Just when you thought it was hard enough to see a GP....

[dingerr]

I was trying to make the point that doctors do top themselves more often than average. The post I replied to sought to cast doubt on that and I didn't think it was accurate or reasonable. I might be wrong, this is subject to the vagaries and bias of statistics etc.

My own position is based on hearsay (old TV documentary) and anecdotes (my childhood GP killed himself, news reporting etc). I've spent some time interacting with Drs in various roles over my life and I can empathise with the idea that it could get overwhelming in certain circumstances. I'm not claiming scientific rigour here, but I would be very surprised if the group had a lower rate of suicide than the population.

When it comes to improving service then there's a lot that can be done. But if you have an individual GP that is struggling to cope then adding extra pressure onto them won't usually help unless there's some aspect of personal laziness that needs to be disrupted.

There's a lot I hear about this business that sounds crap, like GPs on "part time" gigs still having to do 40+ hours p/w to get everything done. That's the kind of BS I would not tolerate and would demand more money for. But if HMRC nicks 50% of it what's the point of doing the overtime? Add on the pension tax and the incentive to say "**** it" is even greater.

Fundamentally there's a labour shortage, which is why getting a GP is a ballache. It's hardly surprising given the tax disincentives we've created for them to do any overtime.

That’s fair enough, but i’m really not interested in all the excuses in the world. I (and others) have a level of expectation that is not unreasonable.

People coming on here and spouting statistics with no basis is bullshít.

People coming on here and making up things that are easily discredited is bullshít.

 

[GDog]

How often has a doctor had to walk up to a bomb?

I had my job, they have theirs and many others have theirs that they crack on with.

In the spirit of fairness, an awful lot of EOD/ATO and general military personnel have dealt with unpleasant circumstances too, and accordingly the military also has a pretty unfavorable record when it comes to suicide.

I've got younger friends that have been in longer than I, that struggled recently due to the sheer number of their own oppos that killed themselves over the years.

It's all quite shit. As an employer you should aim to minimise the chance of it happening in either industry as having your employees top themselves doesn't help get things done.

 

[GDog]

That’s fair enough, but i’m really not interested in all the excuses in the world. I (and others) have a level of expectation that is not unreasonable.

It becomes unreasonable from a GP's perspective when their workload goes through the roof due to the demographic of the patch getting much more geriatric and needing more care, without there being more GPs to handle the extra work.

It's a rather boring supply-demand problem, where the growing demand was entirely predictable and the supply has been constrained by idiotic restrictions on training places, tax and pensions.

We are ruled by fuckwits.

 

[GDog]

“yes, but I’ve never had the pressures you’ve had to face”

Reminds me of a Jasper Carrott sketch.

During the IRA days, he spoke to a plod/mil guy armed to the teeth and clad in body armour at a venue, who told Jasper he "could never do your job, not with all that pressure"

It demonstrated an interesting idea of what people think of as pressure!

 

[GDog]

Again that is mainly related to the fact that farmers have the means (i.e. shotguns) to make a successful attempt rather than frequency. Doctors fall into that category too with access to lethal medicines.

I did look at the ONS stats and it said doctors have a lower level of suicide than farmers and in the general population which surprised me. Healthcare workers in general are quite high.

Compare paediatricians with anaesthetists

 

[Excognito]

HowI was trying to make the point that doctors do top themselves more often than average. The post I replied to sought to cast doubt on that and I didn't think it was accurate or reasonable. I might be wrong, this is subject to the vagaries and bias of statistics etc.

My own position is based on hearsay (old TV documentary) and anecdotes (my childhood GP killed himself, news reporting etc).

In case you're referring to my post referencing the stats up to 2015, then I wasn't "seeking to cast doubt", I was seeking to use statistics to get some kind of handle on the magnitude of the problem. That is, at least, some kind of starting point to understanding what the situation is.

And then there's the thorny issue of deciding where to throw the limited funds and resources to effect the best overall outcome for the health services and the rest of society. For example, are doctors at much more risk than nurses or paramedics?

I've spent some time interacting with Drs in various roles over my life and I can empathise with the idea that it could get overwhelming in certain circumstances. I'm not claiming scientific rigour here, but I would be very surprised if the group had a lower rate of suicide than the population.

