colleagues are suffering quite severely and I could be next if something doesn’t change.

Over the last few years I have been on a mission to restore my own health and wellbeing, and that of my colleagues. I have made many changes to my own lifestyle and my practice, which have helped reduce my own stress, and that of my colleagues, and in doing so I have become more empowered to help my patients to make similar changes in their life. Whilst I do not hold the answers to the crisis in our profession, I want to share some of the practical ways we can help to reduce our workload and stress day to day:

1. Closing the surgery at lunchtimes and at 5pm so to concentrate the bulk of our work into a manageable time frame, and give admin staff, and GPs, time to catch up with a bit of time away from patient contact, an ‘on call phone’ will ensure that emergencies are not missed.

2. Appropriate and effective signposting to pharmacies, opticians, physio’s etc really does help with the increasing workload. I am fortunate to be practicing in Scotland where the new contract has driven minor ailment care into these supplementary services.

3. Daily huddles of 10mins before starting our surgery can give everyone a much needed chance to touch base and communicate the issues of the day. It’s also a great opportunity to catch up with colleagues. If you are really keen, you can even add in a short exercise for everyone – we do the Zach Bush 4 min workout.

4. We need to learn how to say “no”. If we take greater control of our workload and delegate sensibly, and set reasonable limits as to what we will do in a day, this will help keep our workload manageable. For anyone who thinks this is unachievable I would urge you to read the work of Dr Deen Mirza a GP and health coach, who has written some fantastic books on this.

5. Having tight protocols and procedures around acute and repeat prescribing prevents additional workload Eg daybooks and patient queries coming your way, and also improves safe prescribing.

6. Our own health matters, so prioritise time for exercise – even a 10 minute walk at lunchtime can make a difference to your concentration and energy, but if you can manage more then all the better. I do a 30min jog on Thursday lunchtime, a walk with patients on Wednesday lunchtime and I cycle to work and back twice a week. My improved energy and concentration in the afternoons more than makes up for the time away from the surgery. Tackle sedentary behaviour at work by getting a standing desk or a Pilates ball to sit on – its a great talking point for patients on posture and movement in the workplace.

7. What we eat can make a difference to our concentration and energy too. I follow a whole food, plant based diet with lots of fruit, vegetables and whole grains. This has helped reduce my afternoon drowsiness and stress levels.

8. A good night sleep can make a huge difference to how we manage stress, it also improves our concentration, memory, mood, blood pressure and keeps our weight down – all essential for our demanding job. If you are struggling with sleep, its really worth investing the time to rectify this. Thesleepcharity.org.uk is a brilliant resource.

9. Share your problems with colleagues and friends – we all know the power of friendship so make sure you make time to socialise and talk to friends and family.

10. If we are suffering from stress or burnout we mustn’t bottle it up, there is no shame in taking some time off to address this. There are lots of helpful resources available to us one of which is bma.org.uk/yourwellbeing. See below for more resources.

We have not always been the most harmonious profession, with partnership break ups and disagreements becoming quite normal. But now is not the time for these. If we can be more understanding and appreciative of our colleagues, we can mend our relationships and work together. Investing time in our work colleagues, can give us a much greater insight into how they are coping, and we can support each other through this stressful time.

I desperately hope that we can solve the problems in General Practice. We are the heart of the NHS and are crucial for its success. I am not ready to give up on it yet.
General practice may be in crisis, but we don’t have to be.

References

1. BMJ. (2021). Burnout is harming GP’s health and patient care. Available: https://www.bmj.com/content/374/bmj.n1823/rr. Last accessed 11th Jan 2022.
2. BMA. (2022). Your Wellbeing. Available: https://www.bma.org.uk/yourwellbeing. Last accessed 11th Jan 2022.
3. Mirza D. (2022). Personal Improvement for GPs. Available: http://betterdoctor.org. Last accessed 11th Jan 2022.