Doctors are dying younger! Physician heal thyself first!

GUEST COLUMN: Dr N Prabhudev

Bengaluru, Oct. 19: The supreme irony of life is that hardly anyone gets out of it alive!
The world is full of occupational irony: corrupt politicians, crooked cops, bankrupt bankers, seasick sailors, and immoral clergy and unhealthy doctors. Instead of using the body as a temple we use it as a vehicle for indulgences! We often prioritize indulgence over health. Illness is the result of our choices! Doctors who help us stay fit and live longer are themselves dying younger. Beware- Being a doctor in India is injurious to one’s health!
Doctors are expected to live longer as they know more about how to stay fit and healthy and address the medical conditions ahead of time. Despite this heart diseases and cancer among doctors is swiftly rising. Also, the emerging trend of doctors committing suicide- hitherto uncommon—is a matter of grave concern.
The average lifespan of a doctor in India is around 59 years only as compared to the general population who have a lifespan of 68 to 70 yrs.! The rise in obesity amongst doctors is propelled by sedentary life style, over-consumption of processed meat, food high in fats, carbohydrates and salt! A doctor should be a model of health! Seems logical, and to be sure, some conventional physicians are healthy. But for many the long hours, work-life imbalances, workplace pressure and violence in the work place, fundamentally bring into question the state of stress in the life of doctors.
Conventional medical education- a training of 40,000hrs. denies you of sleep. It feeds you junk food. It gives you no time to exercise. It teaches you nothing about stress reduction and management! Instead, it demands – you shut off your emotions! The doctors are required to project an Olympian aura of perfection – In fact, they are just as human as the patients they care for.
Doctors are not Gods!
Not Gods all right! But Let us be humans first and remain human always! Medicine is a noble Profession, but Healthcare has become a Business. Medicine is a science of uncertainty and an art of probability! Physicians are now providers. Profits decide health care policy.
Health operates according to a social gradient – those with more money and education, generally do better and live longer. Pedestal societal placement, Middle to large income, influence and cultural deference lead us to assume we take care of ourselves and set an example of best care! But there seems to be a problem of poor well-being in the medical profession.
Top causes of death among doctors!
Your body is the only place you have – to live your entire life! No matter how old you are, no matter how much you weigh, No matter what your health numbers are, you can still control the health of your body. Most of the early deaths among doctors are sudden and are caused by Cardiac arrest! Stress, a sedentary lifestyle and lack of exercise are the main causes of death!
The top 10 causes of death for physicians are – heart disease, strokes, cancer, accidents, COPD, pneumonia/influenza, diabetes mellitus, suicide, liver disease, and HIV/AIDS!
Physicians have traditionally neglected their own health in favour of their many professional and personal obligations. Physicians often view – attention to their own needs as a sign of weakness. More than 50% of heart attacks are occurring in less than 50 years of age in India! Physicians are at a risk for a heart attack because of stress, Odd working hours, stressful work situations, sedentary lifestyle and irregular dietary habits unhealthy lifestyles besides conventional risk factors like high incidence of high BP, cholesterol and blood sugar. Many doctors think that others get heart attacks and not themselves!
It is apparent that physicians experience a higher prevalence of three factors: extreme physical stress, mental stress, and infections. The stress associated with caring for sick individuals, challenging hostile work environment, long working hours, and increased exposure to infections – all contribute to this incremental vulnerability. Stress management is not seen as crucial as the prevention of other risk factors like hypertension, diabetes, family history, and smoking.
Medicine is a fast paced evolving science. Doctors are required to constantly absorb new and complex information! In medicine, being in the job longer actually increases risks. Physicians are not consistently meeting the recommended guidelines for physical activity. Earning money has overtaken the desire to serve!
Doctors are at risk of the same things as their patients—including acute or chronic conditions! Uncertainty, high personal responsibility, vicarious trauma of witnessing suffering, and negative outcomes are all common, and exceptional coping is the norm!
Many health professionals report excessive workload, poor rewards, negativity in relationships, lack of supplies, and in some cases institutional failure will exacerbate risks! Choice of specialty, stage of career and loss of leadership role in patient care add to the stress!
Doctors though highly educated there is a high prevalence of Non communicable diseases, suicide rates are disproportionately high and mental illness is common, 20% are obese, 53% have metabolic syndromes, 24% are hypertensive! Doctors are prone to burnout, depression, anxiety, substance abuse problems, and dysfunctional personal relationships. When doctors suffer, the human side of the care they are trained to give suffers!
Medical care is rarely straightforward. A doctor’s specialty has a significant association with their age at death, with general practitioners living the longest and emergency physicians the shortest, with proportionately more accidental deaths. Ophthalmologists and Dermatologists are better placed in stress related to the practice!
To improve the life expectancy of doctors, there are two aspects that need analysis. Firstly, the work atmosphere and conditions require improvement to optimize work-life balance. Secondly, doctors need to address their individual lifestyle and adopt work-life balance.