Hospital consultants feel 'undervalued and stressed'

Irish hospital consultants feel stressed and undervalued, largely as a result of a lack of health service planning and unrealistic patient expectations, according to a new study.

Ninety-three per cent of consultants interviewed for the study consider stress a very significant or highly significant problem, as do 95 per cent of trainee consultants.

Work-life balance is considered important by three-quarters of consultants but is mostly felt by its absence, the study published in BMJ Open says. This question prompted responses from doctors such as "We don't have it", "All has been sacrificed on the altar of medicine" and "It's important to get a break from colleagues moaning."

The most significant cause of stress experienced by consultants was the lack of long- term planning, resulting in an “always reactive” system.

Consultants are also deeply concerned about the quality of care being provided for patients; this accounted for four of the top 10 causes of stress identified in the study. “They are aware that good treatment takes time and that this is not available, citing staff shortages, poor facilities, inadequate time for important paperwork and excessive patient numbers.”

“There is evidence they feel undervalued and sense a threat to their professional identity from their employer, the media and the regulator [the Medical Council]. This is exacerbated by unrealistic patient expectations.”

Consultant contract

Trainee consultants feel undervalued and share their senior colleagues’ concerns. They are also concerned about revisions to the consultant contract, overall financial loss and an unattractive future.

The stress felt by doctors most likely impacts on the delivery of high-quality care, the study says. “They feel insecure within the system of which they are part and powerless to influence what matters to them,” say the authors. One interviewee sums it up as: “You are responsible and accountable for things over which you have no control.”

Consultants believe there is little support if they are unwell. One is quoted in the study saying: “There is pressure not to appear sick even if you have a problem, as ultimately it will narrow your career options.”

Although contractual and salary changes are seen as causes of stress, they do not feature in the top 10. “This belies the popular portrayal of consultants as ‘greedy’,” the authors say.

“We are not looking for adulation, just appreciation for what we do,” one consultant is quoted as saying.

Consultants view the regulator as unsupportive while trainees are quite preoccupied by financial concerns and poor future prospects.

Almost 50 doctors were interviewed for the study.