General practitioners are depressed, anxious and exhausted by the pandemic

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Primary care physicians around the world are facing increasing chronic stress and burnout that is affecting their mental health and well-being.

According to the first systematic review to explore the psychological well-being of general practitioners during the COVID-19 pandemic, it has left general practitioners depressed, anxious and exhausted, with women and older doctors most affected.

For the systematic review, published in the British Journal of General Medicine , researchers from the University of York searched six bibliographic databases, Google Scholar and MedRxiv and performed a reference check to identify studies on the psychological well-being of general practitioners during the pandemic. They identified 31 studies that assessed the impact of COVID-19 on the wellbeing and mental health of primary care doctors, three of which were studies of GPs working in the UK.

Study author Dr Laura Jefferson from the University of York’s Department of Health Sciences said: “While there has been a tendency for research like this to focus on hospital roles, there was a need to synthesize evidence and explore factors associated with GP mental health and well-being during the pandemic.”

Women and older doctors fare worse

The new review found that the pandemic has left many GPs around the world feeling depressed, anxious and, in some cases, exhausted. The researchers also found that female primary care physicians reported more psychological problems, including higher stress levels, burnout and anxiety. The authors suggested that one reason for this could be that “women may be more open to discussing difficulties and seeking support due to socialized gender norms”. However, they also suggested that their findings may be because “women may also have come under greater pressure during the pandemic due to broader family responsibilities.”

Additionally, the researchers said that older primary care physicians reported greater stress and burnout, adding that “increased stress with age may result from seniority and additional roles, including practice management.

The authors pointed out that “physician burnout has been described as a ‘global crisis,’ affecting the quality of patient care and the sustainability of health systems.” They said there were common themes when it came to the challenges faced by physicians in primary care settings, with sources of stress such as “altered work practices, exposure to COVID-19 and inadequate PPE, information overload, lack of pandemic preparedness and poor communication between health sectors”.

Dr Jefferson said: “The COVID-19 pandemic has presented additional challenges to GPs including rapid change, infection risks, remote working, pent up demand and reductions in face-to-face patient care. face to face.”

Physical symptoms also increased

The researchers explained that the studies demonstrated an impact on the psychological well-being of primary care physicians, “with some also experiencing fear of COVID-19 and lower job satisfaction.”

Physical symptoms were also reported in a third of the studies, due to the impact of the pandemic. Some of the problems reported by GPs included migraines and headaches, fatigue and exhaustion, sleep disturbances and increased eating, drinking and smoking. GPs with symptoms of long COVID felt “let down” and expressed frustration at the lack of support and recognition for the disease, the authors said.

“Many GPs have reported stress and burnout in recent years,” said Dr Jefferson, “which is potentially detrimental not only to physicians themselves, but also to patients and healthcare systems” .

At the opening session of the House of Commons Health Select Committee’s inquiry into the future of general practice last week, GPs pointed out that workload pressures and low job satisfaction led to the early departure of many general practitioners.

In fact, even before the COVID-19 pandemic hit, a 2019 survey by the General Medical Council (GMC) found that around 1 in 6 (18%) GPs said they were considering quitting. completely medicine within the next year, about a third who planned to retire. Excluding those considering retirement, 1 in 10 GPs (11%) said they might be considering a career outside of medicine. Prof Martin Marshall, RCGP Chairman of the Board, told the Health Select Committee: “Our own work at the college showed that 34% of GPs said they planned to retire within the next 5 years. “

GPs also told the health select committee inquiry that ‘the dangerous workload of GPs must be reduced to prevent an exodus of struggling doctors from the profession’.

The researchers noted that their review highlighted the need for policy and infrastructure to support GPs and that further research is needed to explore gender and age differences, identifying interventions targeted at these groups. They added that the identified sex and age differences should be taken into account by policymakers and researchers when designing “tailor-made interventions”.

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