Keynote:
Initial situation
Every day, doctors devote themselves to the well-being of their patients with dedication and commitment. The healthier the doctors themselves, the better they succeed. However, everyday life presents a different picture: High performance pressure, long working days and great emotional stress take their toll. For example, 77% of hospital doctors in 2020 agreed or strongly agreed with the statement that they are constantly under high pressure to perform. According to their assessment, 70% of hospital doctors are always under a lot of time pressure.(1)The basic knowledge for a conscious handling of one's own health and a sensible behaviour in the case of an illness is given by doctors to patients, but is hardly used by doctors themselves.
The connection between occupational strain, stress and illness is generally recognised. Research groups deal with occupational health issues and try to improve working conditions for the benefit of employees. The main focus is usually on physically demanding work and its consequences. The working conditions of doctors, however, often seem to be outside the scope of research interest. The working conditions of the medical profession have undergone considerable change in recent years: administrative activities in particular, have increased considerably in all areas. The medical profession has inherent stressors: long working days, time constraints, high expectations of patients, increasing bureaucracy are just a few of them. These stresses lead to an increased rate of depression, emotional and occupational exhaustion among doctors compared to the general population. Resident doctors, for example, also have a high rate of drop-outs, addictions and general mental illnesses, as well as an increased suicide rate. Young doctors are confronted with these problems only after they have completed their studies. Students are not prepared enough for the actual tasks in everyday clinical practice during their studies. Dealing with stressful situations and high demands are also rarely part of the curriculum and are often too much the responsibility of the individual young doctors themselves.
The causes of this problem lie on the one hand in the technical development of today's society: information is free and easy to obtain, patients are informed. The demand for the most effective and effi-cient treatment is more present than ever before. Misinformation and anecdotal evidence from the internet or from the patient's environment increasingly lead to discussions between the person seeking help and the therapist. On the other hand, the working conditions of doctors have been characterised for years by long shifts, competition and pressure to perform. Applicable legal framework conditions are sometimes exploited by employers to the disadvantage of doctors or are not adhered to at all; a willingness to self-exploit on the part of doctors often also contributes to this. Contact points for complaints are sometimes non-existent or not anonymous. In addition, social exchange and leisure time activities are negatively influenced by the working conditions. Time for friends and family is sacrificed in favour of career.
The Corona pandemic brought to light the grievance of high workload and low compensation for all health workers. The observed high workload for health workers, the lack of social contacts and leisure time compensation were not consequences of the pandemic, but the reinforcement of an already exist-ing problem. It is not surprising that doctors were exposed to particular stress during this time: in everyday clinical practice they bear the medico-legal responsibility for the well-being of the patients, they decide together with the affected persons on the treatment to be given, and in addition they carry out a wealth of administrative tasks. The high utilisation of emergency wards during the first and second Corona wave brought the health care system in Switzerland and thus the doctors to the limits of their capacity. The workload of treatment, monitoring, counselling, vaccination and research during the pandemic made it impossible for many doctors to maintain social contacts and take care of their own health.
It is scientifically proven and understandable that such high stress levels have a negative impact on health. Only a sustainably healthy medical profession can cope with the demands and challenges of modern everyday life. The health of all doctors is important, and it is essential to strengthen the professional and private balance and the quality of life of doctors today and in the future. The Corona pandemic has clearly shown the importance of a strong medical profession. The untiring efforts of the medical profession and all other health care professions made it possible to successfully overcome this crisis. However, it also clearly shows the difficulties and burdens that doctors have to deal with on a daily basis. Long working days, hardly any social contacts and opportunities to compensate in their free time put an extraordinary strain on the health of doctors. It is our responsibility to ensure that our doctors remain healthy both during and after the pandemic. Therefore, it is time to act.
The Swiss Medical Association drew up a charter “charter: healthy doctors for healthy patients” with the help of a working group made up of representatives from very different professional medical societies: swiss medical students / assistant and senior physicians / Swiss general practitioners / Young General Practitioners Switzerland / Occupational physicians as well as already existing programs like “coach my career” and of course “Remed” (which is the Swiss support network for physi-cians) based on the arguments
Healthy doctors are a necessary prerequisite for optimal and high-quality patient care.
The general conditions of everyday medical life are not conducive to the health of doctors.
Doctors are confronted with high expectations and place equally high expectations on themselves.
Doctors have a higher risk of suffering from health problems than the general population.
Doctors are not used to asking for help.
Boundary management is a key competence for practising medicine.
Employers, educational and training institutions have a duty to safeguard the health of students and employees.
Leaders and team members are crucial health factors for doctors.
Structured and systematically implemented interprofessionality can have a relieving effect.
Students are not sufficiently prepared for the transition from study to professional life.
Politics, employers and educational institutions share the responsibility for maintaining the health of doctors.
Help can only be accepted by those who really receive it.
The Charter will be presented at the Assembly of the FMH-Delegates in April 2022 and at the Swiss Medical Chamber in May 2022. We then invite all Swiss medical societies to sign up this Charter officially thus declaring their support.
The next steps are then to perennialise and, if necessary, expand the working group and then to define a concrete working programme (with budget) for the next 3-5 years.
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