Trapped and overburdened—what can be done for doctors facing burnout?

Abstract

Increasing numbers of doctors are struggling at work, while the support available to them is at risk. Emma Wilkinson investigates When Anne Noble, a GP in Sheffield, contacted NHS Practitioner Health she was feeling hopeless and couldn’t see a way out. Working as a partner in a deprived area for 10 years had taken its toll. Every consultation was complex and emotionally challenging. She was experiencing moral injury (box 1) and feeling overwhelmed at how little she could help. Box 1 ### Moral distress and moral injury The BMA defines moral distress as “where institutional and resource constraints create a sense of unease among doctors from being conflicted about the quality of care they can give.”12 Moral injury, the union says, can arise where sustained moral distress leads to impaired function or longer term psychological harm. Moral injury can produce profound guilt, shame, and in some cases a sense of betrayal, anger, and profound “moral disorientation.” It’s also been linked to severe mental health problems.RETURN TO TEXT That phone call with NHS Practitioner Health—a free, confidential NHS primary care mental health and addiction service for doctors—gave her the external validation she needed to take a break. She was signed off sick for a month. “I do feel massively lucky we have that as a resource, because there was that unique recognition of what was happening for me,” says Noble. She hadn’t felt able to speak to her own GP about it, she wasn’t interested in taking medicines, and although NHS counselling was an option, she knew that cognitive behavioural therapy wasn’t the answer either. The most recent General Medical Council (GMC) annual report into doctors’ workplace experiences, which drew on data and research from 2023, found that almost a quarter of doctors (23%) had taken a leave of absence in the past year owing to stress.1 One in …