Dr Volker Hitzeroth, Medicolegal Consultant at Medical Protection, analyses the results of our recent survey on the mental health of doctors

Healthcare practitioners in South Africa are facing myriad challenges. Many are becoming increasingly exhausted, disillusioned and demotivated as their ability to provide care to their patients is continually being eroded by external factors and uncertainty about the future direction of healthcare in South Africa.

The results of a survey – announced at the Medical Protection Ethics For All conference in October 2023 – highlight the serious impact these challenges are having on the mental wellbeing of the medical profession, with some worrying implications on the horizon for the healthcare system in South Africa as well.

The survey of more than 650 Medical Protection members in South Africa found that more than a third (35%) believe their mental wellbeing to be worse now than it was during the COVID-19 pandemic.

To understand why that is, you do not have to dig too deep into the survey results.

Why burnout also affects patient safety

Over half (55%) said political, economic and financial concerns are impacting their mental health, while 39% said the impact of burnout and exhaustion on patient safety was affecting their mental wellbeing.

Meanwhile, 59% said staff shortages plaguing the South African health system were having an impact on their mental wellbeing.

Based on these results, it is clear that the status quo cannot continue. When the mental wellbeing of practitioners is poor, it is not just concerning for the individual practitioner, but can also jeopardise patient care and patient safety.

Without support, mental wellbeing issues may deteriorate and result in doctors needing extended periods of time off work or even contemplating leaving the profession altogether.

Already, 25% of the survey respondents said they are considering leaving the medical profession, or retiring early, due to mental wellbeing concerns. A further 22% said they planned to, or considered, leaving South Africa to practise elsewhere.

This will place even more pressure on the strained healthcare system and the doctors who choose to remain.

What needs to be done?

In response to the survey findings, Medical Protection is calling for improved mental health awareness and support for healthcare professionals who require it.

This can be achieved by establishing more local mental wellbeing resources and expanding those already in existence, to ensure that doctors struggling with their mental wellbeing can access appropriate support.

In addition, measures need to be introduced that ensure the healthcare system has adequate capacity so that those needing time off to recuperate can do so without adding to staff shortages or detracting from patient care.

It would also be beneficial for the central government to launch a nationwide campaign to increase awareness and research into mental health and its impact on healthcare.

While the statistics from the survey are no doubt cause for alarm, the impact that the worsening mental wellbeing situation is having on the medical profession really hits home when you read some of the comments left by those who took part in the survey.

Comments such as “I no longer enjoy what I do”, “there is no support” and “I cannot do my job correctly because of the challenges faced” were common throughout – and are heart-breaking to read.

Another doctor said: "The pandemic broke me. I am about the same but haven't recovered because as soon as it was over, it was business as usual, like nothing happened and no one cared."

The central government along with state hospitals, private providers and professional societies as well as Medical Aids and Medical Aid administrators owe it to all people of South Africa, not only the healthcare professionals, to improve mental wellbeing within the healthcare profession as a matter of urgency.

If this issue is not properly addressed, I fear South Africa’s fraught healthcare system will face even more unwanted challenges, not least an exodus of healthcare practitioners.  

Medical Protection offers a 24/7, independent counselling service to members in South Africa who are experiencing work-related stress, or stress that they feel could impact their practice. This is a benefit of membership.