Our ailing profession: we need more than resilience and replenishment

Abstract

The malaise among NHS healthcare workers is akin to a patient dying from an internal haemorrhage: oral replenishments, or even transfusions, may be very inadequate. A recent day conference parried this perspective. The conference was designed to ventilate and motivate our dispirited and defecting doctors. Its brief title was businesslike in its optimism: Restoring Health in the NHS. Recruitment was geared towards the young: the growing loss of their ranks is causing increasing concern for, first, abandoned colleagues and, then, health planners and government. In the morning about a hundred of us sat together. A young and cheery consultant, Dr Y, outlined the now familiar litany of unavoidable stresses for doctors: increased expectations from ‘consumers’, ‘providers’, and commissioners amidst unyielding, or declining, resources; increasingly complex, technical multitasking amidst ever-present, often opaque, human complexity; the frequent anxiety from inevitable yet serious fallibility; our often foolishly litigious culture; perennial exposure to pain, loss, decline, and handicap; long and antisocial hours; the eventual damage to our intimate relationships. But Dr Y was upbeat: we could prepare and brace ourselves for these ordeals, tend to our resilience. Anchoring her suggestions in Selye’s classic research into the physiology of stress,1 she offered sensible, restorative, and reparative advice on our needs for eating, sleeping, breathing, exercising, emoting, laughing, loving, and meditating. She ended …