Doctors ‘must put own health first’

A Kiwi doctor’s efforts have led the World Medical Association (WMA) to amend the Declaration of Geneva – the vow made by doctors upon entering the profession.

Sam Hazledine has been fighting to improve doctors’ wellbeing after researching the ‘‘alarming’’ rates of burnout, suicide and mental health issues they experience. He found these issues could lead to medical errors and ultimately harm patients.

He believed it all started when doctors take oath with the statement: ‘‘The health of my patient will be my first consideration.’’

He launched a petition, signed by more than 4500 Australasian doctors, to add a clause prioritising doctors’ wellbeing to the declaration.

The petition was presented to the WMA general assembly last year. After consultation and work on the wording, the WMA assembly ratified the change last Friday. The new clause states: ‘‘I will attend to my own health, wellbeing and abilities in order to provide care of the highest standard.’’

It is one of the three new clauses that have been added as part of a broader review of the declaration. The other new clauses relate to the respect of patients’ autonomy and dignity and the sharing of medical knowledge.

The declaration of Geneva was first adopted in 1948 as a global standard of medical ethics after

"I will attend to my own health, wellbeing and abilities in order to provide care of the highest standard." The new oath clause

the atrocities committed during WWII. It has only been amended three times since then.

Recent research by the American Academy of Orthopaedic Surgeons showed 87 per cent of doctors said they were stressed and more than half said that, in hindsight, they would not choose to become a doctor. In New Zealand, the Association of Salaried Medical Specialists published a report last year showing half of public hospital specialists felt burnt out, potentially affecting patient care and increasing the risk of medical errors.

The Royal New Zealand College of General Practitioners (RNZCGP) said it needed to address burnout in doctors after a 2016 survey revealed 22 per cent of GPs self-reported being burnt out. About a third said they did not have enough time to complete their daily tasks.

Doctors often felt they should sacrifice themselves to look after patients, Hazledine said.

There had been no resistance to amend the declaration, which was a ‘‘huge acknowledgement’’ of the issue for the profession.

Solutions included correct levels of staffing, a shift in managers’ expectations and doctors themselves making time for their wellbeing.

Hazledine left the medical profession 11 years ago to create a medical recruitment company, MedRecruit. He realised he was himself suffering burnout while researching the issue. At the time, he worked 15-hour days and dedicated all his free time to his family with two young children.

‘‘It was great until it wasn’t. I became tired, lost enthusiasm. I had such a blind spot to acknowledge burnout in myself. That’s part of the problem.’’

He made simple lifestyle changes such as getting more sleep and going mountainbiking once a week.

New Zealand Medical Association (NZMA) chairwoman Dr Kate Baddock said the association supported the new clauses.

Doctors’ health and wellbeing was a concern, and in 2013 the NZMA issued specific recommendations for doctors, medical students, employers, medical schools and Government to improve doctors’ wellbeing.

RNZCGP medical director Dr Richard Medlicott said doctors were human ‘‘just like everyone else’’ but often struggled to look after their own health.

The new clause was a good step in a shift in the medical culture, he said.