Emotional Female by Yumiko Kadota
(Penguin House, Released 2 March 2021)
I recently listened to this audio book and was fascinated by this highly competent and driven young woman’s description of how studying and developing surgical experience in Australia ultimately resulted in her burnout. By burnout, I mean a capital “B” illness, whereby she was diagnosed with a chronic depressive illness that took over a year to recover from.
The book got me wondering about the cumulative effect of high workloads as well as possible sexism and racism within hospital hierarchies. It also makes a point about being criticised for “experiencing emotions” in this profession. The author talks about “Karoshi”, a Japanese term meaning essentially “death by overwork”. The word refers to sudden death related to overwork, most notably death caused by cardiac events or stroke. Will such a word be added to the New Zealand language, or will we learn and change the culture of overworking to one of balance where work and wellbeing co-exist?
It raises a question as to whether depression and burnout are the same thing, although a recent review of research suggests they are different constructs that share common characteristics.
I reflected that New Zealand medical staff and students must be doing better than our Australian counterparts. So I went looking for research. In 2015, Dr Charlotte Chambers and Professor Chris Frampton investigated burnout levels of medical specialists in New Zealand. Of the 3740 members of the Association of Salaried Medical Specialists (senior doctors and dentists), 1487 responded (40%). They found that 50% or one in every two reported symptoms of burnout; that is, high levels of exhaustion and fatigue. More than half (58%) of respondents attributed this burnout to work or interaction with patients. They reported strong relationships between burnout and (a) greater number of hours worked in the preceding week, (b) working more than 14 consecutive hours in the week prior to the survey and (c) not having 24 hours free of work in the preceding week.
Interestingly, burnout was higher in women and those people working in emergency medicine, dentistry and psychiatry had the highest rates for patient-related burnout.
A repeat of this study, conducted in 2020, showed no significant change in overall burnout scores between 2015 and 2020. There was a significant reduction in women reporting burnout from 2015 to 2020, however women continued to score significantly higher than men in both 2015 and 2020.
Anecdotally, junior doctors are also struggling, and judging by the challenges for nurses in New Zealand, the challenge of overworking and burnout are just as salient. So where to from here?
By Bronwyn Moth