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Distressed doctors pushed to the limit -

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Distressed doctors pushed to the limit

Broadcast: 11/10/2010

Reporter: Kirstin Murray

The 7.30 Report goes inside an emergency department to film just one doctor at work for a period of
24 hours to illustrate the intense demands doctors placed on doctors.


KERRY O'BRIEN, PRESENTER: The chronic ills of the nation's health system often present first at
hospital emergency departments, where long queues and long hours add to extreme stress and pressure
on medical staff. It's long been seen as a rite of passage for doctors and nurses working very long
shifts while solving sometimes complex cases and bearing the brunt of patients' emotional distress.
But the relentless demands of the job drive many medics to alleviate their work-related stress and
anxiety by self-medicating and struggling on.

One study in America has found that some 20 per cent of medical residents in hospitals suffered
clinical depression.

Kirstin Murray and a 7.30 Report crew were granted access to an emergency department for 24 hours
to film just one doctor at work to illustrate the intensity of events in a typical emergency ward
where any case can happen and all too frequently does. And I should warn, some viewers may find
some of the images in this story distressing.

KIRSTIN MURRAY, REPORTER: On duty in this regional Victorian public hospital is emergency physician
Peter Wirth. Tonight he's overseeing the care of 26 patients.

PETER WIRTH, EMERGENCY PHYSICIAN: The average shift is 10 hours and what can happen in a 10-hour
shift can be horrendously busy. ... There's no tap - on and off taps. We have very little warning
and no control over what's coming through the doors.

KIRSTIN MURRAY: In this ward, every bed is full. Cases are backing up in corridors. But tonight is
no different from any other.

PETER WIRTH: This isn't chaotic; this is actually quite calm for us. We never use the word quiet.
Never. It's a jinx.

KIRSTIN MURRAY: For those doing the rounds, it's a demanding, stressful job and sometimes the
pressure can take its toll.

Now the health of health workers is under focus after a beyondblue study found suicide rates among
medical practitioners could be twice that of the general population.

PETER WIRTH: In my first 11 years, I had 11 colleagues kill themselves. Now if you're already
fragile, if your bucket's already full, then it doesn't take much - things that you would normally
cope with in a normal day-to-day situation can become, um, even more overwhelming.

We have access to some extremely powerful drugs. They are absolutely, to the public's
understanding, they're like carrying a loaded gun.

KIRSTIN MURRAY: Over a 25-year career, Dr Wirth's witnessed the downfall of many co-workers, but
four years ago, he himself came close to the edge.

PETER WIRTH: I was losing my focus on my job, I was becoming very distracted, I was doubting
myself. And I remember at one point really believing in all of my soul that I was absolutely
worthless and hopeless and there was nothing to live for.

MUKESH HAIKERWAL, beyondblue SPOKESMAN: We're humans and, you know, we aren't immune from any of
the ups and downs of life that everybody in the rest of the population has.

KIRSTIN MURRAY: Former AMA president Mukesh Haikerwal says it's no surprise medical practitioners
can find it hard to cope.

MUKESH HAIKERWAL: We're trained that you make a difference and cure people, and in fact when you
work in the community in general practice, you make little difference, and actually, there's a
large number of people that obviously succumb to their illnesses or their old age or whatever goes
on in their lives, and it's hard to deal with.

KIRSTIN MURRAY: The danger is, those medics who do struggle rarely seek professional help for

PETER WIRTH: We're supermen in our own mind. We've been trained to believe that we are, and I think
there's a fear that the public are going to judge us if we show fallibility.

KIRSTIN MURRAY: For some, there's the urge to self-diagnose and self-medicate; others simply battle

But both coping mechanisms can have dire consequences.

CRAIG HASSAD, DEPT. OF GENERAL PRACTICE, MONASH UNI: There was a study in the US, and they found
that 20 per cent of doctors working in the hospital would've had clinical depression at any given
time. They made six times as many - over six times as many medical areas prescribing errors,
medication errors as non-depressed doctors doing the same jobs.

KIRSTIN MURRAY: GP-turned-university lecturer Dr Craig Hassad says it's high time doctors'
attitudes change. And he's trying to teach the next generation how to better care for their own
mental health.

CRAIG HASSAD: I think we really need to get beyond the notion that this is just a little bit of
warm fuzzy stuff you tack on at the end of your medical curriculum just to make yourself feel like
you're humanising it in some way. And this is actually right upfront and centre of core clinical

KIRSTIN MURRAY: But changing how mental illness is dealt with in the workplace may take some time.

PETER WIRTH: We can pull back a curtain in a cubicle of an emergency department, but it seems as
doctors and nurses and others that we have a reluctance to treat a colleague the way we would treat
a complete stranger.

KIRSTIN MURRAY: And doctors warn mandatory reporting laws are making the situation even worse.

MUKESH HAIKERWAL: There is a concern which if someone is looking after another doctor for whatever
problem they have medically, that not only do they have to mandatorily report it, they could be
rubbed off the register.

KIRSTIN MURRAY: Now seven hours into his shift, Peter Wirth has to tell this very ill man there are
no treatment options left.

PETER WIRTH: You understand that if you get much, much worse, and the only thing we could do would
be to put you on life support, what's your feeling about that?

KIRSTIN MURRAY: All doctors could do was take away his pain. Within 24 hours, the 83-year-old died.

Years ago, Dr Wirth would've struggled with the heavy weight of an emotional day like this. But
after seeking treatment for his depression, he finds he's not only better able to cope, but is a
better doctor for his experience.

PETER WIRTH: Now that I'm a bit more empathetic to it, I can recognise not only in patients that
might come in, but you can recognise that in colleagues too.

It is a very tough job, no question, but it is enormously fulfilling and rewarding. All I would
suggest is the system needs to be able to help people when they hit the little speed humps along
the way.

KERRY O'BRIEN: Incidentally, if anyone in the wider community feels they need help or further
information, they can call lifeline on 131 114 or contact beyondblue. Kirsten Murray with that