A problem with empathy is that people can project their own feelings onto people who are less affected by events or have found ways to more effectively compartmentalise them or otherwise deal with them.

Don't forget that these professions and their training partially select people who can deal with traumatic events. Most of the paramedics I've had the pleasure of being dealt with by really like their jobs and have had many years of experience. My daughter is recently qualified paramedic and saw more sh*t on some days during her training than I think I could cope with ever. Even dealing with the very sad cases of infants who didn't make it hasn't put her off. How midwives cope is beyond me, and yet many of them are longtermers who love their jobs and have had children despite what they see.

Interestingly, my daughter has talked about paramedics working with or in surgeries to ease the burden on GPs (google "paramedic practitioner")

https://www.pressandjournal.co.uk/fp/politics/scottish-politics/1460566/paramedics-drafted-in-to-help-ease-pressure-on-gps-in-scotland/

 

[RaiderBoat]

How often has a doctor had to walk up to a bomb?

I had my job, they have theirs and many others have theirs that they crack on with.

EVERY Patient is a potential “Bomb”.

 

[Grownup_Rafbrat]

It becomes unreasonable from a GP's perspective when their workload goes through the roof due to the demographic of the patch getting much more geriatric and needing more care, without there being more GPs to handle the extra work.

It's a rather boring supply-demand problem, where the growing demand was entirely predictable and the supply has been constrained by idiotic restrictions on training places, tax and pensions.

We are ruled by fuckwits.

It's also a problem that the NHS now exists to provide well paid jobs for administrators, managers and co-ordinators, not a health service for patients.

And that the Unions want it to stay that way.

 

[kandak01]

That’s fair enough, but i’m really not interested in all the excuses in the world. I (and others) have a level of expectation that is not unreasonable.

People coming on here and spouting statistics with no basis is bullshít.

People coming on here and making up things that are easily discredited is bullshít.

I agree, you should have a reasonable level of expectation, and that should be delivered.
The problems are that expectations have been raised far higher than our taxes and available workforce can deliver, and the traditional solution (work overtime for extra cash) has been changed (work overtime for financial and lifestyle punishment).

The pissing contest about toughest job and suicide rates is separate and unhelpful against the wealth of (not made up) statistics showing that staff retention in the NHS is terrible.

Whatever the reason (and it's not lazy staff), your service is likely to get worse, not better over the next few years. Blaming the workers won't help, and implies you have either not read, or not understood, much of this thread.

I get that you don't like your GP and have multiple problems, and tbh I don't envy any wounded veteran now the public interest has moved onto other things, but your subjective experience is simply a microcosm of the wider objective systematic problems in the NHS, which should concern all of us, whether as healthcare provider or recipient (current or future)

 

[Sadurian]

Does anyone know of any stats that compare medical staff suicide rates to other stressful professions?

If we are playing suicide Top Trumps, then this site and associate data might be useful.

Suicide by occupation, England and Wales, 2011 to 2020 registrations - Office for National Statistics

The tables show that, in 2020, the professions most likely to see a suicide were skilled construction trades, followed by elementary admin and service.

Doctors ('Health Professionals') came very much down the list.

 

[Sadurian]

EVERY Patient is a potential “Bomb”.

Bugger me, I'm not going to a GP surgery or A&E waiting room any time soon then. I had no idea the people waiting had a good chance of killing or maiming me and destroying the room.

 

[Ho2331]

If we are playing suicide Top Trumps, then this site and associate data might be useful.

Suicide by occupation, England and Wales, 2011 to 2020 registrations - Office for National Statistics

The tables show that, in 2020, the professions most likely to see a suicide were skilled construction trades, followed by elementary admin and service.

Doctors ('Health Professionals') came very much down the list.

As I suspected.

 

[Sadurian]

Remember that those figures are whole numbers only, not by proportion of people in that occupation.

 

[Sadurian]

The stats come via health committee reports (I think I linked to one earlier)
Adjusting for education, wealth, social circumstances etc., doctors should have very low suicide rates, but they don't.

