A Crisis in Health Care

By many indications, all is not well in the emotional lives of health care workers. Studies show that the suicide rate for male doctors is about 1.4 times the general population, and female doctors commit suicide more than twice as often as women in the general population. Health care practitioners and technicians have a depression rate of 9.6 percent per year. This is 2.6 percent higher than the average for full-time workers. Why are doctors and health care workers so unhappy?

A 1996 Lancet study indicated that doctors and other health care workers commonly struggle with emotional exhaustion, depersonalization (treating people in an impersonal, unfeeling way), low estimation of personal accomplishment, work overload, and poor management and resources. Dealing with the suffering of patients and their distressed, angry, or blaming relatives on a daily basis is extremely taxing.

The doctors in the Lancet study reported their primary sources of job satisfaction were good relationships with patients, relatives, and staff, and having professional status and esteem. They said being understood by management contributed to their happiness, as did enjoying a high degree of autonomy, and performing a variety of tasks.

Significantly, only 45 percent of the doctors in the study thought they had received adequate training in communication skills, while all believed they had received adequate training in the treatment of disease and management of symptoms. As the report reaffirms, "The mental health of (doctors) may nevertheless be protected by maintaining or enhancing their job satisfaction ... through giving them autonomy and variety in their work, as well as providing effective training in communication and management skills."

It seems that at least some of the missing pieces in the wellness of health care professionals relate to the personal, human dimensions of their work rather than the technical dimensions: less than half feel adequately prepared to communicate effectively with others, which means less than half feel skilled at connecting in meaningful and effective ways with the people around them. Doctors are also terrified of giving empathy to a patient for fear that it will take too much time. That absence of meaningful connection is surely a contributor to the kind of alienation and depression that underlies the grim suicide statistics.

Health care institutions also feel the costs of these missing pieces. Low job satisfaction and high turnover are extraordinarily costly for hospitals, which shoulder an average cost of $60,000 for every employee turnover. No wonder many hospitals are looking for ways to increase retent