Cynthia Bradford MD
Risk of burnout, increasing workloads and the need for more investment in public ophthalmology services were the focus of a lively session on the future of the specialty at the Irish College of Ophthalmologists (ICO) 2018 Annual Conference in Kilkenny.
Dr Cynthia Bradford, Professor of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma Health Sciences Centre, US, discussed the impact of doctor burnout.
Burnout can lead to depression and around 400 doctors a year die by suicide in the US, she said.
Factors leading to medical burnout include lack of control over working conditions and decision-making, excessive workload pressures, chaotic and inefficient work environments and onerous administration tasks, Dr Bradford outlined. The most susceptible doctors are dedicated, conscientious, responsible, motivated and often idealistic with perfectionist qualities, she contended.
Burnout not only impacts doctors, it also impacts patients negatively, in relation to the quality of care they receive, and leads to higher healthcare costs, Dr Bradford said.
She said a major culture change is needed to help better support doctors, which would include returning trust to doctors, less onerous regulation and administrative processes and “letting them concentrate on the work only they can do”.
BUILDING RESILIENCE
Some of Dr Bradford’s points were echoed by ICO Dean of Education and Ophthalmic Surgeon Miss Yvonne Delaney during her presentation on educating the doctors of tomorrow and building resilience.
“People (doctors) love their job – they just want to be able to do it,” Miss Delaney said. She highlighted the importance of communication in medicine: Around 50-65% of complaints against doctors are related to communication errors, and 10% of health budgets are spent on error/negligence.
The session also heard that while there have been many positive advances in treating and better diagnosing ocular conditions like age-related macular degeneration and diabetic retinopathy, this has led to increased and unsustainable workloads for ophthalmologists.
Ireland’s Health Service Executive National Director of Quality Improvement Dr Philip Crowley stressed that public health funding is finite so countries like Ireland, who have high ophthalmology waiting lists and inadequate staff numbers, should try and learn from those with less resources but smaller waiting lists about how they maximise services and outcomes. We need efficient models of outpatient delivery but also adequate Consultant numbers to deliver the service.
Dr Crowley also stressed that it is vital that healthcare staff are involved in health service decision-making and that roles for clinical leaders are developed and supported. “While it is important to learn from our mistakes, we must also learn from excellence,” he commented.
Cynthia Bradford: cynthia-bradford@dmei.org
Yvonne Delaney: yvonnedelaney1@gmail.com
Philip Crowley: nationalqid@hse.ie