(my bold) I'm not sure how you come to that conclusion. The report you linked to states:

Male health professionals, particularly doctors, had a low risk of suicide​

The most recent data show that male health professionals are at relatively low risk of suicide. In the period between 2011 and 2015 they experienced a 16% reduced risk of suicide relative to the national average. Low risk of suicide was particularly seen among medical practitioners (37% lower). These findings are in keeping with past national and international research showing lower incidence of suicide among male health professionals (see Hawton et al, 2001 and Kõlves and De Leo, 2013). Despite the low incidence of suicide, when compared with other groups of occupations male health professionals had the highest proportion of deaths due to poisoning (33% of all suicides in this group; in England this figure is 18.6%). This suggests that when suicides do occur among male health professionals, means of access to, and knowledge of, methods of suicide is an important risk factor.

 

[kandak01]

(my bold) I'm not sure how you come to that conclusion. The report you linked to states:

Fill your boots. Clare Gerada is probably the go to author on the subject at the moment.

Fallen friend – dealing with the loss of a colleague

When GP Louise Tebboth died by suicide, her partners had to keep the practice open, dealing with their own intense grief and an avalanche of questions from patients. Seren Boyd hears why more support for doctors in these tragic circumstances is urgently needed

www.bma.org.uk

2-5 x more likely to commit suicide

Clare Gerada: Suicide and the myth of Sisyphus - The BMJ

This article is about suicide, in particular about doctors and suicide. The themes are as relevant to any health professional, where work gives both purpose and meaning to their life. [...]More...

blogs.bmj.com

Doctors and suicide

On Monday 28 April 1902, Dr Jeannie Charlotte MacLeod (Jeannie) buttoned her starched white coat, checked her pockets for her stethoscope and notebook, took one last look at herself in the mirror, and walked onto the paediatric ward as the new House Officer at Aberdeen Children’s Hospital. She...

bjgp.org

 

[Blues&Twos]

Much of that is shíte. Cushions for wheelchairs don’t cone from GPs.

ECG - not available at GP, hospital appt required.

MH from a GP, don’t make me laugh, they even refuse to accept their requirement for referral to TILS when asked (despite it being on the NHS & Gov.uk websites).

I’d love a knee, forget the sicknote you ignorant príck.

It’s funny that I’ve talked to quite a few doctors, each of us talking about our respective jobs and a few different doctors have said “yes, but I’ve never had the pressures you’ve had to face”. Blows your assertion out of the water.

Thank you for proving my point that you’re utterly ******* clueless.

Of course GPs don’t provide wheelchair parts. But we’re expected to fill out a pointless form to the service who does this, because apparently doing it themselves is unreasonable.

Of course we don’t do 24 hour ECGs. But hospitals expect us to send the referral to cardiology to arrange this, despite them being the one requesting it in the first place.

And of course we’re not the ones who should be taking the lead on mental health. But as the MH services will refuse to see people in a timely manner, or will decide they’re not engaging enough so discharge them, we’re left carrying the can.

You want a knee? Tough luck, part of the job, you knew what you were signing up for etc. Or does that line of reasoning only work when slinging it at GPs?

 

[Excognito]

Fill your boots. Clare Gerada is probably the go to author on the subject at the moment.

Fallen friend – dealing with the loss of a colleague

When GP Louise Tebboth died by suicide, her partners had to keep the practice open, dealing with their own intense grief and an avalanche of questions from patients. Seren Boyd hears why more support for doctors in these tragic circumstances is urgently needed

www.bma.org.uk

2-5 x more likely to commit suicide

Clare Gerada: Suicide and the myth of Sisyphus - The BMJ

This article is about suicide, in particular about doctors and suicide. The themes are as relevant to any health professional, where work gives both purpose and meaning to their life. [...]More...

blogs.bmj.com

Doctors and suicide

On Monday 28 April 1902, Dr Jeannie Charlotte MacLeod (Jeannie) buttoned her starched white coat, checked her pockets for her stethoscope and notebook, took one last look at herself in the mirror, and walked onto the paediatric ward as the new House Officer at Aberdeen Children’s Hospital. She...

bjgp.org

I haven't studied them in detail, but the author of Doctors and Suicide seems to be talking about doctors worldwide in the first part and then switches to the perceived situation with UK doctors. A problem with this is that suicide rates are different in different countries even the general population, and a global rate may not be true in the UK.

