Hospital doctors in Ireland and the struggle for work-life balance.

Niamh Humphries,Edel Conway,Jennifer Creese,Anne Matthews,Aoife M Mcdermott,John-Paul Byrne

doi:10.1093/eurpub/ckaa130

Abstract

Ireland has a high rate of doctor emigration. Challenging working conditions and poor work–life balance, particularly in the hospital sector, are often cited as a driver. The aim of this study was to obtain insight into hospital doctors’ experiences of work and of work–life balance. In late 2019, a stratified random sample of hospital doctors participated in an anonymous online survey, distributed via the national Medical Register (overall response rate 20%; n = 1070). This article presents a qualitative analysis of free-text questions relating to working conditions (n = 469) and work–life balance (n = 314). Results show that respondent hospital doctors, at all levels of seniority, were struggling to achieve balance between work and life, with work–life imbalance and work overload being the key issues arising. Work–life imbalance has become normalized within Irish hospital medicine. Drawing on insights from respondent hospital doctors, this study reflects on the sustainability of this way of working for the individual doctors, the medical workforce and the Irish health system. If health workforce planning is about getting the right staff with the right skills in the right place at the right time to deliver care, work–life balance is about maintaining doctor wellbeing and encouraging their retention.

Highlights

Ireland has a high rate of doctor emigration with difficult working conditions in the Irish health system frequently cited as a key driver of doctor emigration.[1,2,3]
Drawing on free-text responses from hospital doctors surveyed in late 2019, this article aims to explore the extent to which work–life imbalance is normalized within Irish hospital medicine and to consider the impact on individual doctors, the medical workforce and the Irish health system
The overwhelming sense from the data is that work–life imbalance is standard in Irish hospital medicine

Summary

Introduction

Ireland has a high rate of doctor emigration with difficult working conditions in the Irish health system frequently cited as a key driver of doctor emigration.[1,2,3] Austerity measures introduced following the 2008 global financial crisis reduced health spending,[1] staffing levels, hospital bed numbers[4] and new entrant salaries.One study of Irish-trained doctors who emigrated to Australia between 2008 and 2018 found that they did so in response to deteriorating working conditions[5] in the Irish health system. Moving to Australia, which had escaped the worst effects of the global financial crisis,[1] enabled these doctors to access better working conditions and a better work–life balance.[5]. Ireland’s medical workforce crisis is not caused by an absolute shortage of doctors, but a shortage of doctors willing to work for the terms and conditions on offer.[6,7] Generational issues are at play.[7] Research with early career doctors in Ireland (2015) highlighted their dissatisfaction with the heavy, intense workloads in hospital medicine and their desire for work–life balance.[7] It suggests that expectations of this cohort are in line with their peers in other countries[8] and in other professions. Employees today, ‘want work that doesn’t require substantial recovery in the evening after work, on weekends or vacations’.9

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Conclusion