She states, for example,

Throughout time and across the world, doctors have always had higher rates of suicide compared with the general population and with other professional groups. Female doctors in particular have higher rates — 2.5–4.0 times the rate by some estimates.

However, in the period 1979-1995, male doctors in the UK had lower rates than the general population (~67 %), albeit female rates were higher (~200 %).

Suicide in doctors: a study of risk according to gender, seniority and specialty in medical practitioners in England and Wales, 1979–1995 | Journal of Epidemiology & Community Health

MAIN RESULTS Two hundred and twenty three medical practitioners in the National Health Service who died by suicide or undetermined cause were identified. The annual suicide rates in male and female doctors were 19.2 and 18.8 per 100 000 respectively. The suicide rate in female doctors was higher than in the general population (SMR 201.8; 95% CI 99.7, 303.9), whereas the rate in male doctors was less than that of the general population (SMR 66.8; 95% CI 46.6, 87.0). The difference between the mortality ratios of the female and male doctors was statistically significant (p=0.01), although the absolute suicide risk was similar in the two genders. There were significant differences between specialties (p=0.0001), with anaesthetists, community health doctors, general practitioners and psychiatrists having significantly increased rates compared with doctors in general hospital medicine. There were no differences with regard to seniority and time period.

CONCLUSIONS There is an increased risk of suicide in female doctors, but male doctors seem to be at less risk than men in the general population. The excess risk of suicide in female doctors highlights the need to tackle stress and mental health problems in doctors more effectively. The risk requires particular monitoring in the light of the very large increase in the numbers of women entering medicine.

This all harks back to having a proper view of the magnitude of the problem and where resources are more effectively deployed. If, for example, female doctors have a higher suicide rate than male doctors, this suggests both prioritising female doctors and also that gender differences are at play and that a one-size-fits-all intervention strategy may not be applicable.

Anecdotal evidence has its uses but it's not necessarily a good basis for tackling a problem.

 

[Sadurian]

Fill your boots. Clare Gerada is probably the go to author on the subject at the moment.

Fallen friend – dealing with the loss of a colleague

When GP Louise Tebboth died by suicide, her partners had to keep the practice open, dealing with their own intense grief and an avalanche of questions from patients. Seren Boyd hears why more support for doctors in these tragic circumstances is urgently needed

www.bma.org.uk

2-5 x more likely to commit suicide

Clare Gerada: Suicide and the myth of Sisyphus - The BMJ

This article is about suicide, in particular about doctors and suicide. The themes are as relevant to any health professional, where work gives both purpose and meaning to their life. [...]More...

blogs.bmj.com

Doctors and suicide

On Monday 28 April 1902, Dr Jeannie Charlotte MacLeod (Jeannie) buttoned her starched white coat, checked her pockets for her stethoscope and notebook, took one last look at herself in the mirror, and walked onto the paediatric ward as the new House Officer at Aberdeen Children’s Hospital. She...

bjgp.org

Except that the ONS statistics show that doctors are less likely to commit suicide than many other professions. Cherry-picking individual cases won't alter the official national statistics, and none of the studies you linked to has reliable hard data to back them up.

Indeed, the first article admits that the figures used are 'estimates' and are, in any case, 'old'. The studies referenced by the second article says that the data are contradictory but show a decrease over time. The third also states that the numbers it uses are 'estimates'.

Now using estimates and contradictory data is fine so long as it is acknowledged (and this is), but it its veracity is superseded when you have the official numbers.

 

[7gunner]

EVERY Patient is a potential “Bomb”.

My GP complains about working from 0800 to 1900. Never complains about her £125,00 pa.

 

[Blues&Twos]

My GP complains about working from 0800 to 1900. Never complains about her £125,00 pa.

Most people who’ve had to work their arse off most hours of most days from A levels until the end of their GP training (12 years minimum) then sinks their own money into owning a liable stake in a business that is doomed to fail, is fully entitled to a wage that would be laughed at for an equivalent doctor in any other reasonable nation. Have you any idea how much Canadian docs are paid? And let’s not even start on the yanks.

Yes, GPs make a good wedge. They make it for a reason, same as every specialty of doctor in this country.